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Evaluation of the effectiveness of different treatment approaches in preventing coronal discoloration caused by regenerative endodontic treatment

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Abstract

Objectives

This study aimed to evaluate the effectiveness of Teethmate desensitizer, a dentin bonding agent (DBA), Nd:YAG laser, and Er:YAG laser, which provides dentin tubule occlusion in the pulp chamber with different mechanisms, in preventing tooth discoloration due to regenerative endodontic treatment.

Materials and methods

One hundred five extracted maxillary human incisors with single roots and single canals were included in the study. The apical third of each tooth was resected below the enamel-cementum junction (CEJ) to obtain a standard root length as 10 ± 1 mm. Root canal preparation was performed using the ProTaper Next files up to X5. Root canals were prepared with Gates Glidden (# 2–4) burs to simulate the immature root apex and an apical diameter of 1.1 ± 0.1 mm was obtained. The teeth were randomly divided into 7 groups (n = 15): DBA, Teethmate, Nd:YAG, Er:YAG, Biodentine, Blood, and Negative Control. Relevant dentin tubule occlusion methods were applied to DBA, Teethmate, Nd:YAG, and Er:YAG groups. Following dentin tubule occlusion procedures, Biodentine was placed on the blood clot after filling the root canals with blood up to 4 mm below the CEJ. No dentin tubule occlusion procedure was applied for Blood and Biodentine groups. Color measurement was performed with the spectrophotometer Vita Easyshade Advance before treatment, immediately after treatment, and at days 7, 30, and 90. Data were converted to L*a*b color values of Commission International de I'Eclairage (CIE L*a*b) and ΔE values were calculated. Two-way ANOVA and post hoc Tukey test (p = 0.05) were performed for statistical analysis.

Results

A clinically detectable color change was observed in all groups except for the negative control (ΔE ≥ 3,3). It was observed that Biodentine used alone has a potential for discoloration. It was determined that as the contact time with blood increased, tooth discoloration increased. However, no significant difference was found between dentin tubule occlusion methods in preventing color change (p > 0.05).

Conclusions

It was determined that no dentin tubule occlusion method could 100% prevent discoloration caused by RET.

Clinical relevance

DBA and Teethmate, which do not have a significant difference in terms of preventing color change, are considered to be suitable for dentin tubule occlusion due to their ease of application and low cost compared to Nd:YAG laser and Er:YAG laser.

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Data availability

The study materials and data can be requested in writing from the corresponding author.

References

  1. Fagogeni I, Metlerska J, Lipski M, Falgowski T, Maciej G, Nowicka A (2019) Materials used in regenerative endodontic procedures and their impact on tooth discoloration. J Oral Sci 61(3):379–385. https://doi.org/10.2334/josnusd.18-0467

    Article  PubMed  Google Scholar 

  2. Kim SG, Malek M, Sigurdsson A, Lin LM, Kahler B (2018) Regenerative endodontics: a comprehensive review. Int Endod J 51(12):1367–1388. https://doi.org/10.1111/iej.12954

    Article  PubMed  Google Scholar 

  3. Taweewattanapaisan P, Jantarat J, Ounjai P, Janebodin K (2019) The effects of EDTA on blood clot in regenerative endodontic procedures. J Endod 45(3):281–286. https://doi.org/10.1016/j.joen.2018.10.010

    Article  PubMed  Google Scholar 

  4. Žižka R, Šedý J, Gregor L, Voborná I (2018) Discoloration after regenerative endodontic procedures: a critical review. Iran Endod J 13(3):278–284. https://doi.org/10.22037/iej.v13i3.21271

    Article  PubMed  PubMed Central  Google Scholar 

  5. Shokouhinejad N, Khoshkhounejad M, Alikhasi M, Bagheri P, Camilleri J (2018) Prevention of coronal discoloration induced by regenerative endodontic treatment in an ex vivo model. Clin Oral Investig 22(4):1725–1731. https://doi.org/10.1007/s00784-017-2266-0

    Article  PubMed  Google Scholar 

  6. Kohli MR, Yamaguchi M, Setzer FC, Karabucak B (2015) Spectrophotometric analysis of coronal tooth discoloration induced by various bioceramic cements and other endodontic materials. J Endod 41(11):1862–1866. https://doi.org/10.1016/j.joen.2015.07.003

    Article  PubMed  Google Scholar 

  7. Adl A, Javanmardi S, Abbaszadegan A (2019) Assessment of tooth discoloration induced by biodentine and white mineral trioxide aggregate in the presence of blood. J Conserv Dent 22(2):164–168. https://doi.org/10.4103/jcd.jcd_466_18

