Inverted Layering Technique as a Biomimetic Procedure in a Multidisciplinary Resolution of Discolored Teeth: A Case Report.

The objective of this work is to report a restorative approach with composite resin applied in reverse in the aesthetic resolution of darkened anterior teeth. A 27-year-old female patient presented with the main complaint of dissatisfaction with the aesthetics of her smile due to dental darkening, a result of childhood trauma, without painful symptoms, pathological clinical signs or change in care. In the intraoral examination, a darkening of teeth 11 and 21 was observed, which radiographically showed thickening of the periodontal ligament, with disharmonious configuration of the marginal gingiva. From the clinical and radiographic characteristics, we opted for periodontal intervention for recovery and gingival levelling, followed by endodontic intervention and aesthetic restorative restoration. The restorative step was carried out sequentially by internal tooth bleaching, removal of dentin still pigmented after bleaching and enamel preservation. Soon after, it was restored in an alternative way and layered using a technique called reverse, using strips of polyethylene fiber over the dentin resin. The technique preserved the remaining enamel with the maintenance of the original remaining guides, proving to be a viable conservative alternative since of the diagnosis to the restorative conclusion in view of the longitudinal confirmation of the restorative efficacy after 1 year.

Two Cases of Children With Black Hairy Tongue and Tooth Discoloration Caused by Antibacterial Agents.

Black hairy tongue (BHT) is a lesion in which the filiform papillae of the tongue are significantly extended by hyperkeratosis, thereby giving the tongue a hairy appearance. Here, we report two rare cases of children with BHT and tooth discoloration caused by antimicrobial agents. Case 1: A four-year-old female patient received intravenous linezolid after spinal surgery, and BHT developed on day eight of treatment. Subsequently, the patient developed teeth discoloration. Linezolid was continually administered for 50 days, and BHT and teeth discoloration improved 10 days after the end of linezolid treatment. Case 2: A two-year-old male patient with a brain abscess received intravenous meropenem and vancomycin. On the fourth day of treatment, BHT developed, and teeth discoloration was subsequently observed. Antibiotic therapy was continued for 82 days, and BHT and tooth discoloration improved 20 days after the treatment was discontinued.

Evaluation of the effects of different photosensitizers used in antimicrobial photodynamic therapy on tooth discoloration: spectrophotometric analysis.

BACKGROUND: Tooth discoloration is a common concern in antimicrobial photodynamic therapy (aPDT) using various photosensitizers (PS). Toluidine Blue (TB), Methylene Blue (MB), Phthalocyanine (Pc), and 2-mercaptopyridine-substituted zinc phthalocyanine (TM-ZnPc) are among those studied, but their relative impacts on tooth discoloration remain unclear. AIM: This study aimed to compare the effects of TB, MB, Pc, and TM-ZnPc in aPDT on tooth discoloration, utilizing a controlled experimental setup. MATERIALS AND METHODS: The study comprised seventy-five single-rooted incisors with root canals. Following meticulous preparation, a standardized area on the crown surface was designated for examination, and precise measurements of the initial tooth colors were recorded. Samples were randomly divided into five groups: Negative control, MB, TM, Pc, and TM-ZnPc. Photoactivation was performed using LED light, and color measurements were taken at multiple time points up to 90 days. Data were converted to Lab* color values of the CIE Lab* color system (International Commission on Illumination, Vienna, Austria), and ΔE values were calculated. Statistical analysis was performed using Two-way ANOVA and Post-Hoc Tukey tests (p < 0.05). RESULTS: At day 7 and 30, TM-ZnPc and Pc caused less discoloration compared to MB and TB. TM-ZnPc caused more tooth discoloration compared to Pc (p < 0.05). Compared to baseline, MB and TM-ZnPc caused more tooth discoloration at 30 days and TB caused more tooth discoloration at 90 days (p < 0.05). No significant difference was observed in terms of tooth discoloration at all periods evaluated after Pc application (p > 0.05). All photosensitizers tested in the study caused tooth coloration. CONCLUSION: All PS induced clinically detectable tooth discoloration, with TB and MB causing more significant discoloration compared to Pc and TM-ZnPc at certain time points. TM-ZnPc and Pc demonstrated more stable coloration levels over time, suggesting their potential reliability in aPDT applications. This study highlights the importance of selecting appropriate PS to minimize tooth discoloration in aPDT, with Pc showing promise in this regard.

