sodium-hypochlorite and Tooth-Discoloration

A major cause of crown discoloration is root canal sealer remnants in the pulp chamber, after root canal obturation. The aim of this study was the evaluation of the chromogenic effect of common and new-generation root canal sealers. The tested null hypothesis was that none of the sealers induced clinically perceptible crown discoloration, ex vivo (H(0): CIE color difference ∆Ε < 3.7).. The crowns of 80 intact, fully developed third mandibular molars were cross-sectioned 1 mm below the cementoenamel junction and stored in standard conditions (100 % humidity, 37 °C). The pulp chambers were chemomechanically debrided with hand files and sodium hypochlorite (NaOCl) and the specimens were randomly assigned into four experimental (1-4) and one control (5) groups. In the experimental groups, the internal axial walls of the pulp chambers were coated with sealers (Group 1; Roth 811, Group 2; AH26, Group 3; GuttaFlow, Group 4; Epiphany SE). The pulp chambers of the control group (Group 5) remained unfilled. The spectral reflectance lines of the crowns were recorded by a UV-Vis spectrophotometer. CIE total color differences [Formula: see text] were calculated after 1 week, 1 month, 3 months, and 6 months, respectively. A pilot study was also conducted for the validation of the experimental model. Two-way mixed ANOVA models were used for statistical data analysis.. The experimental model presented values of ∆Ε < 1 unit and high positive correlation values, after repeated measurements (p < 0.05). Roth 811 sealer (Group 1) induced clinically perceptible crown discoloration (∆Ε > 3.7, p < 0.05) and presented statistically significant differences from Groups 2-5 in all examination intervals (p < 0.05). In Groups 2-5, clinically perceptible crown discoloration was not observed (∆Ε < 3.7, p < 0.05).. Roth 811 sealer exhibited severe discoloration effects. Within the limitations of this study, it can be concluded that any sealer remnants should be removed from the pulp chamber after root canal obturation and before placement of a final restoration.. The chromogenic potential may play an important role in selecting proper root canal sealers.

Topics: Bismuth; Chromogenic Compounds; Color; Dental Pulp Cavity; Dimethylpolysiloxanes; Drug Combinations; Epoxy Resins; Gutta-Percha; Humans; Materials Testing; Molar; Pilot Projects; Root Canal Filling Materials; Root Canal Irrigants; Root Canal Preparation; Silver; Sodium Hypochlorite; Spectrophotometry, Ultraviolet; Time Factors; Titanium; Tooth Crown; Tooth Discoloration; Zinc Oxide-Eugenol Cement

The objectives of this in vitro study, is to evaluate the influence of various dentin treatment procedures prior to bleaching namely, demineralization and demineralization in conjunction with deproteinization on the dentin permeability and bleaching efficacy.. The study used a total of 40 sound premolars, which were sectioned longitudinally, and their color coefficients and absorption spectrum was recorded and used as control values for the later study. These dentin samples were then discolored by blood and their color coefficients and absorption spectrum were calibrated. They were then divided into two Groups with 20 samples each per group. Group A--dentin samples were demineralized prior to bleaching. Group B--dentin samples were deproteinized also in conjunction to demineralization prior to bleaching. The values of color coefficient and absorption spectrum were determined using Spectrophotometer for samples of each group respectively.. There were significantly higher color coefficient and absorption spectrum values in the group where dentin was treated with demineralization in conjunction with deproteinization prior to bleaching when compared to the group where dentin was treated by demineralization alone prior to bleaching.. Demineralization in conjunction with deproteinization has proven to be a good method of increasing dentin permeability for achieving a higher bleaching efficacy.

Topics: Acid Etching, Dental; Adolescent; Blood; Borates; Child; Collagen; Color; Dentin; Dentin Permeability; Humans; Hydrogen Peroxide; Materials Testing; Oxidants; Phosphoric Acids; Protein Denaturation; Sodium Hypochlorite; Spectrophotometry; Tooth Bleaching; Tooth Discoloration

