title: Evaluation and Comparison of Occurrence of Tooth Discoloration after the Application of Various Calcium Silicate-based Cements: An Ex Vivo Study.
abstract: BACKGROUND
  Biodentine (Septodont, Saint Maur des Fossés, France), OrthoMTA (BioMTA, Seoul, Korea), and EndoSequence Root Repair Material (ERRM; Brasseler, Savannah, GA) have been developed to overcome the shortcomings of mineral trioxide aggregate (MTA). The purpose of this study was to compare tooth discoloration after the application of ProRoot MTA (Dentsply Tulsa Dental Products, Tulsa, OK) and 3 recently introduced calcium silicate-based cements in the presence and absence of blood.
  
  
  METHODS
  In total, 104 human anterior teeth were prepared; 96 were randomly divided into 2 groups (blood and saline contamination). Each group was subdivided into 4 experimental subgroups (n = 12) of ProRoot MTA, Biodentine, OrthoMTA, and ERRM that were used to fill the pulp chambers. The remaining 8 teeth served as the saline and blood groups. Color analysis of tooth crowns was performed using a spectroradiometer before the application of materials and at 24 hours, 1 month, and 6 months after application. Repeated measures analysis of variance was used to evaluate the effects of blood, material, and time on color change (ΔE*).
  
  
  RESULTS
  Tooth color change in all experimental groups increased over time (P < .05). Blood contamination significantly increased ΔE* (P < .05), but no significant difference occurred between the 4 groups in this respect in the presence of blood. However, in the absence of blood, the ΔE* of Biodentine and ERRM was significantly less than that of OrthoMTA (P < .05).
  
  
  CONCLUSIONS
  There was no significant difference between tooth discolorations with materials in the presence of blood. However, in the absence of blood, Biodentine and ERRM exhibited less tooth discoloration than OrthoMTA.
authors.affiliation: Department of Endodontics, School of Dentistry, Tehran, Iran; Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Noushin
authors.initials: N
authors.lastname: Shokouhinejad
authors.affiliation: Department of Endodontics, School of Dentistry, Tehran, Iran; Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Endodontology Research Group, School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, United Kingdom. Electronic address: nekoofarmh@cardiff.ac.uk.
authors.forename: Mohammad H
authors.initials: MH
authors.lastname: Nekoofar
authors.affiliation: Department of Endodontics, School of Dentistry, Tehran, Iran.
authors.forename: Salma
authors.initials: S
authors.lastname: Pirmoazen
authors.affiliation: Research Center for Caries Prevention, Dentistry Research Institute, Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Ahmad R
authors.initials: AR
authors.lastname: Shamshiri
authors.affiliation: Endodontology Research Group, School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, United Kingdom.
authors.forename: Paul M H
authors.initials: PM
authors.lastname: Dummer
mesh_terms: D017607:Aluminum Compounds / Q000009:adverse effects*; D001769:Blood; D017610:Calcium Compounds / Q000009:adverse effects*; D002130:Calcium Phosphates / Q000009:adverse effects*; D003738:Dental Cements / Q000009:adverse effects*; D004338:Drug Combinations; D006801:Humans; D010087:Oxides / Q000009:adverse effects*; D017640:Silicates / Q000009:adverse effects*; D014075:Tooth Discoloration / Q000139:chemically induced*
chemical_list: D017607:Aluminum Compounds; D017610:Calcium Compounds; D002130:Calcium Phosphates; D003738:Dental Cements; D004338:Drug Combinations; C550603:EndoSequence root repair material; D010087:Oxides; D017640:Silicates; C086631:mineral trioxide aggregate; C506393:tricalcium silicate
keywords: Biodentine; EndoSequence Root Repair Material; calcium silicate–based cements; mineral trioxide aggregate; tooth discoloration