Quantifying Coronal Permanent Tooth Discoloration Caused by Different Pulpotomy Materials

Abstract

Introduction: Bioceramic materials, gray and white mineral trioxide aggregate (GMTA, WMTA), have been shown to have high rates of success in various endodontic applications. A major drawback is their tendency to discolor teeth compared to Biodentine (BD), that has been claimed not to discolor teeth. The aim of this study was to compare tooth discoloration after applying different pulpotomy base materials (BD, GMTA and WMTA). Study design: Forty human incisors teeth were used in this study. Coronal access was achieved by a Tungsten Carbide drill, and the pulp chambers were accessed and chemo-mechanically debrided. Each material was placed in the pulp chamber, up to the cervical sectioning level. All specimens were incubated at 37°C and 100% humidity for three months and have been evaluated before the study and weekly. Color was assessed according to the CIE L*a*b* color space system. Results: ΔE of all experimental groups (GMTA, WMTA and BD) were significantly different from the control group at all time points (P<0.05). Color changes in the GMTA and WMTA groups, had no statistically significant differences, but showed higher discoloration compared to BD group in the cervical part of the crown, since week 1 (P<0.05). WMTA group showed significant discoloration in the cervical part as of week 1 (P<0.05), and gradually increased over time (Figure 2). BD group showed no significantly discoloration over time. GMTA group showed the significant discoloration at week 1 and week 14 (P<0.05). Conclusions: both GMTA and WMTA pulpotomy materials may discolor tooth structure over time in an extracted permanent anterior tooth model. When choosing bioceramic pulpotomy material, BD may be preferable in esthetic area.