Whitening Efficacy of Toothpastes on Coffee-Stained Teeth: An Enamel Surface Analysis.

AIM: This study aimed to identify the optimal toothpaste for removing coffee-induced stains while also evaluating its impact on tooth enamel through roughness and abraded depth parameters, providing a comprehensive understanding of their effects. MATERIALS AND METHODS: Three whitening toothpastes and 2 conventional toothpastes were prepared for a simulated brushing procedure on coffee-stained bovine enamel tooth specimens. Using a toothbrushing machine, up to 10,000 brushstrokes were completed, while spectrophotometric readings were taken at designated intervals. A mixed-effects model for statistical analysis determined the effects of toothpaste and brushing on colour change, roughness, and abraded depth. RESULTS: Whitening toothpastes significantly deviated from the control (P < .001, P < .001, and P < .003, respectively), whereas the conventional toothpaste did not exhibit a significant contrast (P < .081). Regarding colour restoration following coffee staining, whitening toothpastes showed higher restoration than conventional toothpastes. Surface roughness and abraded depth parameters increased with accumulated brushing. CONCLUSIONS: Sodium hexametaphosphate-containing toothpaste demonstrated the highest efficacy in removing coffee-induced stains and restoring tooth colour. Nevertheless, this stronger whitening effect was associated with increased abrasion. While conventional toothpastes exhibited some whitening effects, the most substantial improvement in lightness was consistently observed with whitening toothpastes. CLINICAL RELEVANCE: Understanding how whitening toothpaste affects enamel integrity is crucial for refining formulations and advancing dental care. This knowledge lays the groundwork for more effective oral care products and improved whitening procedures, ultimately enhancing the overall quality of dental treatments.

Long-Term Success of Regenerative Endodontic Treatment in Managing Traumatized Teeth: A Case Report With Seven-Year Follow-Up.

Traumatic injuries to maxillary incisors often result in complex dental complications, such as pulp necrosis and periapical pathology, particularly in young patients. Traditional root canal treatments may prove insufficient, especially for immature teeth requiring apexification. Regenerative endodontic treatment (RET) presents a promising alternative, aiming to eliminate infection while fostering root development and tooth vitality. This case report illustrates the successful management of a necrotic-infected traumatized maxillary incisor in a seven-year-old girl using RET. The treatment involved a meticulously planned protocol comprising disinfection, induction of bleeding, and placement of a calcium-enriched mixture (CEM) cement plug, followed by composite restoration. Remarkably, despite the initial detection of an endodontic lesion in the postoperative radiograph, the clinical outcomes remained aesthetically pleasing, with subsequent radiographs revealing regression of the apical lesion and complete tooth maturation over the seven-year follow-up period. This case highlights the efficacy and feasibility of RET using CEM in managing infected, traumatized teeth, emphasizing its potential for long-term healing and functional restoration. The absence of tooth discoloration further underscores the benefits of utilizing specific materials and protocols.

Tooth whitening: current status and prospects.

As a safe, effective, economical, and convenient technique, tooth whitening is one of the most popular treatments for improving tooth discoloration. This review summarizes the theoretical and recent research developments in the classification and mechanisms of tooth discoloration, as well as the principles, agents, effects, and side effects of tooth whitening techniques. The aim is to provide a basis for the clinical treatment of tooth whitening techniques and to suggest possible new ideas for further research. The accepted mechanism of whitening is the redox reaction of oxides in the whitening reagent, and the whitening effect is remarkable. However, side effects such as tooth sensitivity and irritation of gum and other oral soft tissues can still occur. It is recommended that more monitoring be carried out in the clinic to monitor these side effects, and care should be taken to protect the soft tissues in the mouth during office whitening procedures. Furthermore, there is a need to develop new additives or natural whitening products to reduce the occurrence of side effects.

Tetracycline staining of the dentition: a review of the literature and report of a clinical case.

