Effect of Bleaching on Color Change and Refractive Index of Dental Composite Resins

Effect of aging and bleaching on the color stability and surface roughness of a recently introduced single-shade composite resin

OBJECTIVES

To assess the effects of aging and bleaching procedures on the color stability and surface roughness of a new single-shade composite versus multi-shade composite resins.

METHODS

A single-shade composite resin (Charisma Diamond One, CDO) and 3 multi-shade composite resins (Tetric NCeram, Filtek Z350 XT, Clearfil Majesty Posterior) were tested. Thirty specimens of each material were subjected to one of the aging procedures respectively: immersion in distilled water (12 days/37 °C), immersion in coffee (12 days/37 °C), or water thermocycling (10,000 cycles/5-55 °C). All specimens underwent in-office bleaching after aging. Kruskal-Wallis tests and analysis of variance were used for statistical analysis (α=0.05).

RESULTS

All materials exhibited a change of color (ΔE00), translucency (RTP), whiteness (WID) and surface roughness parameters (Sa,Sv) after aging and bleaching procedures. CDO showed the highest ΔE00 among all resins with the highest RTP value, regardless of the aging procedures. Immersion in coffee led to the significantly highest ∆E00 values and lowest RTP values for nearly all resins. Positive ΔWID1 (WID(bleaching)-WID(baseline)) values were found in distilled water immersion and thermocycling groups, while negative ΔWID1 values were found in the coffee immersion group for all materials. Besides, positive ΔWID2 (WID(bleaching)-WID(aging)) values were found in all aging groups for nearly all materials. All materials showed an increasing trend in Sa and Sv after bleaching.

CONCLUSIONS

CDO showed more pronounced discoloration than multi-shade composite resins. Although the whiteness of all resins increased after bleaching, none was completely restored in the coffee immersion group. Bleaching significantly increased the surface roughness of all materials.

CLINICAL SIGNIFICANCE

Charisma Diamond One is more susceptible to discoloration, which may affect its long-term success rate. Bleaching could partially reduce the color change of the composite resins but did not return them completely to their original state. The roughness of the resins increased after bleaching, prompting dentists to repolish them after bleaching.

Effects of Dental Bleaching Agents on the Surface Roughness of Dental Restoration Materials

Background and Objectives: This study aimed to evaluate the surface roughness evolution of several finished and polished composites when bleaching materials are applied. The research was conducted on four microhybrid or nanofilled composites that are used in dental restorations. Materials and Methods: For each composite type, 5 samples were selected for control, 5 samples were subjected to the bleaching protocol "office bleach" with 40% hydrogen peroxide, and 5 other samples were subjected to the "home bleach" protocol with 16% carbamide peroxide, resulting in a total number of 60 samples. The surfaces of all the samples were tested for roughness, and the values of the most relevant parameter (Ra), were collected. Comparisons between composites and samples were performed using one-way ANOVA (in Statistical Package for Social Sciences). Results: After the bleaching protocol with 40% hydrogen peroxide gel, it was found that the roughness of the group increased considerably compared to the control group, so the highest roughness was found at GC Gradia direct anterior group, and the lowest value was registered for the 3M ESPE Valux Plus group. Following the bleaching protocol with 16% carbamide peroxide (home bleach), it was noted that the sample surfaces were not as affected. In this case, the lowest roughness was found at 3M ESPE Valux Plus group, and the highest roughness was registered for the GC G-aenial anterior group. Following the interpretation of the results, all four types of dental composites tested showed significant surface roughness differences between the groups subjected to bleaching protocols and those kept as control (p < 0.05). Conclusions: The surfaces of the samples were affected by the bleaching protocols by increasing the roughness compared to the control samples.

Effect of in-office bleaching agent on the surface roughness and microhardness of nanofilled and nanohybrid composite resins

Background: To compare the surface roughness and microhardness of Ceram.x® SphereTEC™ one and Filtek Z350 XT after in-office bleaching with Pola office. Methods: Twenty samples each of (10 mm diameter and 2 mm height) Ceram.x® SphereTEC™ one and Filtek Z350 XT were prepared. The samples were subjected to three bleaching sessions with 35% hydrogen peroxide (Pola office) with a seven-day interval between each session. Surface roughness and microhardness of the prepared samples prior to and after the bleaching regimen were measured using a profilometer and Vickers hardness tester, respectively. Results: A significant reduction (p <0.001) in the surface hardness of Filtek Z350 XT from 27.67 ± 2.10 to 17.83 ± 1.36 Vickers hardness number (VHN) was observed after the bleaching whereas no significant reduction in surface hardness was observed with Ceram.x® SphereTEC™ one. The adjusted mean (estimated marginal mean) microhardness after bleaching for Ceram.x ® SphereTEC™ one (35.79 ± 1.45) was significantly higher than Filtek Z350 XT (19.54 ± 1.45) (p < 0.001). However, in-office bleaching of these materials did not significantly alter their surface roughness. Conclusions: In office-bleaching with 35% hydrogen peroxide can reduce the microhardness of nanofilled composite. However, the surface roughness was not influenced by the bleaching procedure in both nanohybrid and nanofilled composite resin materials.

