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Dental discoloration caused by bismuth oxide in MTA in the presence of sodium hypochlorite

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Abstract

Objectives

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.

Materials and methods

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.

Results

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.

Conclusions

MTA Angelus in contact with a tooth previously immersed in sodium hypochlorite resulted in colour alteration at the cement/dentine interface.

Clinical relevance

MTA Angelus should not be used after irrigation with sodium hypochlorite as this will result in tooth discoloration.

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Acknowledgments

Authors acknowledged the University of Malta Research Grant committee and the Faculty of Dental Surgery for the funding; Ing. James Camilleri of the Department of Metallurgy and Materials Engineering, Faculty of Engineering, University of Malta for his technical expertise; and ERDF (Malta) for the financing of the testing equipment through the project: “Developing an Interdisciplinary Material Testing and Rapid Prototyping R&D Facility” (Ref. no. 012). This work was supported by the State of São Paulo Research Foundation (FAPESP 2013/04054-8 and 2011/13573-3).

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Dentistry, Dental School of Bauru, University of São Paulo - USP, Bauru, SP, Brazil

    Marina Angélica Marciano & Marco Antonio Hungaro Duarte

  2. Department of Restorative Dentistry, Faculty of Dental Surgery, Medical School, University of Malta, Msida, MSD 2090, Malta

    Josette Camilleri

Authors
  1. Marina Angélica Marciano
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  2. Marco Antonio Hungaro Duarte
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  3. Josette Camilleri
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Correspondence to Josette Camilleri.

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Marciano, M.A., Duarte, M.A.H. & Camilleri, J. Dental discoloration caused by bismuth oxide in MTA in the presence of sodium hypochlorite. Clin Oral Invest 19, 2201–2209 (2015). https://doi.org/10.1007/s00784-015-1466-8

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  • DOI: https://doi.org/10.1007/s00784-015-1466-8

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