The present article reviews the literature regarding tetracycline staining of the dentition and its esthetic management. A total of 49 articles were identified in the initial search, and 22 articles met the eligibility criteria of this narrative literature review. Tetracycline staining results from its use in children between the ages of 6 months and 6 years, when tooth crowns are formed; the effects are dependent on the dosage, duration of treatment, stage of tooth mineralization, and activity of the mineralization process. Tooth bleaching is always the first treatment option for low-grade cases of tetracycline staining. Restorative procedures are indicated for severe staining. The article also describes the treatment of severe staining affecting the maxillary anterior dentition of a 48-year-old man who reported the systemic administration of tetracycline during childhood. Direct composite resin laminate veneers were proposed to achieve immediate, highly esthetic restorations. A combination of different resinous materials in different shades was applied to meet the needs of the patient. The use of direct composite resin laminate veneers satisfied the functional and esthetic demands of the patient at a lower cost than ceramic materials.

The Efficacy of Different Antibiotic Compounds in Regenerative Treatment of Immature Necrotic Teeth.

Objectives: Endodontic treatment of immature teeth poses a significant challenge, especially in achieving a proper seal using traditional obturation methods. Revascularization presents itself as an alternative approach to this problem, and the application of triple antibiotic paste (TAP) has been suggested as a means to achieve disinfection during the procedure. This study aims to compare the antibacterial properties of three different antibiotic combinations to assess their effectiveness on root canal disinfection. Materials and Methods: Eighty samples were employed to assess the impact of three antibiotic combinations on Enterococcus faecalis, Escherichia coli, Streptococcus mutans, and a combination thereof. The antibiotics included metronidazole, ciprofloxacin, and cefaclor (CCM), the commonly used TAP, and a double antibiotic paste (DAP) composed of metronidazole and ciprofloxacin. Dentin shavings collected using Gates-Glidden drills were placed in microtubes containing a 2ml standard bacterial suspension. Microtube contents were diluted and cultured on BHI agar plates, with colony counts calculated based on dentine shavings' weight in CFU/mg. Kruskal-Wallis and Dunn's post-hoc tests were used for statistical analysis and P<0.05 was considered significant. Results: A significant difference in mean CFU was observed among all bacterial groups (P<0.05). Dunn's post-hoc analysis showed a significant difference only between the control group (methylcellulose) and the other antibiotic groups. There was no significant difference between the other antibiotic groups in two-by-two comparisons. Conclusion: There was no significant difference in the antimicrobial properties of DAP, TAP and CCM. Therefore, DAP and CCM may be used during regenerative treatment.

Influence of Post-Curing in Nitrogen-Saturated Condition on the Degree of Conversion and Color Stability of 3D-Printed Resin Crowns.

Post-curing is the process of applying extra light to complete the polymerization process of 3D printing. The mechanical properties of light-cured three-dimensional (3D) printed resin can be improved by decreasing the oxygen concentrations during post-curing, and nitrogen-saturated post-curing has been applied for this purpose. This study aimed to evaluate and compare the color stability of 3D-printed resin crowns that were post-cured in both normal air and nitrogen-saturated conditions. Crowns were fabricated with a 3D printer and post-cured in normal air (control group; air) or nitrogen-saturated conditions (experimental group; nitrogen). The specimens in each group were subdivided into four subgroups, each exposed to different discoloration agents: distilled water, coffee, wine, and curry. Post-immersion color changes were measured using a digital spectrophotometer and analyzed using repeated-measures ANOVA. Fourier transform infrared (FT-IR) spectroscopy evaluated the degree of conversion of resin over immersion times for both post-curing conditions. Upon comparing the effects of post-curing conditions, a significant difference between the control and experimental groups in terms of immersion time in the wine and curry subgroups was found. FT-IR analysis showed a significant difference in the degree of conversion between the air and nitrogen groups from 10 to 300 s. These findings suggest that nitrogen-saturated post-curing can potentially enhance the conversion rate of 3D-printed resin crowns, thereby improving their color stability.

Evaluation of pediatric dentists' knowledge and approaches to tooth discoloration.