Effects of polishing procedures on optical parameters and surface roughness of composite resins with different viscosities

The aims of this study were to evaluate the optical properties of flowable and injectable composites after polishing, such as translucency (translucency parameter [TP], TP₀₀), opalescence (OP-BW), chroma (C*ab), refractive index (RI), and change in surface roughness (Ra, Rz). Ninety disc-shaped samples were prepared from micro-hybrid, flowable, and injectable composites and divided into 3 groups according to the polishing systems (n=10). The RI was measured with an Abbe refractometer, and optical measurements were performed with a spectrophotometer. The surface roughness was measured with a two-dimensional profilometer. Data were analyzed with the generalized linear model method and two-way analysis of variance. The results showed that the polishing procedure did not significantly impact the RI (p=0.987). Injectable composite had the highest translucency (TP=28.67; TP₀₀=13.49) and opalescence (OP-BW=13.11); showed the lowest C*ab value (17.95). Also, the effects of the composite type and polishing procedure on surface roughness were statistically significant (p=0.047 and p<0.001).

Effect of Water Storage and Bleaching on Light Transmission Properties and Translucency of Nanofilled Flowable Composite

This study investigated the effect of water sorption and bleaching on light transmission properties (Straight-light transmission (G0), Light diffusion (DF) and Amount of transmitted light (AV)) and translucency parameters (TP) of nano-filled flowable composites. A total of 35 composite disks (0.5 mm thickness) were prepared using A2 shade of 5 nanofiller composites (n = 7/each); Beautifil Flow Plus X F03 (SHOFU INC), Clearfil Majesty ES Flow (Kuraray Noritake Dental), Estelite Universal Flow (EUF, Tokuyama Dental), Estelite Flow Quick (Tokuyama Dental) and Filtek Supreme Ultra Flowable Restorative (FSU, 3M ESPE). Then, they were cured by LEDs (VALO, Ultradent) on standard mood (1000 mW/cm2) for 20 s. Samples were tested for straight-line transmission (G0), diffusion (DF), the amount of transmitted light (AV) and (TP) immediately after 24 h (dry storage), after 1-week water storage and after each of the three cycles of in-office bleaching (HiLite, SHOFU INC). Result: G0, DF, AV and TP were significantly affected by different materials (p < 0.001). The AV of FSU increased significantly after the 1-week water storage, then after the second bleaching cycle (p < 0.001). The TP for EUF slightly decreased (p = 0.019) after 1-week water storage, then increased throughout bleaching. Conclusion: Ageing/bleaching conditions do not affect G0, DF, AV and TP. The compositional variation between nano-filler composites resulted in a significant difference between materials.

Time-dependent effect of intense capsule-coffee and bleaching on the color of resin-infiltrated enamel white spot lesions: an in vitro study

Background and Objectives

White spot lesions (WSLs) are a common problem that can be conservatively managed by resin infiltration. Consumption of dark beverages such as coffee causes staining of dental hard tissues, which can deteriorate the esthetic qualities of treated WSLs. The aims of this study were to investigate the effect of dark coffee heavy consumption on ICON^® resin infiltrated WSLs and the influence of bleaching on them after staining.

Methods

Twenty surfaces from sound human extracted third molars were used in the study. Two square-shaped buccal and lingual window areas had artificially created WSLs (received buccal resin infiltration afterward). Using VITA Easyshade, the baseline ΔE was recorded. Espresso coffee was used to immerse all surfaces for 8 days. The color coordinates according to CIE LAB were recorded for all surfaces at 2, 4, 6, and 8 days of immersion, and ΔE was calculated at each timepoint. After 8 days, in-office bleaching was applied to all surfaces according to the manufacturer's instructions and the color. Coordinates and ΔE were recorded. For statistical analysis, an independent sample t-test was used to compare each group. A general linear mixed model (GLMM) repeated measure ANOVA was applied for statistical analysis of L^*and changes due to staining over time.

Results

Analysis of time as a main effect on the L values of surfaces was statistically highly significant (p < 0.01). The interaction of time with surfaces under investigation and type of surface (test vs. control) as a main effect were non-significant (p = 0.47 and p = 0.35, respectively). Bleaching showed a significant difference in color lightness in both test and control surfaces compared to the mean L value at 8 days of staining (p < 0.01).

Conclusion

Capsule-coffee consumption gradually influences the esthetic of resin infiltration on treated teeth. However, bleaching materials might restore an esthetic shade.

Color Change of Resin-based Composites After In Vitro Bleaching Protocols: A Systematic Review and Meta-analysis

OBJECTIVES

To systematically review the literature on color stability of resin-based composites (RBC) after in vitro bleaching protocols and to assess the influence of bleaching protocols by meta-regression analysis on RBC color stability, and the association with clinical and experimental characteristics.

METHODS

The electronic search was conducted in MEDLINE/PubMed, Scopus, and Web of Science databases and included English language studies that evaluated and reported color differences (CIELAB values) of RBC after in vitro bleaching procedures using hydrogen peroxide and/or carbamide peroxide.

