Clinical Oral Investigations

, Volume 23, Issue 3, pp 1281–1286 | Cite as

Ability of two single-step restorative materials to avoid crown darkening caused by intracanal minocycline paste

  • Ane PolyEmail author
  • Fernando Marques
  • Sandra R. Fidel
  • Antonio Fernando Monnerat
  • Luciana M. Sassone
Original Article



This study aimed to quantitatively assess the ability of two single-step restorative materials to avoid crown darkening caused by the use of minocycline as an intracanal medicament.

Materials and methods

After coronal access and instrumentation, 120 maxillary incisors were divided into four groups (n = 30). Two experimental groups according to the restorative material applied to the inner walls of the access cavity: OB, OptiBond All-In-One + minocycline intracanal paste; U200, RelyX U200 + minocycline intracanal paste. Two control groups without restorative materials: MIN, minocycline intracanal paste and SL, saline intracanal. Color determination was performed using a spectrophotometer at five time points, immediately after materials were applied (baseline), and at 7, 14, 21, and 28 days from the baseline.


Decrease in the mean values of L* (luminosity) was observed after insertion of minocycline paste in all groups at all time points. Statistically significant differences were absent between the time points (P > .05). After 28 days, MIN showed significantly more darkening (ΔL*) (− 10.6 ± 7.3) than OB (− 5.4 ± 6.2), U200 (− 5.8 ± 3.9) and SL (− 2.3 ± 1.2) (P < .05).


Crown darkening can be minimized by the previous application of RelyX U200 or OptiBond All-In-One to the inner walls of the access cavity before a minocycline-containing paste is applied as an intracanal medication.

Clinical relevance

The American Association of Endodontists Clinical Considerations for Regenerative Procedures in necrotic immature teeth suggests the triple antibiotic paste as an intracanal medication (2018). However, discoloration and crown darkening are common unfavorable outcomes. The clinical protocol suggested in this paper has shown to be able to minimize crown darkening, predictably leading to a better patient-centered clinical success.


Dentin-bonding agent Discoloration Minocycline Regenerative endodontic therapy Revascularization Triple antibiotic paste 



The work was supported by the FAPERJ (Proc. E-26/202.839/2015).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by a panel from Pedro Ernesto University Hospital/Rio de Janeiro State University Ethical Committee (CAAE no. 24840413.8.0000.5259/CEP-HUPE).

Informed consent

For this type of study, formal consent is not required.


