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Spectrophotometric insights: calcium hydroxide influences tooth discolorations induced by short-term application of antibiotic/corticosteroid pastes

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Abstract

Objectives

This in vitro study aimed to assess the influence of a calcium hydroxide dressing regarding the relative color change (ΔE) of enamel–dentin specimens previously exposed to antibiotic/corticosteroid pastes.

Materials and methods

Eighty bovine enamel–dentin specimens with a cylindrical central cavity were randomly allocated to four groups: NEG (empty), POS (blood), LED (Ledermix), and ODO (Odontopaste) (n = 20 each). The materials were applied and sealed with self-adhesive resin luting material. After 3 weeks, the materials were removed and a calcium hydroxide (Ca(OH)2) dressing was placed in all cavities. After a further 3-week storage period, the cavities were restored with resin-based composite. Spectrophotometric color measurements were taken over 6 months, and ΔE values were calculated. A Tukey’s multiple comparison test was performed to assess significant differences within the treatment groups (p < 0.05).

Results

Tooth discolorations were present after 3 weeks in LED (ΔE 29.14 ± 6.55) and POS (ΔE 18.05 ± 7.03); NEG and ODO remained color stable (ΔE 3.2 ± 1.36 and ΔE 2.3 ± 1.16). The 3-week Ca(OH)2 dressing decreased discolorations of POS (ΔE 15.93 ± 6.63; p = 0.37), whereas LED showed a further significant increase (ΔE 39.55; p < 0.0001). Between the end of the Ca(OH)2 dressing and the final restoration no significant color changes were observed in any group (p > 0.9).

Conclusions

Discolorations induced by LED progressed during the Ca(OH)2 dressing despite careful removal of all residues.

Clinical relevance

Calcium hydroxide might negatively affect the discoloring potential of Ledermix. This highlights the need for direct intracanal application methods of Ledermix ensuring a material-free access cavity or alternative antibiotic/corticosteroid pastes such as Odontopaste should be used.

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Author information

Author notes

  1. Florin Eggmann and Jeremy Rihs contributed equally to this work.

Authors and Affiliations

  1. Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine Basel, University of Basel, Basel, Switzerland

    Florin Eggmann, Jeremy Rihs & Roland Weiger

  2. Department of Reconstructive Dentistry, University Center for Dental Medicine Basel, University of Basel, Basel, Switzerland

    Patrik Lenherr & Lucia K. Zaugg

  3. Department of Operative Dentistry and Periodontology and Center of Dental Traumatology, University Hospital of Würzburg, Würzburg, Germany

    Gabriel Krastl

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  1. Florin Eggmann
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  4. Roland Weiger
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Correspondence to Lucia K. Zaugg.

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This article does not contain any studies with human participants by any of the authors. The tooth specimens were obtained from slaughtered calves at the slaughterhouse Bell AG (Oensingen, Switzerland). The present investigation was conducted in conformity with the principles set forth in the World Medical Association’s Statement on Animal Use in Biomedical Research.

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Eggmann, F., Rihs, J., Lenherr, P. et al. Spectrophotometric insights: calcium hydroxide influences tooth discolorations induced by short-term application of antibiotic/corticosteroid pastes. Clin Oral Invest 25, 1141–1149 (2021). https://doi.org/10.1007/s00784-020-03414-1

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