RESULTS

Database search for color change of RBC after bleaching retrieved 1335 eligible papers after removing duplicates. After initial screening, 66 articles were assessed for full-text reading with final inclusion of 23 published papers. A meta-regression analysis showed that storage time (p≤0.01), color measuring device (p≤0.01), and background color (p≤0.01) had influenced on color changes of RBC. The bleaching protocol (bleaching agent and time of application) did not influence on color changes of RBC (p>0.01).

CONCLUSIONS

There is evidence that RBC change color after bleaching, but the change is not clinically significant.

Efficiency of activated charcoal powder in stain removal and effect on surface roughness compared to whitening toothpaste in resin composite: In vitro study

Objectives

To evaluate the efficacy of activated charcoal powder on extrinsic stain removal and its effect on surface roughness in stained resin composite in comparison with whitening toothpaste.

Materials and methods

Sixty-six disk-shaped composite specimens were fabricated using a custom-made ring mold. The specimens were stained using a coffee solution and stored in distilled water at 37 °C. The specimens were divided randomly into two groups, Group 1: Thirty-Three disks were subjected to brushing using whitening toothpaste (Control), and Group 2: Thirty-Three disks were subjected to brushing using charcoal powder. Specimens were evaluated for surface color and surface roughness at baseline after staining protocol and after the brushing process.

Results

Changes in color and surface roughness were highly significant (p < 0.0001) after brushing with activated charcoal powder and whitening toothpaste. However, no significant differences were found in color (p = 0.90) and surface roughness (p = 0.33) between the two bleaching techniques.

Conclusion

The changes in the color and surface roughness of resin composite was significant after brushing with activated charcoal powder and whitening toothpaste. However, there were no significant differences between the two techniques.

Effects of tooth bleaching protocols assisted by Er,Cr:YSGG and diode (980 nm) lasers on color change of resin-based restoratives

OBJECTIVE

To evaluate color change of three resin-based restorative materials after two laser-assisted in-office tooth bleaching protocols using Er,Cr:YSGG and diode (980 nm) lasers.

MATERIALS AND METHODS

A nanohybrid composite resin (EP), a Bis-GMA free composite resin (EPBio) and a resin-matrix CAD-CAM ceramic (HC) were tested. Ninety specimens were prepared and stored in artificial saliva. Group 1 received an in-office bleaching treatment using 40% H₂ O_2. The same bleaching procedure was assisted by Er,Cr:YSGG laser in Group 2 and by a diode laser (980 nm) in Group 3. Color measurements were performed using a double-beam UV-Vis spectrophotometer at four time intervals (before, 24 h, 15 and 30 days), converted to L*, a*, and b* units of the CIELAB color space and assessed on the basis of 50:50% acceptability (ΔΕ_ab * = 2.7 and ΔΕ₀₀  = 1.77) and 50:50% perceptibility (ΔΕ_ab * = 1.2 and ΔΕ₀₀  = 0.81) thresholds. Three-way ANOVA with repeated measurements was used for statistical analysis of the data.

RESULTS

Color and whiteness changes did not exceed the established 50:50% acceptability thresholds. EP presented the highest color change after the bleaching followed by EPBio and HC (p ≤ 0.05). Three-way ANOVA revealed that type of material and time interval significantly affected color change (p ≤ 0.001).

CONCLUSIONS

The tested bleaching treatments assisted by Er,Cr:YSGG and diode (980 nm) lasers did not induce unacceptable color and whiteness changes in the resin-based restorative materials.

CLINICAL SIGNIFICANCE

The tested Er,Cr:YSGG and diode (980 nm) laser-assisted tooth bleaching protocols which may be recommended to accelerate the clinical procedures cannot affect the color of the existing resin-based restorations in case they are accidentally exposed on the bleaching gel and laser irradiation.

Efficacy and tooth sensitivity of at-home bleaching in patients with esthetic restorations: a randomized clinical trial

OBJECTIVES

This study aims to evaluate the color change and tooth sensitivity (TS) caused by at-home bleaching in patients with sound and with restored teeth.

METHODS

Forty patients were selected according to the inclusion and exclusion criteria and divided into two groups: So (patients with six caries-free maxillary anterior teeth) and Re (patients with at least one restoration in the six maxillary anterior teeth). Both groups were bleached with 10% carbamide peroxide (CP) at-home bleaching. The color change (CIELab [ΔE*_ab], CIEDE00 [ΔE₀₀], and whiteness index [∆WI_D]) were assessed using a spectrophotometer at baseline, 2 weeks, and 1 and 3 months after bleaching. Patients recorded their TS using a numeric rating scale (0-4). Data of color change were submitted to Student's T-test. The absolute risk and intensity of TS were compared using Fisher's and the Mann-Whitney tests, respectively (α = 0.05).

RESULTS

Higher ΔE*_ab, ΔE₀₀, and ∆WI_D values were observed for So in relation to Re after all recall rate (p < 0.0001). No significant differences were observed regarding of bleaching-induced TS (p > 0.9).

