title: Spectrophotometric evaluation of color changes of bleach-shade resin-based composites after staining and bleaching.
abstract: Spectrophotometric evaluation of color changes of Bleach-shade resin-based composites after staining and bleaching.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the color stability of two commercially available bleach-shade resin composites (RC) after exposure to 3 storage solutions and the effect of 3 bleaching agents on the color stability and stain removal from stained RC.
  
  
  METHODS
  Two bleach-shade RC were evaluated in this study, including a nanoflled RC, Filtek(TM) Z350 XT (FZ), and a nanohybrid RC, Tetric(®) N-Ceram (TC), in the extra-white body (shade) (XWB) and L shades, respectively. Twenty-seven disk-shaped specimens, each measuring 12 mm in diameter and 2 mm in thickness, were prepared for each RC, with a total of 54 specimens. Specimens were randomly allocated into 3 groups of 9 specimens each and immersed in 3 storage solutions (distilled water, tea and coffee) for 7 days period. The 9 specimens in each staining group were further divided into 3 subgroups. Specimens in each subgroup (n = 3) were bleached using one of the bleaching agents (10 and 16% Zoom NiteWhite amorphous calcium phosphate (ACP), and Zoom 2 chairside with light activation) for 5 days period. The specimen colors were measured with spectrophotometer. The measurements were performed on each sample three times at baseline, after staining, and after bleaching. Color was expressed using the commission international de I'Eclairage (CIE) L*a*b* color space. The color differences (ΔE) between the three measurements were calculated and the results were statistically analyzed using Two-way and Three-way analysis of variance (ANOVA) and Tukey's posthoc tests. Level of significance was set at p < 0.05.
  
  
  RESULTS
  Tetric(®) N-ceram materials demonstrated significantly less color change than the FZ and the color change, which was greater after storage in coffee compared to tea, was statistically significant. The bleaching agents significantly influence the color changes of composite specimens. All groups showed (ΔE) values below 3.3 after bleaching, except for 'Zoom 2 chairside' with light activation groups, which is shown clinically unacceptable lighter shade (ΔE >3.3).
  
  
  CONCLUSIONS
  Bleach-shade composites showed significant discoloration (ΔE > 3.3) after being immersed into coffee and tea solutions. Nanoflled composites discolored more than nano-hybrid composites, and carbamide peroxide-based bleaching agents were effective in reducing the discoloration to a clinically acceptable value (ΔE > 3.3).
authors.affiliation: Assistant Professor, Department of Prosthodontics, Qassim University, Kingdom of Saudi Arabia, e-mail: dr.rafat.farah@qudent.org.
authors.forename: Rafat Ibrahim
authors.initials: RI
authors.lastname: Farah
authors.affiliation: Assistant Professor, Department of Prosthodontics, Qassim University, Kingdom of Saudi Arabia.
authors.forename: Hytham
authors.initials: H
authors.lastname: Elwi
mesh_terms: D000077463:Carbamide Peroxide; D003069:Coffee; D003116:Color; D003188:Composite Resins / Q000737:chemistry*; D003764:Dental Materials / Q000737:chemistry*; D006801:Humans; D006861:Hydrogen Peroxide / Q000737:chemistry; D008422:Materials Testing; D053761:Nanocomposites / Q000737:chemistry; D010545:Peroxides / Q000737:chemistry; D011897:Random Allocation; D013053:Spectrophotometry / Q000379:methods; D013499:Surface Properties; D013662:Tea; D013696:Temperature; D013997:Time Factors; D058205:Tooth Bleaching Agents / Q000737:chemistry*; D014508:Urea / Q000031:analogs & derivatives / Q000737:chemistry; D014867:Water / Q000737:chemistry
chemical_list: D003069:Coffee; D003188:Composite Resins; D003764:Dental Materials; D010545:Peroxides; D013662:Tea; C121818:Tetric ceram; D058205:Tooth Bleaching Agents; C533204:filtek Z350; C532950:tetric ceram bleach; D014867:Water; D000077463:Carbamide Peroxide; D014508:Urea; D006861:Hydrogen Peroxide