In recent years, esthetic expectations have come to the fore in pediatric dentistry, as in every field of dentistry. Therefore, to better meet patients' expectations, the steps taken to determine and improve the current level of knowledge of pediatric dentists on tooth discoloration gain importance. This study aims to measure the knowledge levels of pediatric dentists regarding tooth discoloration. A 33-questioned survey created online was emailed to pediatric dentists between March and December 2021. The first part included four multiple-choice and two open-ended questions regarding demographic characteristics. The second part was to measure the participants' knowledge of tooth discoloration. The last part was to evaluate the clinical approaches of the participants. Participants who agreed to answer all of the questions were included in the study (n = 129). The knowledge levels of the participants were scored according to the accuracy of their answers. The data were statistically analyzed using descriptive statistics and chi-square tests. Of the pediatric dentists who participated in this study, 16.3% had high knowledge, 79.8% had medium knowledge, and 3.9% had insufficient understanding of tooth discoloration. There was no correlation between time since dental school graduation and time spent practicing as a pediatric dentist (p > 0.05). The group with the highest average level of knowledge was the group most frequently encountered with tooth discoloration in the clinic (p ≤ 0.05). On average, pediatric dentists had moderate knowledge of tooth discoloration. The group with the highest average expertise in this field was the group that most frequently encountered and treated tooth discoloration. Information on tooth discoloration due to systemic factors was insufficient. To increase the knowledge level of pediatric dentists about the causes and treatments of tooth discoloration, it may be beneficial to establish training programs during and after specialization education.

The Efficacy of Different Laser Applications on Dentin Sealing in Preventing Discoloration Induced by Mineral Trioxide Aggregate.

The aim of this in vitro study was to evaluate the effect of the pre-application of a dentin-bonding agent and the application of different lasers on the prevention of tooth discoloration caused by mineral trioxide aggregate (MTA) in the presence of blood. Sixty extracted human anterior teeth were selected, with root lengths standardized to 10 mm and root canals shaped using Gates-Glidden drills #3 to #5. The samples were divided into six groups (n = 10): Group 1 with no surface treatment and Groups 2 to 6 with Optibond universal adhesive and Neodymium yttrium aluminum garnet (Nd:YAG), Erbium yttrium aluminum garnet (Er:YAG), Erbium-chromium-yttrium-scandium-gallium-garnet (Er:Cr:YSGG), and diode laser applications, respectively. Root canals were filled with fresh human blood, and ProRoot MTA and a collagen barrier were then placed. Color changes were measured with a spectrophotometer at 0, 7, 30, 90, and 180 days post MTA placement. Color differences (∆E) were analyzed using a two-factor mixed-design ANOVA with the Sidak method (p = 0.05). All treatment groups exhibited discoloration above the acceptability threshold. Although all treatment approaches exhibited less color change compared to the control group (p < 0.05), there was no significant difference among them in terms of preventing color change (p > 0.05). It was determined that none of the methods could guarantee 100% prevention of discoloration caused by MTA-blood contact.

[Laboratory evaluation of the effectiveness and safety of the Chairside Light Whitening System fläsh]. / Laboratornaya otsenka effektivnosti i bezopasnosti otbelivayushchei sistemy Chairside Light Whitening System fläsh.

THE AIM OF THE STUDY: Optimization of methods for treating dental discoloration using whitening systems based on hydrogen peroxide by laboratory studying their chemical properties. MATERIAL AND METHODS: The effectiveness of the bleaching system was assessed by quantitatively assessing the color change of model samples of hydroxyapatite (HAP) in the CIE L*a*b* system on a Spectron-M color analyzer after exposure to coloring food media. Safety assessment was carried out on samples made from teeth removed according to indications. RESULTS: The results of laboratory tests allow us to conclude that the Chairside Light Whitening System professional teeth whitening system fläsh. (WHITEsmile GmbH, Germany) has high whitening efficiency with a whitening degree of ~84%, which significantly exceeds the norm of GOST R 702.3.004-2021. the microhardness of the enamel of samples exposed to the whitening gel for 15 minutes changes extremely little. After exposure of the studied samples to the Chairside Light Whitening System fläsh whitening system for 45 minutes, an increase in digital microhardness indicators is observed, which indicates the dynamics of processes demineralizing the hard tooth structure. CONCLUSIONS: Chairside Light Whitening System fläsh professional teeth whitening system has high whitening efficiency with minimal impact on the teeth structure and high safety.

An in vitro evaluation of the effects of fluoride, CPP-ACP, or resin infiltration on discoloration caused by pediatric supplements.