CONCLUSIONS

At-home dental bleaching with 10% CP generated the same pattern of TS in patients with or without restorations. However, in patients with restored teeth, it produced a lower color change after 2 weeks of bleaching.

CLINICAL SIGNIFICANCE

After 2 weeks of at-home bleaching, a lower whitening effect was observed in patients with anterior restorations when compared with patients with sound teeth.

TRIAL REGISTRATION

ClinicalTrials.gov identifier RBR-52j6gmg.

Effect of polishing technique and immersion in beverages on color stability of nanoceramic composites

Background

Polishing of dental composite restorations to achieve a highly smooth and reflective surface not only enhances esthetics but also their color stability and improves resistance to staining. The objective of this study was to evaluate the effect of beverages on the color stability of nanoceramic composites polished using different techniques.

Methods

80 samples of ceram. X SphereTEC one were prepared by condensing the material into a stainless-steel split mold and divided randomly into two groups. Group I was subjected to polishing using Sof-Lex system™ disks, and Group II was kept unpolished. Each group was subdivided into four sub-groups of 10 samples each. Each subgroup samples were immersed into designated beverages (Tropicana orange juice, Coco-cola, Nescafe coffee, and distilled water) for a duration of 15mins/day for 15 days. The color of all specimens before immersion, one day, and 15 days after immersion was measured using a Spectrophotometer.

Results

Significant staining of the material was found with cola drinks and coffee compared to orange juice and distilled water. Polished material showed better resistance to staining by various beverages compared to control group.

Conclusion

Nanoceramic composites exhibited superior color stability after polishing with Sof-Lex system™. Among the beverages, coco-cola significantly altered the color of the composite.

Influence of Bleaching and Aging Procedures on Color and Whiteness of Dental Composites

Bleaching can cause perceptible color changes on resin-based composite (RBC) restorations that may not be stable with aging. The objective of this study was to evaluate color stability and whiteness variations of RBCs after bleaching and aging procedures. Discs (10 mm in diameter and 1 mm thick) of shades A2 and A3 were fabricated from two RBCs (Filtek Z250 and Filtek Z350 XT) and divided into three subgroups (for each composite and shade) (n=5) as follows: control (no bleaching), at-home bleaching, and in-office bleaching. All specimens underwent an accelerated artificial aging up to 450 KJ/m2 and 900 KJ/m2 in an aging chamber (Suntest XXL+). A spectroradiometer (SpectraScan PR-670) was used to obtain CIE L*a*b* coordinates. CIEDE2000 color difference (ΔE00) and whiteness index for dentistry (WID) were used to evaluate color stability. Color and whiteness differences data were analyzed considering the 50:50% visual color difference thresholds (perceptibility [PT] and acceptability [AT]) and 50:50% whiteness thresholds (whiteness perceptibility [WPT] and whiteness acceptability [WAT]). Analysis of variance and Tukey tests (α=0.05) were used to statistically analyze the data. After bleaching, all specimens showed ΔE00 and ΔWID values below their corresponding acceptability thresholds (AT and WAT, respectively). After aging, L* and WID values decreased while b* values increased (p≤0.05), resulting in ΔE00 and ΔWID values above AT and WAT, respectively. Color changes after bleaching RBCs were clinically acceptable, while aging provoked clinically perceptible color changes.

Hydrogen peroxide bleaching induces changes in the physical properties of dental restorative materials: Effects of study protocols

OBJECTIVE

The purpose of this study was to evaluate the influence of study protocols on the effects of bleaching on the surface roughness, substance loss, flexural strength (FS), flexural modulus (FM), Weibull parameters, and color of 7 restorative materials.

MATERIALS AND METHODS

The test materials included 4 composite resins, 1 glass-ionomer cement, 1 dental ceramic, and 1 polyacid-modified composite. The specimens were randomly divided into 4 groups (n = 20) according to different study protocols: a bleaching group at 25°C (group 25B), a bleaching group at 37°C (group 37B), a control group at 25°C (group 25C), and a control group at 37°C (group 37C). The specimens in the bleaching group were treated with 40% hydrogen peroxide for 80 min at the respective environmental temperatures. The surface roughness, substance loss, FS, FM, and color of the specimens were measured before and after treatment. FS data were also subjected to Weibull analysis, which was used to estimate of the Weibull modulus (m) and the characteristic strength (σ₀ ).

RESULTS

Surface roughness increased and significant color changes were observed for all tested specimens after bleaching treatment, except for the ceramic. After bleaching at 37°C, the polyacid-modified composite showed significantly reduced FS, FM, m, and σ₀ values in comparison to the control specimens stored at 37°C in whole saliva. Significant differences were also found between the 37B and 25B polyacid-modified composite groups in terms of surface roughness, FS, m, σ₀ , and color changes.

CONCLUSIONS

Varying effects of bleaching on the physical properties of dental restorative materials were observed, and the influences of the study protocols on bleaching effects were found to be material-dependent.

CLINICAL SIGNIFICANCE

The influence of study protocols on the effects of bleaching on the surface roughness, flexural properties, and color of dental restorative materials are material-dependent and should be considered when evaluating the effects of bleaching on dental restorative materials.