    Article  PubMed  PubMed Central  Google Scholar 

  8. Shokouhinejad N, Nekoofar MH, Pirmoazen S, Shamshiri AR, Dummer PM (2016) Evaluation and comparison of occurrence of tooth discoloration after the application of various calcium silicate-based cements: an ex vivo study. J Endod 42(1):140–144. https://doi.org/10.1016/j.joen.2015.08.034

    Article  PubMed  Google Scholar 

  9. American Association of Endodontists (2021) Clinical Considerations for a Regenerative Procedure. Revised 5/18/2021 https://www.aae.org/specialty/wp-content/uploads/sites/2/2021/08/ClinicalConsiderationsApprovedByREC062921.pdf

  10. Chen SJ, Karabucak B, Steffen JJ, Yu YH, Kohli MR (2020) Spectrophotometric analysis of coronal tooth discoloration induced by tricalcium silicate cements in the presence of blood. J Endod 46(12):1913–1919. https://doi.org/10.1016/j.joen.2020.09.009

    Article  PubMed  Google Scholar 

  11. Akbari M, Rouhani A, Samiee S, Jafarzadeh H (2012) Effect of dentin bonding agent on the prevention of tooth discoloration produced by mineral trioxide aggregate. Int J Dent:563203. https://doi.org/10.1155/2012/563203

  12. FundaoğluKüçükekenci F, Küçükekenci AS, Çakici F (2019) Evaluation of the preventive efficacy of three dentin tubule occlusion methods against discoloration caused by triple-antibiotic paste. Odontology 107(2):186–189. https://doi.org/10.1007/s10266-018-0385-y

    Article  Google Scholar 

  13. Maximiano V, Machado AC, Lopes RM, Rabelo FEM, Garófalo SA, Zezell DM, Aranha ACC, Scaramucci T (2021) Association of Nd:YAG laser and calcium-phosphate desensitizing pastes on dentin permeability and tubule occlusion. J Appl Oral Sci 29:e20200736. https://doi.org/10.1590/1678-7757-2020-0736

    Article  PubMed  PubMed Central  Google Scholar 

  14. Zhuang H, Liang Y, Xiang S, Li H, Dai X, Zhao W (2021) Dentinal tubule occlusion using Er:YAG Laser: an in vitro study. J Appl Oral Sci 29:e20200266. https://doi.org/10.1590/1678-7757-2020-0266

    Article  PubMed  PubMed Central  Google Scholar 

  15. FundaoğluKüçükekenci F, Çakici F, Küçükekenci AS (2019) Spectrophotometric analysis of discoloration and internal bleaching after use of different antibiotic pastes. Clin Oral Investig 23(1):161–167. https://doi.org/10.1007/s00784-018-2422-1

    Article  Google Scholar 

  16. Shokouhinejad N, Razmi H, Farbod M, Alikhasi M, Camilleri J (2019) Coronal tooth discoloration induced by regenerative endodontic treatment using different scaffolds and intracanal coronal barriers: a 6-month ex vivo study. Restor Dent Endod 44(3):e25. https://doi.org/10.5395/rde.2019.44.e25

    Article  PubMed  PubMed Central  Google Scholar 

  17. Ayar MK, Erdemir F (2017) Bonding performance of universal adhesives to er, cr:YSGG laser-irradiated enamel. Microsc Res Tech 80(4):387–393. https://doi.org/10.1002/jemt.22807

    Article  PubMed  Google Scholar 

  18. Abed AM, Mahdian M, Seifi M, Ziaei SA, Shamsaei M (2011) Comparative assessment of the sealing ability of Nd:YAG laser versus a new desensitizing agent in human dentinal tubules: a pilot study. Odontology 99(1):45–48. https://doi.org/10.1007/s10266-010-0136-1

    Article  PubMed  Google Scholar 

  19. Fotona (2019) Tooth Desensitization Available at: <https://www.fotona.com/media/documents/dentistry/2019/102643_v1_leaflet_tooth_desensitization_web.pdf >

  20. Kurt S, Kırtıloğlu T, Yılmaz NA, Ertaş E, Oruçoğlu H (2018) Evaluation of the effects of Er:YAG laser, Nd:YAG laser, and two different desensitizers on dentin permeability: in vitro study. Lasers Med Sci 33(9):1883–1890. https://doi.org/10.1007/s10103-018-2546-1

    Article  PubMed  Google Scholar 

  21. Marconyak LJ Jr, Kirkpatrick TC, Roberts HW, Roberts MD, Aparicio A, Himel VT, Sabey KA (2016) A comparison of coronal tooth discoloration elicited by various endodontic reparative materials. J Endod 42(3):470–473. https://doi.org/10.1016/j.joen.2015.10.013