  1. 1.
    Nygaard-Østby B (1961) The role of the blood clot in endodontic therapy: an experimental histological study. Acta Odontol Scand 79:333–349Google Scholar
  2. 2.
    Nygaard-Ostby B, Hjortdal O (1971) Tissue formation in the root canal following pulp removal. Scand J Dent Res 79:333–348Google Scholar
  3. 3.
    Banchs F, Trope M (2004) Revascularization of immature permanent teeth with apical periodontitis: new treatment protocol? J Endod 30:196–200CrossRefGoogle Scholar
  4. 4.
    Trope M (2008) Regenerative potential of dental pulp. J Endod 34:S13–S17CrossRefGoogle Scholar
  5. 5.
    Hargreaves KM, Diogenes A, Teixeira FB (2013) Treatment options: biological basis of regenerative endodontic procedures. J Endod 39(38):S30–S43CrossRefGoogle Scholar
  6. 6.
    Skoglund A, Tronstad L (1981) Pulpal changes in replanted and autotransplanted immature teeth of dogs. J Endod 7:309–316CrossRefGoogle Scholar
  7. 7.
    Cvek M (1992) Prognosis of luxated non-vital maxillary incisors treated with calcium hydroxide and filled with gutta-percha. A retrospective clinical study. Endod Dent Traumatol 8:45–55CrossRefGoogle Scholar
  8. 8.
    Fouad AF, Nosrat A (2013) Pulp regeneration in previously infected root canal space. Endod Top 28:24–37CrossRefGoogle Scholar
  9. 9.
    Hoshino E, Kurihara-Ando N, Sato I et al (1996) In-vitro antibacterial susceptibility of bacteria taken from infected root dentine to a mixture of ciprofloxacin, metronidazole and minocycline. Int Endod J 29:125–130CrossRefGoogle Scholar
  10. 10.
    Parasuraman VR, Muljibhai BS (2012) 3Mix-MP in endodontics—an overview. IOSR-JDMS 3:36–45CrossRefGoogle Scholar
  11. 11.
    Takushige T, Hataoka H, Ando M, Hoshino E (2009) Endodontic retreatment using 3Mix-MP without removal of previous root canal obturation. J LSTR Ther 8:3–7Google Scholar
  12. 12.
    Dental Professional Community of American Association of Endodontists (2013) Regenerative endodontics. IOP Publishing American Association of Endodontists (AAE). Accessed 22 March 2018
  13. 13.
    Dental Professional Community of American Association of Endodontists (2018) AAE Clinical Considerations for Regenerative Endodontic Procedures Revised 4/1/2018. IOP Publishing American Association of Endodontists (AAE). Accessed 23 May 2018
  14. 14.
    Reynolds K, Johnson J, Cohenca N (2009) Pulp revascularization of necrotic bilateral bicuspids using a modified novel technique to eliminate potential coronal discolouration: a case report. Int Endod J 42:84–92CrossRefGoogle Scholar
  15. 15.
    Petrino J, Boda K, Shambarger S et al (2010) Challenges in regenerative endodontics: a case series. J Endod 36:536–541CrossRefGoogle Scholar
  16. 16.
    Nosrat A, Seifi A, Asgary S (2011) Regenerative endodontic treatment (revascularization) for necrotic immature permanent molars: a review and report of two cases with a new biomaterial. J Endod 37:562–567CrossRefGoogle Scholar
  17. 17.
    Porter ML, Münchow EA, Albuquerque MT et al (2016) Effects of novel 3-dimensional antibiotic-containing electrospun scaffolds on dentin discoloration. J Endod 42:106–112CrossRefGoogle Scholar
  18. 18.
    Thelen DS, Trovik TA, Bardsen A (2011) Impact of traumatic dental injuries with unmet treatment need on daily life among Albanian adolescents: a case-control study. Dent Traumatol 27:88–94CrossRefGoogle Scholar
  19. 19.
    Viegas CM, Scarpelli AC, Carvalho AC, Ferreira Fde M, Pordeus IA, Paiva SM (2012) Impact of traumatic dental injury on quality of life among Brazilian preschool children and their families. Pediatr Dent 34:300–306Google Scholar
  20. 20.
    Krisdapong S, Prasertsom P, Rattanarangsima K, Sheiham A (2014) Associations between perceived needs for dental treatment, oral health-related quality of life and oral diseases in school-aged Thai children. Community Dent Oral Epidemiol 42:323–332CrossRefGoogle Scholar
  21. 21.
    Miller EK, Lee JY, Tawil PZ, Teixeira FB, Wann WF Jr (2012) Emerging therapies for the management of traumatized immature permanent incisors. Pediatr Dent 34:66–69Google Scholar
  22. 22.
    McTigue DJ, Subramanian K, Kumar A (2013) Management of immature permanent teeth with pulpal necrosis-a case series. Pediatr Dent 35:55–60Google Scholar
  23. 23.
    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 36:1086–1091CrossRefGoogle Scholar
