Spectrophotometric Analysis of Coronal Tooth Discoloration Induced by Various Bioceramic Cements and Other Endodontic Materials

• Bioceramic cements Biodentine and Endosequence RRM putty and paste did not discolor teeth.
• White mineral trioxide aggregate (MTA), gray MTA, and triple antibiotic paste showed the worse chromogenic effect.
• The discolorations worsen over time.

IntroductionCoronal tooth discoloration induced by various endodontic materials was evaluated in vitro.MethodsEighty extracted human maxillary anterior teeth were accessed, instrumented, and sectioned to standardized root lengths of 10 mm below the cementoenamel junction. Pulp chambers were cleaned chemomechanically to ensure complete tissue removal. Specimens were filled with experimental materials in 8 random groups: RRM, EndoSequence RRM putty (Brasseler, Savannah, GA); RRMF, EndoSequence RRM fast set paste (Brasseler); BD, Biodentine (Septodont, Saint-Maur-des-Fossés, France); WMTA, white MTA (Dentsply, York, PA), GMTA, gray MTA (Dentsply); AH+, AH Plus sealer (Dentsply); TAP, triple antibiotic paste (metronidazole, ciprofloxacin, and minocycline); and NF, no filling (negative control group). After incubation in 100% humidity at 37°C, color changes were evaluated with a spectrophotometer (Ocean Optics, Dunedin, FL) on days 0, 7, 30, 60, and 180 after material placement (T0–T180). Data were transformed into Commission International de I'Eclairage's L*a*b color values, and corresponding ΔE values were calculated. Two-way analysis of variance and the Bonferroni method were performed.ResultsVisual discoloration was observed in all specimens in the GMTA, WMTA, and TAP groups at T7, increasing with time. The ΔE value between the initial color at T0 and at T7, T30, T60, and T180 was significantly different for GMTA, WMTA, and TAP (P < .001). ΔE values for the BD, RRM, RRMF, AH+, and NF groups were not statistically significantly different between T0 and T7, T30, T60, and T180, respectively, except for 3 samples below the human perceptible threshold. Values of L* dropped significantly from T0 to T180 in the TAP, GMTA, and WMTA groups.ConclusionsSignificant coronal tooth discoloration was caused by TAP, GMTA, and WMTA but not by BD, RRM, and RRMF.