The objective of this study was to evaluate the clinical efficacy of 5% sodium hypochlorite solution for removal of stains caused by dental fluorosis in young patients. A clinical trial involved 33 patients with diffuse opacities on the enamel surfaces of maxillary incisors due to effects of dental fluorosis. The protocol of treatment 3 steps: (1) cleaning and enamel etching with 37% phosphoric acid in order to eliminate the layer that covers the fluorotic enamel surface and allow better penetration of the bleaching agent, (2) application of 5% sodium hypochlorite to remove stains caused by organic material, and (3) filling the opened micro-cavities with a light-cured, composite surface sealant to prevent restaining. The whiteness of the enamel lesions before and after treatment were expressed in L*, a*, and b* color space measurements using a Minolta Chroma Meter CR300. Analysis of parameters of [symbol:see text]E (L*, a*, b*) showed that changes were observed in the L* (brightness) and a* (redness), which paralleled the [symbol: see text]E differences. There was no significant difference in the b* (yellow) parameter. The technique described in this study appears to have advantages over other methods for improving the appearance of fluorotic lesions. It is simple, low cost, non invasive so the enamel keeps its structure, relatively rapid, and safe; it requires no special materials, and it can be used with safety on young permanent teeth.

Topics: Acid Etching, Dental; Child; Colorimetry; Female; Fluorosis, Dental; Humans; Male; Oxidants; Resin Cements; Sodium Hypochlorite; Tooth Bleaching; Tooth Discoloration

This study demonstrated a quantitative method for assessing the effect of a tooth whitening agent. Forty human teeth were stained with a tea solution, and randomly assigned to two groups (A, B) of twenty teeth. The teeth were subsequently treated with either sodium hypochlorite (NaOCL) or deionized distilled water (DDW) by intermittent immersion (60 seconds on each occasion) in a 1:10 dilution of NaOCL (group A) or DDW (group B). Prior to whitening and following each immersion, the color of the teeth at the stained spot was measured using ShadeEye-Ex Dental Chroma Meter and quantitative light-induced fluorescence (QLF). ShadeEye-Ex instantly gave a numerical value for the stain intensity, chroma (C), which is the average of three measurements taken automatically by the machine. QLF gave a quantitative value for the stain, delta Q (% mm2), following analysis of the fluorescence image of the tooth. Immersion was stopped after four readings when one specimen, in group A, was observed to have regained its natural color. There was a good correlation between C and delta Q with either NaOCL (Pearson correlation coefficient (r) = 0.974; p < 0.05) or DDW (r = 0.978; p < 0.05). With NaOCL, an inverse relationship observed between stain measurements, C (Linear fit correlation (R) = -0.982; p < 0.05) or delta Q (R = -0.988; p < 0.05) and exposure time correlated to a linear fit, but not with DDW. ANOVA showed a significant difference between the means (n = 20) of the reading at the measurement intervals (0, 60, 120 and 180 seconds) for both C (p < 0.001) and delta Q (p < 0.001) with NaOCL but not with DDW. In conclusion, the study highlighted the potential of ShadeEye-Ex Dental Chroma Meter as a tool for the quantitative assessment of the gradual change in shade of discolored teeth by tooth whitening products.

Topics: Analysis of Variance; Color; Colorimetry; Fluorescence; Humans; Immersion; Linear Models; Oxidants; Sodium Hypochlorite; Tea; Time Factors; Tooth; Tooth Bleaching; Tooth Discoloration; Water

The aim of this study was to evaluate specific chromatic alterations induced by white mineral trioxide aggregate after final irrigation with sodium hypochlorite. Sixty specimens were prepared mechanically and filled with mineral trioxide aggregate after different final irrigation protocols: Group 1 - distilled water, Group 2 - sodium hypochlorite followed by distilled water, Group 3 - sodium hypochlorite, only. Colour changes were recorded with a spectrophotometer at baseline, and then after 1, 2 and 4 months. The Commision Internationale de l'éclairage colour system was used and the total colour changes ΔE were calculated. In groups where sodium hypochlorite was used, parameter L* decreased significantly after the first month (Group 2 (P < 0.006), Group 3 (P < 0.009)). Group 3 demonstrated greater colour change ΔE than Group 1, after the first month (P < 0.02). In conclusion, white mineral trioxide aggregate can lead to tooth discolouration by contact with sodium hypochlorite residues in dentinal tubules.