Monomer conversion, dimensional stability, strength, modulus, surface apatite precipitation and wear of novel, reactive calcium phosphate and polylysine-containing dental composites

Purpose

The aim was to assess monomer conversion, dimensional stability, flexural strength / modulus, surface apatite precipitation and wear of mono / tri calcium phosphate (CaP) and polylysine (PLS)—containing dental composites. These were formulated using a new, high molecular weight, fluid monomer phase that requires no polymerisation activator.

Materials and methods

Urethane and Polypropylene Glycol Dimethacrylates were combined with low levels of an adhesion promoting monomer and a light activated initiator. This liquid was mixed with a hybrid glass containing either 10 wt% CaP and 1 wt% PLS (F1) or 20 wt% CaP and 2 wt% PLS (F2). Powder to liquid mass ratio was 5:1. Commercial controls included Gradia Direct Posterior (GD) and Filtek Z250 (FZ). Monomer conversion and polymerisation shrinkage were calculated using Fourier Transform Infrared (FTIR). Subsequent volume increases in water over 7 weeks were determined using gravimetric studies. Biaxial flexural strength (BFS) / modulus (BFM) reduction and surface apatite precipitation upon 1 and 4 weeks immersion in water versus simulated body fluid (SBF) were assessed using a mechanical testing frame and scanning electron microscope (SEM). Mass / volume loss and surface roughness (R_a) following 7 weeks water immersion and subsequent accelerated tooth-brush abrasion were examined using gravimetric studies and profilometer.

Results

F1 and F2 exhibited much higher monomer conversion (72%) than FZ (54%) and low calculated polymerization shrinkage (2.2 vol%). Final hygroscopic expansions decreased in the order; F2 (3.5 vol%) > F1 (1.8 vol%) ~ Z250 (1.6 vol%) > Gradia (1.0 vol%). BFS and BFM were unaffected by storage medium type. Average BFS / BFM upon 4 weeks immersion reduced from 144 MPa / 8 GPa to 107 MPa / 5 GPa for F1 and 105 MPa / 6 GPa to 82 MPa / 4 GPa for F2. Much of this change was observed in the first week of immersion when water sorption rate was high. Surface apatite layers were incomplete at 1 week, but around 2 and 15 micron thick for F1 and F2 respectively following 4 weeks in SBF. Mass and volume loss following wear were equal. Average results for F1 (0.5%), F2 (0.7%), and FZ (0.5%) were comparable but lower than that of GD (1%). R_a, however, decreased in the order; F1 (15 μm) > F2 (11 μm) > GD (9 μm) > FZ (5 μm).

Conclusions

High monomer conversion in combination with large monomer size and lack of amine activator should improve cytocompatibility of the new composites. High monomer molecular weight and powder content enables low polymerisation shrinkage despite high conversion. Increasing active filler provides enhanced swelling to balance shrinkage, which, in combination with greater surface apatite precipitation, may help seal gaps and reduce bacterial microleakage. High monomer conversion also ensures competitive mechanical / wear characteristics despite enhanced water sorption. Furthermore, increased active filler could help reduce surface roughness upon wear.

In Vitro Effect of Bleaching With 810 nm and 980 nm Diode Laser on Microhardness of Self-cure and Light-Cure Glass Ionomer Cements

Introduction: This study sought to assess the effect of bleaching combined with irradiation of 810 nm and 980 nm diode laser on microhardness of 2 commonly used self-cure and light-cure glass ionomer cements (GICs) in comparison with conventional bleaching (without laser). Methods: In this in vitro, experimental study, 60 samples were fabricated of A2 shade of Fuji IX and Fuji II LC GICs (n=30) and each group was divided into 3 subgroups (n=10). The first subgroups were subjected to bleaching with Opalescence Xtra Boost plus 980 nm diode laser irradiation. The second subgroups were subjected to bleaching with Opalescence Boost plus 810 nm diode laser irradiation and the third subgroups were subjected to bleaching with Opalescence Xtra Boost without laser. Microhardness was measured at baseline and after the intervention using Vickers hardness tester. The data were analyzed using two-way analysis of variance (ANOVA) (P<0.05). Results: Microhardness decreased in all subgroups after the intervention (P<0.001) irrespective of the type of GIC (P=0.201) or surface treatment (P=0.570). The baseline microhardness of the three subgroups within each group of GIC was not significantly different (P=0.456), but the baseline microhardness of conventional GIC was significantly higher than that of resin modified GIC (P=0.004). Conclusion: Bleaching with/without laser irradiation decreases the microhardness of GICs. The baseline microhardness of conventional GIC is higher than that of resin modified GIC.

Discoloration Effects of Traditional Turkish Beverages on different Composite Restoratives

AIM

The aim of this study was to evaluate the discoloring effects of five beverages including, especially, traditional Turkish ones on five commonly used dental composites by using a spectrophotometer device.

