title: Discoloration of teeth after avulsion and replantation: results from a multicenter randomized controlled trial.
abstract: BACKGROUND
  There is evidence to suggest that Ledermix, placed as an intervisit root canal dressing, might improve periodontal healing after replantation of avulsed teeth. As a part of a multicenter randomized controlled trial, we aimed to compare the effect of 2 root canal medicaments, Ledermix and Ultracal XS, on the discoloration of replanted teeth.
  
  
  METHODS
  Discoloration was investigated by using 3 methods: patient satisfaction with the color of replanted teeth, clinical photographs taken at baseline and 12-month reviews, and estimation of color change by using CIELAB scores for baseline and 12-month photographs.
  
  
  RESULTS
  Twenty-two patients (27 teeth) were recruited. Ten patients (12 teeth) were randomized to the Ledermix group and 12 patients (15 teeth) to the Ultracal XS group. At 12 months, 8 patients were concerned with the discoloration of their teeth. Seven came from the Ledermix group and 1 from the Ultracal XS group. This difference was significant (Fisher exact test, P = .009). Standardized photographs were taken for the patients recruited at one center only (17 patients). There was significant discoloration of teeth from baseline with Ledermix, causing a darkening and gray-brown discoloration (mean change from baseline to 12 months, L∗ = -5.1, a∗ = 0.3, b∗ = -1.2, and ΔE = 8.1) and Ultracal XS, causing a yellowing and lightening of teeth (L∗ = 1.9, a∗ = 0.3, b∗ = 3.3, and ΔE = 5.4). There was a significant difference for the L∗ and b∗ variables (independent t test) between the 2 groups.
  
  
  CONCLUSIONS
  Both root canal medicaments cause discoloration, with Ledermix proving less acceptable to patients.
authors.affiliation: Leeds Dental Institute, Leeds, UK. p.f.day@leeds.ac.uk
authors.forename: Peter F
authors.initials: PF
authors.lastname: Day
authors.forename: Monty S
authors.initials: MS
authors.lastname: Duggal
authors.forename: Alec S
authors.initials: AS
authors.lastname: High
authors.forename: Angus
authors.initials: A
authors.lastname: Robertson
authors.forename: Terry A
authors.initials: TA
authors.lastname: Gregg
authors.forename: Paul F
authors.initials: PF
authors.lastname: Ashley
authors.forename: Richard R
authors.initials: RR
authors.lastname: Welbury
authors.forename: Ben O
authors.initials: BO
authors.lastname: Cole
authors.forename: Stephen
authors.initials: S
authors.lastname: Westland
mesh_terms: D002126:Calcium Hydroxide / Q000009:adverse effects; D016009:Chi-Square Distribution; D003124:Colorimetry; D003707:Demeclocycline / Q000009:adverse effects; D004338:Drug Combinations; D006801:Humans; D017060:Patient Satisfaction; D023861:Photography, Dental; D012388:Root Canal Irrigants / Q000009:adverse effects*; D012390:Root Canal Therapy / Q000009:adverse effects; D018709:Statistics, Nonparametric; D014084:Tooth Avulsion / Q000601:surgery*; D014075:Tooth Discoloration / Q000139:chemically induced*; D014090:Tooth Replantation; D014222:Triamcinolone Acetonide / Q000009:adverse effects
chemical_list: D004338:Drug Combinations; D012388:Root Canal Irrigants; C531021:UltraCal XS; D003707:Demeclocycline; C001527:Ledermix; D014222:Triamcinolone Acetonide; D002126:Calcium Hydroxide