Topics: Aluminum Compounds; Calcium Compounds; Drug Combinations; Oxides; Silicates; Sodium Hypochlorite; Tooth Discoloration

The aim of this in vitro study was to compare the various techniques for removing precipitate formed after irrigation with sodium hypochlorite (NaOCl) and chlorhexidine (CHX).. It is still unclear whether different irrigant activation systems can effectively remove precipitate that is firmly attached to the root canal walls.. Eighty-two extracted single-rooted human teeth were instrumented by using the ProTaper rotary system. The roots were irrigated with 5% NaOCl and then 2% CHX to form orange-brown precipitate on the root canal walls. The teeth were sectioned longitudinally, and the amount of precipitate on the canal walls was measured under a stereomicroscope at 15 × magnification before the root halves were reassembled. Then, conventional syringe irrigation (CSI), CanalBrush (CB), EndoActivator (EA) system, photon-induced photoacoustic streaming (PIPS), and manual instrumentation (MI) techniques were used to remove the precipitate, during which 5 mL of distilled water was used for 1 min. The amount of precipitate remaining on the canal walls was measured, and the percentage of precipitate removed was calculated. Data were analyzed by using the Kruskal-Wallis and Mann-Whitney U tests (p = 0.05).. All experimental groups contained residual precipitate. The precipitate was more effectively removed in the MI group than in the other groups (p < 0.05). The CB and EA groups showed better removal than the CSI and PIPS groups (p < 0.05), and there were no significant differences in removal between these latter two groups (p > 0.05).. None of the techniques used was able to completely remove the orange-brown precipitate from the root canal surfaces.

Topics: Anti-Bacterial Agents; Chlorhexidine; Humans; In Vitro Techniques; Microscopy, Electron, Scanning; Root Canal Irrigants; Root Canal Preparation; Sensitivity and Specificity; Sodium Hypochlorite; Statistics, Nonparametric; Surface Properties; Syringes; Tooth Discoloration

Mineral trioxide aggregate (MTA) used for pulpotomy procedures in immature permanent teeth can reduce treatment to 1 session as opposed to classic calcium hydroxide therapy, which necessitates multiple appointments. The main disadvantage of MTA use is crown discoloration after treatment. The aim of this study was to characterize 3 materials that are used for pulpotomy procedures in immature permanent teeth and assess their color stability in the presence of sodium hypochlorite solution.. Hydrated Neo MTA Plus (Avalon Biomed Inc, Bradenton, FL), MTA Plus (Avalon Biomed Inc), and Biodentine (Septodont, Saint-Maur-des-Fossés, France) were characterized after immersion in Hank's balanced salt solution for 1 day and 28 days using a combination of scanning electron microscopy, energy-dispersive spectroscopy, and X-ray diffraction analysis. The color stability of the 3 materials in contact with water or sodium hypochlorite was evaluated by photography, spectrophotometry, and X-ray diffraction analysis.. All the materials hydrated and produced calcium hydroxide as a by-product of hydration at early age. All materials interacted with synthetic tissue fluid, forming a calcium phosphate phase. MTA Plus exhibited discoloration in contact with sodium hypochlorite.. All the materials tested are suitable to be used in the treatment of immature teeth because they all produced calcium hydroxide, which is necessary to induce dentin bridge formation and continued root formation. Neo MTA Plus and Biodentine are suitable alternatives to MTA, and they do not exhibit discoloration.

Topics: Aluminum Compounds; Calcium Compounds; Drug Combinations; Drug Interactions; Humans; Oxides; Pulp Capping and Pulpectomy Agents; Pulpotomy; Silicates; Sodium Hypochlorite; Tooth Discoloration

The aim of this research was to analyse the dental discolouration caused by mineral trioxide aggregate (MTA) induced by bismuth oxide and also assess the colour stability of other dental cements.. Bismuth oxide, calcium tungstate and zirconium oxide were placed in contact with sodium hypochlorite for 24 h after which they were dried and photographed. Phase analyses were performed by X-ray diffraction (XRD) of radiopacifiers before and after immersion in sodium hypochlorite. Furthermore, teeth previously immersed in water or sodium hypochlorite were filled with MTA Angelus, Portland cement (PC), PC with 20 % zirconium oxide, PC with 20 % calcium tungstate and Biodentine. Teeth were immersed for 28 days in Hank's balanced salt solution after which they were sectioned and characterized using scanning electron microscopy (SEM) with energy-dispersive mapping and stereomicroscopy.. Bismuth oxide in contact with sodium hypochlorite exhibited a change in colour from light yellow to dark brown. XRD analysis demonstrated peaks for radiopacifier and sodium chloride in samples immersed in sodium hypochlorite. The SEM images of the dentine to material interface showed alteration in material microstructure for MTA Angelus and Biodentine with depletion in calcium content in the material. The energy-dispersive maps showed migration of radiopacifier and silicon in dentine.. MTA Angelus in contact with a tooth previously immersed in sodium hypochlorite resulted in colour alteration at the cement/dentine interface.. MTA Angelus should not be used after irrigation with sodium hypochlorite as this will result in tooth discoloration.