MATERIALS AND METHODS

Five methacrylate-based composites (shade A2) were selected to evaluate their color stability (175 disk samples). Four of them (Filtek Ultimate Universal, Clearfil Majesty ES-2, Tetric EvoCeram, and Cavex Quadrant Universal LC) were nanofilled universal composites for both anterior and posterior restorations, and one (Clearfil Majesty Posterior) was nano-superfilled for posterior restorations. The tested beverages were tamarind syrup, ottoman syrup, turnip juice, pomegranate juice, and distilled water (control). All samples were kept in an incubator at 37°C for 12 days (measured at 3rd, 6th, 12th day intervals) in immersion solutions which was equivalent to 1 year in vivo. Color measurements were made with VITA Easyshade Advance (Vident, Brea, CA) spectrophotometer device according to CIE L*a*b* system. Statistical analysis was performed with analysis of variance and least significant difference test to analyze differences in L*a*b* and ΔE values.

RESULTS

All materials showed significant discoloration (p < 0.05) when compared with the control group. The highest ΔE was observed in turnip juice, whereas ottoman syrup had the lowest ΔE. Tetric EvoCeram showed the lowest ΔE, while Clearfil Majesty ES-2 showed the highest ΔE.

CONCLUSION

In all the groups tested, clinically unacceptable ΔE values were obtained. Although color stability of methacrylate-based composites has been widely investigated, this has not been done before with these kinds of immersion solutions.

CLINICAL SIGNIFICANCE

Potential discoloration might be limited by dietary adjustments based on in vitro evaluations.

Effects of bleaching agent on physical and aesthetic properties of restorative materials

To investigate the effects of bleaching agent on microhardness, color and light transmission of different restorative materials. Specimens (n=20) of Tetric EvoCeram (TEC), Tetric EvoCeram Bulk Fill (TECBF) and Equia Fill (EQUIA) were treated with either 40% hydrogen peroxide Opalesence Boost or destilled water for 45 min. Specimens were stained in tea solution or stored in deionized water for one and two weeks. Color, microhardness and light transmission were monitored at the baseline, after the bleaching and after the tea immersion or storage in deionized water. After the bleaching a significant reduction in surface microhardness (p<0.001) was recorded for all materials. Clinically visible color change (ΔE>3) was observed after the bleaching and after treatment in tea solution, but only in EQUIA samples. The absorption coefficient was the largest for the samples stained in tea solution. Bleaching can affect the microhardness and color of fillings; therefore, they should be sometimes replaced.

Refractive indices of unfilled resin mixtures and cured composites related to color and translucency of conventional and low-shrinkage composites

This study correlated the refractive indices (RIs) of unfilled resin mixtures and resin-based composites (RBCs) with color and translucency of conventional and low-shrinkage RBCs. Unfilled resin mixtures based on different ratios of conventional monomers Bisphenol A-glycidyl-methacrylate (BisGMA)/triethyleneglycol-dimethacrylate (TEGDMA) and urethane-dimethacrylate (UDMA)/TEGDMA and a low-shrinkage monomer FIT-852 (FIT, Esstech Inc.)/TEGDMA were used to prepare model RBCs, containing 30 wt % of the organic matrix and 70 wt % of silanated barium-glass fillers (n = 1.553, Esstech Inc.). The RIs of resins were measured on an ABBE refractometer, those of cured RBCs using the Becke-line method in immersion oils. Color and translucency were determined using an AvaSpec-2048 (Avantes BV) spectrometer. The RIs of unfilled resin mixtures decreased with increasing amounts of TEGDMA. Cured RBCs had higher RIs than their respective resin mixtures. BisGMA-based composites were more translucent with significantly lower L* values than FIT- and UDMA-based RBCs. The RIs of unfilled resins positively correlated with cured RBCs (p = 0.001), as did the RIs with translucency (p = 0.001) and color (p = 0.008). Resin mixtures and corresponding RBCs based on UDMA and its modified low-shrinkage version, FIT, showed similar optical properties. The RIs of unfilled resins appeared to be good predictors of the RIs of cured RBCs. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 7-13, 2017.

Effect of in-office bleaching agents on the color changes of stained ceromers and direct composite resins

PURPOSE

To evaluate the effect of two in-office bleaching agents on the color changes of two ceromers (Ceramage and Adoro SR) and one direct composite resin (Gradia Direct Anterior) after staining by tea and coffee.

MATERIALS AND METHODS

Twenty-four disk-shaped specimens were fabricated for each resin material and randomly divided into three groups (n = 8). The specimens were immersed in tea, coffee or deionized water, respectively, for 7 days. Each group was then equally divided into two sub-groups (n = 4), which were subjected to two in-office bleaching agents (BEYOND and Opalescence Boost), respectively. The color of the specimens was measured by a spectrophotometer at baseline, after staining and after bleaching. The color differences (ΔE values) between baseline and after treatments were calculated.

RESULTS

Statistical analysis indicated that the staining solution had significant influence on the color change of resin composites tested (p < 0.001). The discolorations of resin composites were perceptible after immersing in tea or coffee solutions (ΔE>2.0). There was no statistically significant difference between BEYOND and Opalescence Boost in stains removal from discolored resins (p = 0.550). The color changes in ΔE value between baseline and after bleaching were less than 2.0 for all resin composite groups.

