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Prevention of coronal discoloration induced by regenerative endodontic treatment in an ex vivo model

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Abstract

Objectives

The aim of this study was to assess the effect of sealing the pulp chamber walls with a dentin-bonding agent (DBA) on prevention of discoloration induced by regenerative endodontic procedures (REPs) in an ex vivo model.

Materials and methods

Ninety-six bovine incisors were prepared and randomly divided into two groups. In one group, the pulp chamber walls were sealed with DBA before placement of triple antibiotic paste (TAP) containing minocycline inside the root canals, but in the other group, DBA was not applied. After 4 weeks, the root canals were filled with human blood and each group was then randomly divided into four subgroups (n = 12) according to the endodontic cements placed over the blood clot (ProRoot MTA, OrthoMTA, RetroMTA, or Biodentine). The color changes (∆E) were measured at different steps. The data were analyzed using t test and two-way ANOVA.

Results

The specimens in which dentinal walls of pulp chamber were sealed with DBA showed significantly less coronal discoloration at each step of regenerative treatment (p < 0.001). However, application of DBA did not completely prevent the clinically perceptible coronal color change. Sealing the blood clot with different endodontic cements did not result in significant difference in coronal discoloration (p > 0.05).

Conclusions

Sealing the pulp chamber walls before insertion of TAP decreased coronal discoloration following REP using different endodontic cements but did not prevent it.

Clinical relevance

Discoloration of teeth undergoing REPs is an unfavorable outcome. Considering the significant contribution of TAP containing minocycline to the coronal tooth discoloration even after sealing the pulp chamber walls, the revision of current guidelines in relation to the use of TAP with minocycline might need to be revised.

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Acknowledgements

The authors wish to thank Dr. MJ. Kharrazifard for his assistance in statistical analysis.

Funding

This study was funded by Tehran University of Medical Sciences (grant number: 32011).

Author information

Authors and Affiliations

  1. Department of Endodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran

    Noushin Shokouhinejad, Mehrfam Khoshkhounejad & Parisa Bagheri

  2. Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran

    Noushin Shokouhinejad

  3. Dental Research Center, Dental Implant Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran

    Marzieh Alikhasi

  4. Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran

    Marzieh Alikhasi

  5. School of Dentistry, Institute of Clinical Sciences, College of Medical and Dental Sciences, The University of Birmingham, 5 Mill Pool Way, Edgbaston, Birmingham, B5 7EG, UK

    Josette Camilleri

Authors
  1. Noushin Shokouhinejad
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  2. Mehrfam Khoshkhounejad
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  3. Marzieh Alikhasi
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  4. Parisa Bagheri
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  5. Josette Camilleri
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Corresponding author

Correspondence to Josette Camilleri.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by a panel from the Tehran University of Medical Sciences Ethical Committee (Ethics code: IR.TUMS.VCR.REC.1395.649).

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Shokouhinejad, N., Khoshkhounejad, M., Alikhasi, M. et al. Prevention of coronal discoloration induced by regenerative endodontic treatment in an ex vivo model. Clin Oral Invest 22, 1725–1731 (2018). https://doi.org/10.1007/s00784-017-2266-0

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  • DOI: https://doi.org/10.1007/s00784-017-2266-0

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