  24. 24.
    Kirchhoff AL, Raldi DP, Salles AC, Cunha RS, Mello I (2015) Tooth discolouration and internal bleaching after the use of triple antibiotic paste. Int Endod J 48:1181–1187CrossRefGoogle Scholar
  25. 25.
    Santos LG, Felippe WT, Souza BD et al (2017) Crown discoloration promoted by materials used in regenerative endodontic procedures and effect of dental bleaching: spectrophotometric analysis. J Appl Oral Sci 25:234–242CrossRefGoogle Scholar
  26. 26.
    Shokouhinejad N, Khoshkhounejad M, Alikhasi M, Bagheri P, Camilleri J (2017) Prevention of coronal discoloration induced by regenerative endodontic treatment in an ex vivo model. Clin Oral Investig 22:1725–1731. CrossRefGoogle Scholar
  27. 27.
    Samra APB, Pereira SK, Delgado LC, Borges CP (2008) Color stability evaluation of aesthetic restorative materials. Braz Oral Res 22:205–210CrossRefGoogle Scholar
  28. 28.
    Seghi RR, Johnston WM, O’Brien WJ (1986) Spectrophotometric analysis of color differences between porcelain systems. J Prosthet Dent 56:35–40CrossRefGoogle Scholar
  29. 29.
    Kahler B, Rossi-Fedele G, Chugal N, Lin LM (2017) An evidence-based review of the efficacy of treatment approaches for immature permanent teeth with pulp necrosis. J Endod 43:1052–1057CrossRefGoogle Scholar
  30. 30.
    Hargreaves KM, Geisler T, Henry M, Wang Y (2008) Regeneration potential of the young permanent tooth: where does the future hold? J Endod 34:S51–S56CrossRefGoogle Scholar
  31. 31.
    Thibodeau B, Trope M (2007) Pulp revascularization of a necrotic infected immature permanent tooth: case report and review of the literature. Pediatric Dent 29:47–50Google Scholar
  32. 32.
    Trope M (2010) Treatment of the immature tooth with a non-vital pulp and apical periodontitis. Dent Clin N Am 54:313–324CrossRefGoogle Scholar
  33. 33.
    Tanase S, Tsuchiya H, Yao J, Ohmoto S, Nobuhiko Takagi, Yoshida S (1998) Reversed-phase ion-pair chromatographic analysis of tetracycline antibiotics aplication to discolored teeth. J Chromatogr B 706:279–285CrossRefGoogle Scholar
  34. 34.
    Thompson A, Kahler B (2010) Regenerative endodontics—biologically-based treatment for immature permanent teeth: a case report and review of the literature. Aust Dent J 55:446–452CrossRefGoogle Scholar
  35. 35.
    Kahler B, Mistry S, Moule A, Ringsmuth AK, Case P, Thomson A, Holcombe T (2014) Revascularization outcomes: a prospective analysis of 16 consecutive cases. J Endod 40:333–338CrossRefGoogle Scholar
  36. 36.
    Kahler B, Rossi-Fedele G (2016) A review of tooth discoloration after regenerative endodontic therapy. J Endod 42:563–569CrossRefGoogle Scholar
  37. 37.
    Culpepper WD (1970) A comparative study of shade-matching procedures. J Prosthet Dent 24:166–173CrossRefGoogle Scholar
  38. 38.
    Donahue JL, Doodking RJ, Shcawabacher WB, Aeppli DP (1991) Shade color discrimination by men and women. J Prosthet Dent 65:699–703CrossRefGoogle Scholar
  39. 39.
    Paul S, Peter A, Pietrobon N, Hämmerle CHF (2002) Visual and spectrophotometric shade analysis of human teeth. J Dent Res 81:578–582CrossRefGoogle Scholar
  40. 40.
    Browning WD, Chan DC, Blalock JS, Brackett MG (2009) A comparison of human raters and an intraoral spectrophotometer. Oper Dent 34:337–343CrossRefGoogle Scholar
  41. 41.
    Lehmann KM, Igiel C, Schmidtmann I, Scheller H (2010) Four color-measuring devices compared with a spectrophotometric reference system. J Dent 38:e65–e70CrossRefGoogle Scholar
  42. 42.
    Mehl A, Bosch G, Fischer C, Ender A (2017) In vivo tooth-color measurement with a new 3D intraoral scanning system in comparison to conventional digital and visual color determination methods. Int J Comput Dent 20:343–361Google Scholar
  43. 43.
    Peutzfeldt A, Asmussen E (2002) Adhesive systems: effect on bond strength of incorrect use. J Adhes Dent 4:233–242Google Scholar
  44. 44.
    Kim-Pusateri S, Brewer JD, Davis EL, Wee AG (2009) Reliability and accuracy of four dental shade-matching devices. J Prosthet Dent 101:193–199CrossRefGoogle Scholar
  45. 45.
    Peutzfeldt A, Vigild M (2001) A survey of the use of dentin-bonding systems in Denmark. Dent Mater 17:211–216CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Proclin Department, School of DentistryRio de Janeiro State UniversityRio de JaneiroBrazil

Personalised recommendations