CONCLUSIONS

Tea solution produces severe discoloration of three resin composites tested. The two in-office bleaching agents can effectively remove the stains from two ceromers and one direct composite resin tested in this study.

Spectrophotometric evaluation of color changes of bleach-shade resin-based composites after staining and bleaching

Spectrophotometric evaluation of color changes of Bleach-shade resin-based composites after staining and bleaching.

AIM

The aim of this study was to evaluate the color stability of two commercially available bleach-shade resin composites (RC) after exposure to 3 storage solutions and the effect of 3 bleaching agents on the color stability and stain removal from stained RC.

MATERIALS AND METHODS

Two bleach-shade RC were evaluated in this study, including a nanoflled RC, Filtek(TM) Z350 XT (FZ), and a nanohybrid RC, Tetric(®) N-Ceram (TC), in the extra-white body (shade) (XWB) and L shades, respectively. Twenty-seven disk-shaped specimens, each measuring 12 mm in diameter and 2 mm in thickness, were prepared for each RC, with a total of 54 specimens. Specimens were randomly allocated into 3 groups of 9 specimens each and immersed in 3 storage solutions (distilled water, tea and coffee) for 7 days period. The 9 specimens in each staining group were further divided into 3 subgroups. Specimens in each subgroup (n = 3) were bleached using one of the bleaching agents (10 and 16% Zoom NiteWhite amorphous calcium phosphate (ACP), and Zoom 2 chairside with light activation) for 5 days period. The specimen colors were measured with spectrophotometer. The measurements were performed on each sample three times at baseline, after staining, and after bleaching. Color was expressed using the commission international de I'Eclairage (CIE) L*a*b* color space. The color differences (ΔE) between the three measurements were calculated and the results were statistically analyzed using Two-way and Three-way analysis of variance (ANOVA) and Tukey's posthoc tests. Level of significance was set at p < 0.05.

RESULTS

Tetric(®) N-ceram materials demonstrated significantly less color change than the FZ and the color change, which was greater after storage in coffee compared to tea, was statistically significant. The bleaching agents significantly influence the color changes of composite specimens. All groups showed (ΔE) values below 3.3 after bleaching, except for 'Zoom 2 chairside' with light activation groups, which is shown clinically unacceptable lighter shade (ΔE >3.3).

CONCLUSION

Bleach-shade composites showed significant discoloration (ΔE > 3.3) after being immersed into coffee and tea solutions. Nanoflled composites discolored more than nano-hybrid composites, and carbamide peroxide-based bleaching agents were effective in reducing the discoloration to a clinically acceptable value (ΔE > 3.3).

Tooth-bleaching procedures and their controversial effects: A literature review

AIM

This review article will help clinicians improve their understanding of the history of bleaching procedures, bleaching types, components, mechanisms, and their effects on soft tissue, tooth structures, resin composite, and bonding.

METHODS

The controversial issues about bleaching procedures and their effects are reviewed. Additionally, the consequences of pre- and post-bleaching on the bonding potential of composite resin restorations to tooth structure are discussed.

CONCLUSION

The overall goal of the paper is to help reduce risks for patients.

Effect of cigarette smoke on color stability and surface roughness of dental composites

OBJECTIVE

To evaluate the color stability and surface roughness of 3 dental composites subjected to cigarette smoke and brushing.

METHODS

Twenty specimens were prepared for each type of restorative material used: nanohybrid (Tetric N-Ceram); hybrid (Z250-3M ESPE) and silorane-based microhybrid (Filtek P90-3M ESPE), which were divided into 2 groups (n=10), according to the type of finishing/polishing received: Group 1 - papers with decreasing abrasive grit and Group 2 - polyester matrix (without polishing). After initial readouts of color (Easy Shade-VITA) and surface roughness (SJ-201P Mitutoyo), specimens were subjected to action of smoke from 20 cigarettes, (Marlboro Red-Philip Morris). After each cigarette, the samples were submitted to brushing in a standardised device. After this, final readouts were taken to calculate change in color (ΔE and ΔL) and roughness (ΔRa), which were statistically analysed (2-way ANOVA, Bonferroni, and Student's-t tests respectively, p<0.05).

RESULTS

Tetric N-Ceram presented color change at clinically unacceptable levels (ΔE>3.3) when the polyester strip was used for finishing, a result differing (p<0.05) from those of the other composites, which presented no difference between them (p>0.05). Unpolished composites presented higher Ra values than those that were polished (p<0.05), with exception of the silorane based composite.

CONCLUSION

Absence of polishing increases cigarette capacity to stain composites and surface roughness of composites, with exception of the silorane based type.

The effect of home-bleaching application on the color and translucency of five resin composites

OBJECTIVES

The aim of this study was to investigate the effect of home bleaching agents on the color and translucency of resin composites.