OBJECTIVES: White spot lesions are more susceptible to staining agents due to their porous structure. This study examines the impact of white spot lesion treatments on discoloration caused by pediatric supplements. METHOD AND MATERIALS: Three treatments (fluoride, casein phosphopeptide-amorphous calcium phosphate [CPP-ACP], resin infiltration), a control, and their respective syrup-based subgroups (iron and black elderberry syrups) were established, each with eight teeth. Artificial white spot lesions were induced, and weekly applications of fluoride varnish, daily applications of CPP-ACP paste, or a single resin infiltration procedure were performed on the white spot lesions within the treatment groups over 4 weeks. Simultaneously, samples were exposed daily to iron or black elderberry syrups. Spectrophotometer measurements were taken at baseline, after demineralization (T0), and after 1 (T1), 2 (T2), and 4 weeks (T4). ΔE00 values were calculated. Statistical analysis was conducted using a three-way mixed-design ANOVA, with the significance level set at P = .05. RESULTS: At T4, ΔE00 values from all groups exceeded the clinical acceptability limit of 1.8. At T2 and T4, the ΔE00 values obtained from the black elderberry syrup subgroups were significantly higher (P < .001). At T4, the highest ΔE00 values were seen in the CPP-ACP groups (P < .001). The lowest ΔE00 values at T2 and T4 were observed in the resin infiltration groups (P < .05). CONCLUSIONS: Supplements containing ferrous sulfate and black elderberry extract caused color changes in white spot lesions that exceeded the clinical acceptability limit. Resin infiltration of white spot lesions provides advantages over remineralization treatments, particularly in minimizing discoloration induced by pediatric supplements.

Investigating the role of chlorogenic acids and coffee type in coffee-induced teeth discoloration.

OBJECTIVE: Coffee is one of the most popular beverages in the world, with millions of people consuming it every day. The effect of coffee on teeth discoloration has long been a concern for both coffee drinkers and dental professionals. To address this concern, this study aimed to investigate the role of chlorogenic acids (CGAs) and the type of coffee in coffee-induced teeth discoloration. MATERIALS AND METHODS: High-performance liquid chromatography with a photodiode array detector was used to determine the CGA contents of instant coffee produced by five manufacturers (Starbucks, Dunkin' Donuts, Kanu, Ediya, Coffee Bean). A total of 180 bovine tooth specimens were immersed in the coffee samples for varying durations (3, 9, 24, 48, and 72 h), and the discoloration levels were measured using a spectrophotometer. A linear mixed-effects model analysis was used to determine the significance of L*, a*, and b* values in relation to the duration of coffee immersion and coffee type. RESULTS: Both immersion time and coffee type had significant effects on tooth discoloration (p < 0.001), with some types of coffee being more strongly associated with tooth discoloration than others. The amount of CGAs present in coffee was found to be positively correlated with the degree of discoloration (p = 0.030). CONCLUSIONS: Prolonged exposure to coffee can exacerbate teeth staining, and different types of coffee can cause varying degrees of discoloration. Furthermore, coffee with higher levels of CGAs may lead to greater tooth discoloration.

Effects of enamel moistening and repositioning guide color on tooth whitening outcomes: A clinical trial.

This clinical trial investigated the effects of pre-application enamel moistening on the impact of a 37% carbamide peroxide whitener on tooth color changes and the influence of repositioning guide colors. Forty participants were randomly assigned to in-office tooth bleaching with either moistened enamel (experimental) or dry enamel (control). The whitener was applied for 45 min over two sessions. Tooth color was visually measured or assessed using a spectrophotometer with purple or green silicone guides. Tooth bleaching was assessed using CIE76 (ΔEab ) and CIEDE2000 (ΔE00 ) formulas and by whitening and bleaching index score changes. Moistening the enamel did not significantly affect tooth color. However, the guide color choice only impacted tooth color when measured instrumentally. At baseline, the green guide resulted in statistically significantly whiter teeth than the purple guide. Less pronounced differences in the b* coordinate between baseline and final measurements were found using the green guide. The green guide also produced lower ΔEab values and less change in indexes. In conclusion, moistening the enamel did not significantly impact tooth color changes. However, the repositioning guide color influenced the tooth bleaching measured instrumentally, except for ΔE00 .

