Evaluation and Comparison of Occurrence of Tooth Discoloration after the Application of Various Calcium Silicate–based Cements: An Ex Vivo Study

• Tooth discoloration after the application of ProRoot MTA, Biodentine, OrthoMTA, and EndoSequence Root Repair Material in the presence and absence of blood was compared.
• Blood contamination significantly increased discoloration associated with all materials.
• No significant difference was noted among the 4 groups in the presence of blood.
• Color change in the experimental groups increased over time.
• After 6 months, a significantly greater color change occurred in blood-contaminated OrthoMTA, whereas a significantly lesser color change was noted in Biodentine followed by ERRM in the absence of blood.

IntroductionBiodentine (Septodont, Saint Maur des Fossés, France), OrthoMTA (BioMTA, Seoul, Korea), and EndoSequence Root Repair Material (ERRM; Brasseler, Savannah, GA) have been developed to overcome the shortcomings of mineral trioxide aggregate (MTA). The purpose of this study was to compare tooth discoloration after the application of ProRoot MTA (Dentsply Tulsa Dental Products, Tulsa, OK) and 3 recently introduced calcium silicate–based cements in the presence and absence of blood.MethodsIn total, 104 human anterior teeth were prepared; 96 were randomly divided into 2 groups (blood and saline contamination). Each group was subdivided into 4 experimental subgroups (n = 12) of ProRoot MTA, Biodentine, OrthoMTA, and ERRM that were used to fill the pulp chambers. The remaining 8 teeth served as the saline and blood groups. Color analysis of tooth crowns was performed using a spectroradiometer before the application of materials and at 24 hours, 1 month, and 6 months after application. Repeated measures analysis of variance was used to evaluate the effects of blood, material, and time on color change (ΔE*).ResultsTooth color change in all experimental groups increased over time (P < .05). Blood contamination significantly increased ΔE* (P < .05), but no significant difference occurred between the 4 groups in this respect in the presence of blood. However, in the absence of blood, the ΔE* of Biodentine and ERRM was significantly less than that of OrthoMTA (P < .05).ConclusionsThere was no significant difference between tooth discolorations with materials in the presence of blood. However, in the absence of blood, Biodentine and ERRM exhibited less tooth discoloration than OrthoMTA.