Topics: Aluminum Compounds; Bismuth; Calcium Compounds; Dental Cements; Drug Combinations; Materials Testing; Microscopy, Electron, Scanning; Oxides; Silicates; Sodium Hypochlorite; Spectrometry, X-Ray Emission; Surface Properties; Tooth Discoloration; Tungsten Compounds; X-Ray Diffraction; Zirconium

In this 2nd part, the current treatment of white spot lesions by erosion/infiltration is presented, beginning with a reminder of the principle of superficial infiltration, which enables most early carious lesions, fluorosis and post-traumatic lesions to be treated. However, this technique has met with frequent failures in cases of MIH or deep lesions of traumatic origin or those associated with fluorosis. For this reason a new deep infiltration technique is proposed: thanks to its global treatment concept, this enables all white spots to be treated. The place of whitening in these treatment options is discussed, with explanations of the main reasons for its failures.

Topics: Acid Etching, Dental; Composite Resins; Dental Caries; Dental Enamel; Dental Enamel Hypoplasia; Dental Materials; Dental Restoration, Permanent; Enamel Microabrasion; Ethanol; Fluorosis, Dental; Humans; Light-Curing of Dental Adhesives; Resins, Synthetic; Sodium Hypochlorite; Tooth Bleaching; Tooth Discoloration; Tooth Injuries

Antibiotic pastes are used for disinfection in regenerative endodontic procedures. This study evaluated the crown discoloration induced by various antibiotic pastes including the mixture of metronidazole and ciprofloxacin with minocycline, doxycycline, amoxicillin, or cefaclor.. Seventy extracted bovine incisors were sectioned to obtain a standardized root length of 10 mm above the facial cementoenamel junction. After pulp tissue removal, irrigation with sodium hypochlorite and the placement of temporary filling material and cotton pellet were performed from the apical aspect. The specimens were then randomly divided into 7 groups (n = 10 for each group), and each group received the following antibiotic paste fillings: no filling (control group), calcium hydroxide, double antibiotic paste (DAP), triple antibiotic paste (TAP) with minocycline, TAP with doxycycline, TAP with amoxicillin, and TAP with cefaclor. Spectrophotometric readings were obtained on the buccal surfaces of the crown on day 1 to week 3 after filling, and the ΔE value was calculated. Data were analyzed with 2-way analysis of variance and the Tukey post hoc tests (P = .05), and the human perceptibility threshold was set to 3.7.. TAP with minocycline, doxycycline, and cefaclor induced more coronal discoloration compared with the control group (P < .05). The control, calcium hydroxide, and DAP groups showed no color changes exceeding the perceptibility threshold at all time points.. The results indicated that all antibiotic pastes, except DAP, induced crown discoloration.

Topics: Amoxicillin; Animals; Anti-Bacterial Agents; Calcium Hydroxide; Cattle; Cefaclor; Ciprofloxacin; Color Perception; Doxycycline; Metronidazole; Random Allocation; Regeneration; Root Canal Filling Materials; Root Canal Irrigants; Root Canal Preparation; Root Canal Therapy; Sodium Hypochlorite; Spectrophotometry; Time Factors; Tooth Crown; Tooth Discoloration