    Article  PubMed  Google Scholar 

  22. Narang I, Mittal N, Mishra N (2015) A comparative evaluation of the blood clot, platelet-rich plasma, and platelet-rich fibrin in regeneration of necrotic immature permanent teeth: a clinical study. Contemp Clin Dent 6(1):63–68. https://doi.org/10.4103/0976-237x.149294

    Article  PubMed  PubMed Central  Google Scholar 

  23. Bezgin T, Yilmaz AD, Celik BN, Kolsuz ME, Sonmez H (2015) Efficacy of platelet-rich plasma as a scaffold in regenerative endodontic treatment. J Endod 41(1):36–44. https://doi.org/10.1016/j.joen.2014.10.004

    Article  PubMed  Google Scholar 

  24. Jadhav G, Shah N, Logani A (2012) Revascularization with and without platelet-rich plasma in nonvital, immature, anterior teeth: a pilot clinical study. J Endod 38(12):1581–1587. https://doi.org/10.1016/j.joen.2012.09.010

    Article  PubMed  Google Scholar 

  25. Dianat O, Mashhadi Abas F, Paymanpour P, Eghbal MJ, Haddadpour S, Bahrololumi N (2017) Endodontic repair in immature dogs’ teeth with apical periodontitis: blood clot vs plasma rich in growth factors scaffold. Dent Traumatol 33(2):84–90. https://doi.org/10.1111/edt.12306

    Article  PubMed  Google Scholar 

  26. Chrepa V, Austah O, Diogenes A (2017) Evaluation of a commercially available hyaluronic acid hydrogel (Restylane) as injectable scaffold for dental pulp regeneration: an in vitro evaluation. J Endod 43(2):257–262. https://doi.org/10.1016/j.joen.2016.10.026

    Article  PubMed  Google Scholar 

  27. Shah N, Logani A, Bhaskar U, Aggarwal V (2008) Efficacy of revascularization to induce apexification/apexogensis in infected, nonvital, immature teeth: a pilot clinical study. J Endod 34(8):919–25. https://doi.org/10.1016/j.joen.2008.05.001. (Discussion 1157)

    Article  PubMed  Google Scholar 

  28. Ramos JC, Palma PJ, Nascimento R, Caramelo F, Messias A, Vinagre A, Santos JM (2016) 1-year in vitro evaluation of tooth discoloration induced by 2 calcium silicate-based cements. J Endod 42(9):1403–1407. https://doi.org/10.1016/j.joen.2016.06.012

    Article  PubMed  Google Scholar 

  29. Lenherr P, Allgayer N, Weiger R, Filippi A, Attin T, Krastl G (2012) Tooth discoloration induced by endodontic materials: a laboratory study. Int Endod J 45(10):942–949. https://doi.org/10.1111/j.1365-2591.2012.02053.x

    Article  PubMed  Google Scholar 

  30. Vallés M, Mercadé M, Duran-Sindreu F, Bourdelande JL, Roig M (2013) Influence of light and oxygen on the color stability of five calcium silicate-based materials. J Endod 39(4):525–528. https://doi.org/10.1016/j.joen.2012.12.021

    Article  PubMed  Google Scholar 

  31. Yoldaş SE, Bani M, Atabek D, Bodur H (2016) Comparison of the potential discoloration effect of bioaggregate, biodentine, and white mineral trioxide aggregate on bovine teeth: in vitro research. J Endod 42(12):1815–1818. https://doi.org/10.1016/j.joen.2016.08.020

    Article  PubMed  Google Scholar 

  32. Felman D, Parashos P (2013) Coronal tooth discoloration and white mineral trioxide aggregate. J Endod 39(4):484–487. https://doi.org/10.1016/j.joen.2012.11.053

    Article  PubMed  Google Scholar 

  33. Marciano MA, Costa RM, Camilleri J, Mondelli RF, Guimarães BM, Duarte MA (2014) Assessment of color stability of white mineral trioxide aggregate angelus and bismuth oxide in contact with tooth structure. J Endod 40(8):1235–1240. https://doi.org/10.1016/j.joen.2014.01.044

    Article  PubMed  Google Scholar 

  34. Akbulut MB, Terlemez A, Akman M, Buyukerkmen B, Guneser MB, Eldeniz AU (2017) Tooth discoloration effects of calcium silicate based barrier materials used in revascularization and treatment with internal bleaching. J Dent Sci 12(4):347–353. https://doi.org/10.1016/j.jds.2017.03.009

    Article  PubMed  PubMed Central  Google Scholar 

  35. Madani Z, Alvandifar S, Bizhani A (2019) Evaluation of tooth discoloration after treatment with mineral trioxide aggregate, calcium-enriched mixture, and Biodentine(®) in the presence and absence of blood. Dent Res J 16(6):377–383