Influence of repositioning guides' color and usage on precision in tooth color measurement with a clinical spectrophotometer

Abstract Repositioning guides are commonly employed in clinical studies to ensure consistent tooth color measurements. Yet, their influence on measured color remains uncertain. Objective This study evaluated the impact of repositioning guides' color and usage on tooth color measurement using a clinical spectrophotometer. Methodology In total, 18 volunteers participated in this study, in which the color of their upper left central incisor and upper left canine was measured with or without repositioning guides (control). The guides were made from pink, blue, or translucent silicone, as well as an acetate-based bleaching tray. Tooth color was measured in triplicates using a clinical spectrophotometer based on the CIELAB system. The standard deviations of these readings were used to estimate reproducibility, and color differences (ΔE00) between the measurements with guides and the control were calculated. Results Repositioning guides had a minimal effect on L* values and no effect on b* values. The use of pink silicone increased a* values, whereas blue or translucent silicone reduced them. Irrespective of the evaluated tooth, the lowest ΔE00 values were observed for the translucent silicone and bleaching tray. The usage of guides only affected data variability for the L* color coordinate. Conclusion Using repositioning guides can significantly impact the precision of tooth color measurement with a clinical spectrophotometer.

Can a dentin bonding agent prevent color change in regenerative endodontic procedures? An in vitro evaluation

Abstract This in vitro study aimed to determine the efficacy of dentin bonding agents in preventing color changes following Regenerative Endodontic Procedures. One hundred twenty bovine incisors were endodontically prepared and randomly assigned to a two main factors design: application of a dentin bonding agent (Scotchbond Adper, 3M ESPE, St Paul, MN, USA) in the pulp chamber (Group 1, n=60) versus no bonding intervention (Group 2, n=60), and five levels of intracanal medication (n=12/subgroup): Triple antibiotic paste (TAP), double antibiotic paste (DAB), calcium hydroxide (CH), modified triple antibiotic paste (TAPM), and Control (CTL). Color changes were measured over 28 days at multiple time points (1, 3, 7, 14, 21, and 28 days) using the CIEDE2000 formula to calculate the color difference (ΔE00) from baseline (T0). The ΔE00 quantifies the perceptible color difference between the initial and final tooth color, with lower values indicating less discoloration. The results were analyzed using repeated measures ANOVA-2 and post-hoc Holm-Sidak tests. The TAP subgroups, both with and without the bonding agent, exhibited the highest color variation. However, a pulp chamber seal with a bonding agent showed a protective effect against discoloration compared to no seal, even though complete prevention was not achieved. All groups demonstrated ΔE00 values beyond acceptable interpretation thresholds for clinical application, primarily driven by a reduction in lightness (L*) and a decrease in redness (a* value, shifting towards green). In conclusion, while the pulp chamber seal with a bonding agent mitigated TAP-induced discoloration, it did not eliminate it.

Resumo Este estudo in vitro avaliou adesivos dentinários na prevenção de alterações de cor após procedimentos endodônticos regenerativos. Cento e vinte incisivos bovinos foram preparados endodonticamente e aleatoriamente designados para um desenho com dois fatores principais: aplicação de agente adesivo (Scotchbond Adper, 3M ESPE, St Paul, MN, EUA) na câmara pulpar (Grupo 1, n=60) versus não intervenção adesiva (Grupo 2, n=60), e cinco níveis de medicação intracanal (n=12/subgrupo): pasta de triantibiótica (TAP), pasta diantibiótica (DAB), hidróxido de cálcio (CH), pasta triantibiótica modificada (TAPM) e Controle (CTL). Alterações cromáticas foram monitoradas por 28 dias em intervalos (1, 3, 7, 14, 21, e 28 dias), usando CIEDE2000 para calcular a diferença de cor (ΔE00) em relação a cor inicial. O ΔE00 quantifica a diferença entre a cor inicial e final do dente, com valores menores indicando menos descoloração. Os resultados foram analisados usando ANOVA-2 de medidas repetidas e teste posthoc de Holm-Sidak. Os grupos utilizando medicação TAP, com ou sem adesivo, possuíram as maiores variações cromática. Contudo, o uso do adesivo na câmara pulpar mostrou um efeito protetor contra descoloração, em comparação com a ausência do selamento adesivo, embora a prevenção completa não tenha sido alcançada. Todos os grupos demonstraram valores de ΔE00 além dos limiares aceitáveis para aplicação clínica, principalmente devido à redução na luminosidade (L*) e redução no vermelho (a*, deslocando-se em direção ao verde). Em conclusão, enquanto o selamento da câmara pulpar com um agente adesivo mitigou a descoloração induzida pelo TAP, mas não a eliminou completamente.

Efficacy of Glutathione Biomolecule in Reducing the Tooth Discoloration Associated with Silver Diamine Fluoride: A Split-mouth In vivo Study.