The purpose of this study was to assess in vitro the tooth color alterations associated with two commonly used endodontic irrigants, the chlorhexidine gluconate (CHX) and the sodium hypochlorite (NaOCl) up to 15 days post-treatment. Additionally, the possible influence of endodontic access preparation on tooth color was investigated.. Thirty intact human anterior teeth were used. Black adhesive tape with a 4 mm diameter window was used to standardize the enamel surface intended for color analysis. After the access cavity, preparation and the initial root canal negotiation with stainless steel hand files, the root canal shaping was completed with rotary nickel-titanium files. The teeth were divided into three groups (n = 10). Conventional syringe irrigation was performed with one irrigant for each group. The enamel surfaces were colorimetrically evaluated before access cavity, after cavity preparation and at 1, 3, 7 and 15 days post-treatment. The CIE color parameters (L*, a*, b*) were recorded and averaged for each material and the corresponding color differences (ΔE) were calculated and statistically analyzed.. The most significant factor in tooth color alteration, during the endodontic treatment, was the access preparation. CHX and NaOCl caused tooth color changes comparable with the saline. CHX and NaOCl did not increase the tooth color changes relative to the values induced by the access preparation.. The two endodontic irrigants were not able to induce tooth color alteration to a greater extent than the access preparation.. Chlorhexidine and NaOCl cannot be considered as discoloring endodontic materials. The most contributing factor in tooth color alteration during endodontic treatment in the anterior teeth is access preparation.

Topics: Chlorhexidine; Color; Colorimetry; Dental Alloys; Dental Enamel; Equipment Design; Humans; Materials Testing; Nickel; Random Allocation; Root Canal Irrigants; Root Canal Preparation; Sodium Chloride; Sodium Hypochlorite; Stainless Steel; Time Factors; Titanium; Tooth; Tooth Discoloration

To determine whether sodium hypochlorite (NaOCl) with 0.2% chlorhexidine gluconate (CHX) leads to colour change and precipitate formation, and to ultrastructurally analyse the dentine surface after simultaneous irrigation with 0.5% NaOCl and 0.2% CHX. Four tubes in which 5ml of different NaOCl concentrations and 5ml 0,2% CHX were placed, were observed every 15 minutes in the first two hours and after 7 days. Mixture solutions were centrifuged at 800 rpm/4 min. A precipitate is observed under light-microscopy. Thirty-five single-rooted teeth were instrumented using crown-down technique with irrigation: Positive control: distilled water, Negative control: 0,5% NaOCl+15% EDTA, Experimental group: identical to the negative control, then canals were treated with 0.5% NaOCl+0.2% CHX. The longitudinal root sections were observed under scanning-electron-microscopy. The amount of debris was assessed with 5/score-system, and the results were analysed using the Mann-Whitney U test (p < 0.001). Change in colour was noticed immediately after the merger and it did not change with time. Mixture solutions showed considerable turbidity, but precipitate was observed only after centrifugation. Statistical analysis showed a significant difference in the dentinal wall purity when comparing the cervical and middle root canal thirds between the experimental and negative control group. The difference was also observed between the cervical and middle thirds compared to the apical third of the root canal within these groups. Interaction between NaOCl and CHX, as well as the creation of precipitates, depends not only on the concentration of NaOCl, but also on the concentration of CHX.

Topics: Centrifugation; Chemical Precipitation; Chlorhexidine; Color; Dental Pulp Cavity; Dentin; Humans; Microscopy, Electron, Scanning; Nephelometry and Turbidimetry; Root Canal Irrigants; Smear Layer; Sodium Hypochlorite; Statistics, Nonparametric; Tooth; Tooth Discoloration

This study reported red-purple staining of light-exposed, root-treated dentin when root canals were rinsed with 1.3% NaOCl as initial rinse followed by the use of BioPure MTAD as final rinse. This intrinsic dentin staining occurred irrespective of whether the root canals were filled, and could be observed even in crown dentin when the latter was sequentially immersed in NaOCl and MTAD. Bench-top reproductions of the phenomenon revealed that the exothermic reaction is not an acid-base reaction. Conversely, the reaction is of a redox nature that highly resembled the previously reported mechanism of tetracycline staining, in which photo-oxidation of tetracycline resulted in a red-purple tetracycline degradation product that has a high affinity for hydroxyapatite. This photo-oxidative degradation process is probably triggered by the use of NaOCl as an oxidizing agent, and may be prevented by rinsing the NaOCl-treated dentin with ascorbic acid, a reducing agent, before the application of MTAD.