    Article  Google Scholar 

  36. Beatty H, Svec T (2015) Quantifying coronal tooth discoloration caused by biodentine and endosequence root repair material. J Endod 41(12):2036–2039. https://doi.org/10.1016/j.joen.2015.08.032

    Article  PubMed  Google Scholar 

  37. Oliveira LV, da Silva GR, Souza GL, Magalhães TEA, Barbosa GLR, Turrioni AP, Moura CCG (2020) A laboratory evaluation of cell viability, radiopacity and tooth discoloration induced by regenerative endodontic materials. Int Endod J 53(8):1140–1152. https://doi.org/10.1111/iej.13308

    Article  PubMed  Google Scholar 

  38. Poly A, Marques F, Fidel SR, Monnerat AF, Sassone LM (2019) Ability of two single-step restorative materials to avoid crown darkening caused by intracanal minocycline paste. Clin Oral Investig 23(3):1281–1286. https://doi.org/10.1007/s00784-018-2557-0

    Article  PubMed  Google Scholar 

  39. Bezgin T, Yilmaz AD, Celik BN, Sönmez H (2014) Concentrated platelet-rich plasma used in root canal revascularization: 2 case reports. Int Endod J 47(1):41–49. https://doi.org/10.1111/iej.12144

    Article  PubMed  Google Scholar 

  40. Kim JH, Kim Y, Shin SJ, Park JW, Jung IY (2010) Tooth discoloration of immature permanent incisor associated with triple antibiotic therapy: a case report. J Endod 36(6):1086–1091. https://doi.org/10.1016/j.joen.2010.03.031

    Article  PubMed  Google Scholar 

  41. Yasuda Y, Inuyama H, Maeda H, Akamine A, Nör JE, Saito T (2008) Cytotoxicity of one-step dentin-bonding agents toward dental pulp and odontoblast-like cells. J Oral Rehabil 35(12):940–946. https://doi.org/10.1111/j.1365-2842.2008.01885.x

    Article  PubMed  Google Scholar 

  42. Aghayan S, Fallah S, Chiniforush N (2021) Comparative efficacy of diode, Nd:YAG and Er:YAG lasers accompanied by fluoride in dentinal tubule obstruction. J Lasers Med Sci 12:e63. https://doi.org/10.34172/jlms.2021.63

    Article  PubMed  PubMed Central  Google Scholar 

  43. Ipci SD, Cakar G, Kuru B, Yilmaz S (2009) Clinical evaluation of lasers and sodium fluoride gel in the treatment of dentine hypersensitivity. Photomed Laser Surg 27(1):85–91. https://doi.org/10.1089/pho.2008.2263

    Article  PubMed  Google Scholar 

  44. Schwarz F, Arweiler N, Georg T, Reich E (2002) Desensitizing effects of an Er:YAG laser on hypersensitive dentine. J Clin Periodontol 29(3):211–215. https://doi.org/10.1034/j.1600-051x.2002.290305.x

    Article  PubMed  Google Scholar 

  45. Rezazadeh F, Dehghanian P, Jafarpour D (2019) Laser effects on the prevention and treatment of dentinal hypersensitivity: a systematic review. J Lasers Med Sci 10(1):1–11. https://doi.org/10.15171/jlms.2019.01

    Article  PubMed  Google Scholar 

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Funding

The costs of this study were covered by the researchers.

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Authors and Affiliations

  1. Department of Endodontics, Faculty of Dentistry, Bolu Abant Izzet Baysal University, Bolu, Turkey

    Melis Oya Ateş

  2. Department of Endodontics, Gulhane Faculty of Dentistry, University of Health Sciences, Ankara, Turkey

    Zeliha Uğur Aydın

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  1. Melis Oya Ateş
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  2. Zeliha Uğur Aydın
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Contributions

MOA and ZUA have made substantial contributions to conception and design; MOA and ZUA acquisition of data, analysis, and interpretation of data; MOA and ZUA have been involved in drafting the manuscript and revising it critically for important intellectual content; MOA and ZUA have given final approval of the version to be published.

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Correspondence to Melis Oya Ateş.

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All procedures performed in studies were in accordance with the ethical standards of the institutional and/or national research committee. The ethics committee of the XXX University approved the study (Ethics No: 2020/165).

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Ateş, M.O., Uğur Aydın, Z. Evaluation of the effectiveness of different treatment approaches in preventing coronal discoloration caused by regenerative endodontic treatment. Clin Oral Invest 27, 4595–4603 (2023). https://doi.org/10.1007/s00784-023-05085-0

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