METHODS

Thirty disc shaped specimens (1mm thick) were fabricated from each resin composite (Reflexions, Grandio, Gradia Direct, Clearfil Majesty Esthetic, Ceram-X Mono) and divided into 3 subgroups as carbamide peroxide (CP, Opalescence 10% PF), hydrogen peroxide (HP, 10% Opalescence Treswhite Supreme) and control group (n=10). Baseline CIE L*a*b* color coordinates were measured with spectrophotometer and translucency parameters (TP) were calculated. CP and HP groups were treated with bleaching agents according to manufacturers' instructions and control group was stored in distilled water (DW) for 14 days. Color and translucency measurements were repeated and color differences were calculated, ΔE values>3.3 were considered as clinically unacceptable.

RESULTS

Clinically unacceptable color change was detected for all resin composites exposed to bleaching agents and there was significant color difference between the control group and bleached specimens (P<0.05). However no significant color difference was found between CP and HP groups. Intragroup comparison revealed that Ceram-X Mono showed the highest color change but there was no significant difference among the other tested materials for both CP and HP groups. Intergroup comparison of TP values of CP, HP and control groups at the end of 14th day revealed that there was no statistical significant translucency difference among the groups.

CONCLUSIONS

Application of CP and HP resulted in clinically unacceptable color change for all resin composites. Translucencies of the resin composites were not affected by bleaching procedure.

CLINICAL SIGNIFICANCE

The results of this in vitro study suggest that patients should be informed regarding a potential color change of existing resin composite restorations with the use of home bleaching agents.

Non-destructive characterization of voids in six flowable composites using swept-source optical coherence tomography

OBJECTIVE

The aim of this study was to evaluate the void frequency (V(F)) and void volume (V(V)) in different flowable composites using swept-source optical coherence tomography (SS-OCT).

METHODS

Standard class I cavities were prepared and filled with six different flowable composites: Clearfil Majesty LV (MJ; Kuraray), MI Flow (MW; GC), MI Fil (ML; GC), Beautifil flow plus (BF; Shofu), Palfique Estelite low flow (EL; Tokuyama) and Surefil SDR flow (SF; Dentsply). The restorations were scanned under OCT. The OCT tomograms were analyzed and average V(F) and V(V) per restoration for each composite were calculated. Scanning electron microscope (SEM) was used to observe the structure of each composite. In addition, the flowability of the materials was evaluated measuring the displacement of each material placed up-right on a glass slide. V(F) and V(V) obtained by OCT were also compared to those calculated using micro-computed tomography (micro-CT).

RESULTS

Kruskal-Wallis ANOVA and Mann-Whitney U tests revealed significantly different V(F) and V(V) values (p<0.05) among the composites. Voids ranging from 35 to 785 μm in diameter were detected in OCT tomograms. MJ showed highest V(F) and V(V) values followed by MW, but ML, BF, EL and SF showed no significant difference. Filler volume in composites showed a positive correlation with void formation, but flowability did not show a specific trend. Micro-CT evaluation validated the V(F) and V(V) calculation by OCT, with a significant correlation in void size (p<0.001, r=0.94).

CONCLUSION

The results of this study indicate the reliability of SS-OCT for real-time void characterization of composite materials and restorations. Void formation in flowable composites is material dependent.

Effect of bleaching on color change and surface topography of composite restorations

This study was conducted to determine the effect of 15% carbamide peroxide bleaching agent on color change and surface topography of different composite veneering materials (Filtek Z350 (3M ESPE), Esthet X (Dentsply India), and Admira (Voco, Germany). Methods. 30 samples were fabricated for evaluation of color change using CIELAB color system and Gonioreflectometer (GK 311/M, ZEISS). 45 disc-shaped specimens were made for evaluation of surface topography after bleaching (Nupro White Gold; Dentsply) using SEM. Statistical analysis. One way ANOVA and Multiple comparison tests were used to analyze the data. Statistical significance was declared if the P value was .05 or less. Results and conclusion. All the specimens showed significant discoloration (ΔE > 3.3) after their immersion in solutions representing food and beverages. The total color change after bleaching as compared to baseline color was significant in Filtek Z350 (P = .000) and Esthet X (P = .002), while it was insignificant for Admira (P = .18). Esthet X showed maximum surface roughness followed by Admira and Filtek Z350. Bleaching was effective in reducing the discoloration to a clinically acceptable value in all the three groups (ΔE < 3.3).

Effects of light curing modes and resin composites on temperature rise under human dentin: an in vitro study

The influence of three curing modes of a high-powered LED curing unit on temperature rise under 2-mm-thick dentin was investigated during the polymerization of resin composite samples of Admira, Filtek P60, Premise, Tetric Flow, Tetric Ceram, and Filtek Z250. Ninety standard specimens were prepared. The bonding agents and resin composites were cured with standard, pulse, or soft-start mode (n=5 for each curing mode). Temperature rise was measured using a type L thermocouple. Data were analyzed by two-way ANOVA and Tukey's test. Soft-start curing led to statistically higher temperature rises compared than the other two modes. The highest temperature rise was observed for Admira and Tetric Flow cured with soft-start mode. The lowest temperature rise was observed for Premise cured with pulse mode. However, temperature rise did not reach the critical value that can cause pulpal damage by virtue of a prominent safety feature of the high-powered LED LCU, which ensures that no excessive heat is produced by all the three curing modes.