Topics: Antioxidants; Ascorbic Acid; Citric Acid; Dentin; Doxycycline; Humans; Iatrogenic Disease; Oxidants; Oxidation-Reduction; Photochemistry; Polysorbates; Root Canal Irrigants; Sodium Hypochlorite; Tooth Discoloration; Tooth, Nonvital

The aim of this project was to determine the effectiveness of sterilisation methods for dental enamel for use in intra-oral cariogenicity tests, and their possible effect on the degree of demineralisation of enamel. Bovine incisors were cut vertically into five portions and each assigned to one of five groups. Group 1 was used as a control while the other four groups were subjected, respectively, to gamma irradiation ( congruent with 25kGy), steam autoclaving (121 degrees C for 15 min), sodium hypochlorite (12% w/v for 24h) and povidone-iodine (7.5% w/v for 24h). Total viable counts of microorganisms remaining following sterilisation of the specimens were performed following incubation of the specimens for 24h at 37 degrees C. Caries-like lesions were produced in each specimen using an acidic buffer solution (pH4.5). Sections were cut from each specimen, ground to 80-microgram thickness, and microradiographed. Mineral loss and lesion depth were quantified using transverse microradiography. Statistical analysis was by ANOVA. Dunnett's and Tukey's tests. Microbial growth (Staphylococcus aureus and bacilli) was observed only in control specimens in both brain heart infusion broth and on blood agar plates. The sterilisation methods affected the enamel surface as follows: gamma irradiation (cream discolouration), NaOCl (bleaching), and povidone-iodine (white spot-like lesion). Compared with the control, there was no significant difference in mineral loss and lesion depth with any of the groups, but the numerical values of mineral loss and lesion depth in groups can be ranked as follows: gamma irradiation

Topics: Acids; Analysis of Variance; Animals; Anti-Infective Agents, Local; Bacillus; Buffers; Cattle; Colony Count, Microbial; Dental Caries; Dental Enamel; Disinfectants; Gamma Rays; Microradiography; Minerals; Povidone-Iodine; Sodium Hypochlorite; Staphylococcus aureus; Steam; Sterilization; Tooth Demineralization; Tooth Discoloration

Many patients suffer from tooth discoloration, a condition that produces more psychological distress than generally thought, especially when the anterior teeth are involused. In this study, tests were carried out to determine the effect of various agents applied discolored teeth for bleaching. Blood, colored tissue fluids I and II, attached to filter papers after being naturally exposed for a week were selected as object bleaching. Each subject was soaked in 30% hydrogen peroxide solution (30%H2O2), 3% hydrogen peroxide (3%H2O2), sodium hypochlorite solution (NaOCl), sodium perborate (NaBO3) and combination of them, then effect of agents were observed according to time-lapse. The following results were obtained. 1. NaOCl was most effective. 2. The action of 3%H2O2 was slow, showing only a slight bleaching effect after one week. 3. NaBO3 alone did not have any bleaching effect.

Topics: Borates; Hydrogen Peroxide; Sodium Hypochlorite; Tooth Bleaching; Tooth Discoloration

Topics: Dental Pulp; Fluorosis, Dental; Humans; Sodium Hypochlorite; Tetracycline; Tooth Bleaching; Tooth Discoloration

Topics: Humans; Hydrochloric Acid; Hydrogen Peroxide; Sodium Hypochlorite; Tin Fluorides; Tooth Bleaching; Tooth Discoloration

Topics: Adolescent; Child; Humans; Hydrogen Peroxide; Sodium Hypochlorite; Tetracycline; Tooth Discoloration

The sandpaper disk method for removing fluorosis stains from teeth was clinically evaluated in 93 teeth in 22 patients. A bleaching solution was first applied to the teeth, and then a sandpaper disk in a straight handpiece was rotated on the stained enamel surface. None of the patients complained of discomfort during or after the bleaching procedure.

Topics: Adolescent; Adult; Child; Child, Preschool; Ethers; Female; Fluorosis, Dental; Humans; Hydrochloric Acid; Hydrogen Peroxide; Male; Sodium Hypochlorite; Tooth Bleaching; Tooth Discoloration

Topics: Hydrogen Peroxide; Sodium Hypochlorite; Tooth Bleaching; Tooth Discoloration

Topics: Dentistry; Root Canal Therapy; Sodium Hypochlorite; Sulfathiazoles; Tooth Discoloration