Abstract

Objective To evaluate the effect of the association between external and internal tooth bleaching on color changes in dentin and enamel, individually or recombined, previously stained with triple antibiotic paste (TAP).Methodology Forty enamel-dentin specimens from bovine incisors were separated into ten blocks according to similarity in their whiteness index (WID). Three specimens within each block were stained by dentin exposure to TAP, and the remaining specimen was used as control to estimate color changes. Specimens were sectioned to separate tissues, and dentin and enamel colors were measured individually and after being recombined. Alterations in color (CIEDE2000 - ΔE00) and translucency parameter (TP) resulting from staining were estimated by color difference between stained and control specimens. The contribution of each tissue to the color change (CTCC) was also calculated. Non-sectioned stained specimens were bleached by applying sodium perborate on dentin, associated or not with 35% hydrogen peroxide on enamel. Color changes caused by bleaching procedures were estimated and data were analyzed using the paired t-test or Two-way repeated measures ANOVA.Results TAP caused more pronounced changes in dentin, but enamel color was also affected. Both protocols presented a similar ΔE00, and dentin showed the greater color change. After exposure to TAP, we observed a reduction in WID; WID values were the same for bleached and control specimens regardless of protocol. We found no significant effect of substrate and bleaching technique on TP. Enamel played a more critical role in color changes caused by either staining or bleaching procedures.Conclusion Enamel color played a greater role on tooth color changes than dentin. External and internal bleaching association did not improve bleaching effect on specimens stained with TAP.

Highlights

  • MethodologyTooth color results from the combination between dentin and enamel individual color and optics characteristics.[1]

  • Considering that, this study aimed to evaluate the effect of the association between external and internal tooth bleaching on color changes in dentin and enamel, individually or recombined, previously stained with triple antibiotic paste (TAP)

  • Twoway repeated measures ANOVA showed that both bleaching technique (p

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Summary

Introduction

Tooth color results from the combination between dentin and enamel individual color and optics characteristics.[1] Being more chromatic, dentin is the main dental tissue affecting overall tooth color;[2,3] enamel surface characteristics affect light transmission, modifying tooth color.[3] Enamel is a chromatic translucent tissue that modifies the underlying dentin appearance,[1,4,5] so changes within the color or translucency of both of these dental hard tissues may cause tooth discoloration. Despite the high success of root canal therapy, endodontic interventions may cause tooth discoloration due to dental trauma and pulp necrosis, and due to some filling materials, sealers, and intracanal medications.[6-8]. Triple antibiotic paste (TAP) was used for a long time as an intracanal medication. This medication was reported to entail significant tooth discoloration[9,10] attributed to the presence of minocycline,[11,12] which lead researchers to recommend its replacement by amoxicillin to avoid discoloration.[13]

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