Background: The necessity to modify silver diamine fluoride (SDF) to make it esthetically acceptable without affecting its beneficial properties keeps the research in this field pertinent. Aim: This study aims to comparatively evaluate the efficacy of Glutathione (GSH) in reducing tooth discoloration associated with SDF. Materials and Methods: This split-mouth in vivo study was conducted on 20 children aged 3-8 years having a minimum of 3 active carious primary teeth. The three teeth in each patient were randomly divided into Group I - 38% SDF; Group II - 38% SDF followed by application of potassium iodide; and Group III - 38% SDF mixed with 20% GSH. Standardized photographs were taken immediately after application and after 6 months, which were analyzed using Image J software. The carious lesions were clinically classified as active or arrested after 6 months. Results: When mean gray values of three groups were compared postoperative, the highest value (lighter shade) was observed for group II and least (darker shade) for group I, whereas, during the 6-month follow-up, the highest value was seen for group III and least for group I. The color change from preoperative to 6 months' follow-up was compared, and a statistically significant difference was observed between groups I and II (P = 0.003) and groups I and III (P = 0.001). When caries arresting effectiveness was analyzed, there was no significant difference found between any of the groups (P = 1). Conclusion: Mixing 20% GSH with 38% SDF was an effective measure in reducing the tooth discoloration associated with SDF, without affecting caries arresting the efficiency of the latter.

Inhibition of Silver Diamine Fluoride-induced Tooth Discoloration by Using Natural Antioxidant: In Vitro Study.

AIM: Silver diamine fluoride (SDF) is a well-known caries preventive aid capable of arresting carious lesions and preventing secondary caries formation. Despite having the caries prevention potential, the clinical use of SDF is limited due to the tooth discoloration caused by SDF. The objective of this study was to evaluate the efficiency of natural antioxidants to inhibit SDF-induced tooth discoloration. MATERIALS AND METHODS: A total of 32 bovine teeth were polished to create a 6 mm circular window on the middle 1/3 (for enamel) or on the cervical 1/3 (for dentin) of the labial surface. Specimens were treated either with SDF alone or SDF followed by ascorbic acid (AA)/alpha lipoic acid (ALA)/7th generation bonding materials. The color parameters Lightness (L*), Chroma (C*), and Hue (H*) of the tooth window were measured at pretreatment, 1-hour, 1-week, and 1-month posttreatment using a digital color chromometer. RESULTS: Repeated measure ANOVA showed a significant tooth color alteration at 1-hour posttreatment. The L* and H* values dropped and C* value elevated significantly in 1-hour posttreatment measurement. All experimental groups showed significant tooth color alteration after treatment (p < 0.05) and were unable to reverse the discoloration even after 1-month period except the ALA group which did not show any significant (p > 0.05) color alteration compared with the pretreatment value. CONCLUSIONS: Within the limitation of the in vitro model and according to the results of this study, it can be concluded that ALA has the potential to prevent SDF-induced tooth discoloration; however, AA was unable to prevent the discoloration. CLINICAL SIGNIFICANCE: SDF induces discoloration of enamel and dentin can be reversed by applying Alpha lipoic acid immediacy after SDF application.

The effect of adding silver nanoparticles on the color stability of feldspathic porcelains.

Background: This study aims to investigate the color stability of feldspathic porcelains with different concentrations of silver nanoparticles (AgNPs). Materials and Methods: In this experimental study, feldspathic porcelain disks with AgNPs of 0 parts per million (ppm), 250 ppm, and 500 ppm were used (sample size = 180). These ceramic discs were subjected to thermocycling in tea, orange juice, and artificial saliva. The optical parameters of disks were measured before and after being immersed in the solutions. Then, the color change (ΔE 00) of the samples was measured by using the CIEDE 2000 formula. The data were analyzed by one-way analysis of variance (ANOVA) and Tukey's post hoc test. The level of significance was determined to be 0.05. Results: The results of the ANOVA test show that there was a significant difference in ΔE 00 (P ≤ 0.05). The maximum ΔE 00 was visible in the samples with AgNPs 0 ppm that were exposed to orange juice, and the minimum ΔE 00 was related to the disks with AgNPs 500 ppm in artificial saliva. Conclusion: Based on the results of this study, adding AgNPs to feldspathic porcelain increases the color stability of the ceramic discs.