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Table of Contents   
ORIGINAL ARTICLE  
Year : 2011  |  Volume : 14  |  Issue : 3  |  Page : 287-292
Evaluation of the effect of various beverages and food material on the color stability of provisional materials - An in vitro study


1 Department of Prosthodontics, Guru Nanak Dev Dental College, Sunam, Punjab, India
2 Department of Conservative Dentistry and Endodontics, Guru Nanak Dev Dental College, Sunam, Punjab, India

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Date of Submission04-Oct-2010
Date of Decision28-Apr-2011
Date of Acceptance28-May-2011
Date of Web Publication10-Oct-2011
 

   Abstract 

Aim: This study evaluated the color stability of four provisional materials: 1) Poly-methyl methacrylates (DPI); 2) Bis-acryl composite (ProtempTM II - 3M ESPE); 3) Bis-acryl composite (Systemp; c and b - Ivoclar Vivadent) and 4) Light polymerized composite resin (Revotek LC- GC).
Materials and Methods: The color and color difference of each specimen after immersion in different staining solutions i.e. 1) tea and artificial saliva, 2) coffee and artificial saliva, 3) Pepsi and artificial saliva, 4) turmeric solution and artificial saliva was measured using reflectance spectrophotometer with CIELAB system before immersion and after immersion at 2, 5 ,7 , 10 and 15 days.
Results: Revotek LC- GC (light polymerized composite resin) was found to be the most color stable provisional restorative material followed by Protemp II (Bis-acryl composite), Systemp (Bis-acryl composite) and DPI (Methylmethacrylate resin). Turmeric solution had the maximum staining potential followed by coffee, tea and Pepsi.

Keywords: Color change, provisional restorative materials, spectrophotometer

How to cite this article:
Gupta G, Gupta T. Evaluation of the effect of various beverages and food material on the color stability of provisional materials - An in vitro study. J Conserv Dent 2011;14:287-92

How to cite this URL:
Gupta G, Gupta T. Evaluation of the effect of various beverages and food material on the color stability of provisional materials - An in vitro study. J Conserv Dent [serial online] 2011 [cited 2019 Jun 25];14:287-92. Available from: http://www.jcd.org.in/text.asp?2011/14/3/287/85818

   Introduction Top


Provisional restoration is a fixed dental prosthesis designed to enhance esthetics, stabilization or function for a limited period of time, after which it is to be replaced by a definitive dental prosthesis. In esthetically critical areas, the provisional restoration must not only provide an initial shade match, but also must maintain its esthetic appearance over the period of service. Perceptible color change of the provisional restorative material may compromise the acceptability of provisional restorations. Discoloration of provisional materials for fixed prosthodontics may result in patient dissatisfaction and additional expense for replacement. This is particularly problematic when provisional restorations are subjected to colorants during lengthy treatment. Hence, color stability is a significant criterion in the selection of a particular provisional material for use in esthetically critical area.

Various studies have been done in literature to measure the color stability of provisional restorative materials. [1],[2] However, the results obtained in the previous literature are quite contradictory and confusing.

This study was planned to compare the color stability of four most commonly used provisional restorative materials in clinical practice after immersing them in various kinds of beverages and food material.


   Materials and Methods Top


A total of 160 specimens using four different provisional materials measuring 20 mm in diameter and 2 mm in thickness were prepared using a brass mold. The samples were divided into four groups of 40 specimens each according to the material used namely:

Group I - 40 specimens of Polymethylmethacrylate (DPI)

Group II - 40 specimens of Bis-acryl composite resin (Protemp™ II, 3M ESPE)

Group III - 40 specimens of Bis-acryl composite resin (Systemp® c and b, IVOCLAR VIVADENT)

Group IV - 40 specimens of Light polymerized composite resin (Revotek LC-GC)

All the provisional materials were mixed according to the manufacturers' instructions. After polymerization the specimens were grossly trimmed using blue-coded followed by red-coded tungsten carbides (DFS- Germany). Then they were polished using pumice followed by diamond polishing paste (YETI DENTAL).

Baseline Color measurement of all specimens were made using reflectance spectrophotometer (Gretag - Macbeth AG CH-8105 Regensdorf Switzerland) with CIELAB system. This system is based on three parameters; L*, a*, and b* for defining color.

The staining solutions were prepared in the following concentrations:

Tea (Brooke Bond, Mumbai, India)

For preparation of tea solution 2.8 g of tea was added to 150 ml of boiling distilled water.

Coffee (Nescafe, New Delhi, India):

For preparation of coffee solution 2.8 g of coffee was added to 150 ml of boiling distilled water.

Pepsi (Pepsico India Holdings Pvt. Ltd., Nelamangala, India) was used as such.

Turmeric solution (Sakthi, Mullampatti, India)

For preparation of turmeric solution 0.5 g of turmeric was added to 150 ml of distilled water.

Artificial saliva

The artificial saliva was prepared in the laboratory from 0.4 g Sodium chloride (NaCl), 1.21 g Potassium chloride (KCl), 0.78 g Sodium dihydrogen phosphate dihydrate (NaH 2 PO 4 .2H 2 O), 0.005 g Hydrated Sodium sulfide (Na 2 S.9H 2 O), 1 g Urea CO (NH 2 ) 2 and 1000 ml of deionized water. 10 N Sodium hydroxide was added to this mixture until the pH value was measured to be as 6.75 ± 0.15 . Later this mixture was sterilized in the autoclave. [3]

Immersion of specimens in staining solutions

To evaluate the color stability in different solutions, 40 specimens of each group were subdivided into four subgroups of 10 specimens each according to the staining solutions used. The staining solutions used were: [4]

Subgroup I - A mixture of tea (330 ml) and artificial saliva (660 ml)

Subgroup II - A mixture of coffee (330 ml) and artificial saliva (660 ml)

Subgroup III - A mixture of Pepsi (330 ml) and artificial saliva (660 ml)

Subgroup IV - A mixture of turmeric solution (330 ml) and artificial saliva (660 ml)

Specimens were immersed in their respective solutions at 37 o C. In each solution, artificial saliva was used in order to simulate the oral conditions. [2],[4] Temperature was controlled using a thermostatically controlled incubator (Teleco, India). Color measurements were made after 2 days (T2), after 5 days (T5), after 7 days (T7), after 10 days (T10) and after 15 days (T15). Fifteen days is the maximum time duration for which provisional materials may be used. The specimens were rinsed with distilled water for five minutes and blotted dry with tissue paper before color measurement.

Color differences of each specimen were measured by reflectance spectrophotometer. L*, a* and b* values of each specimen after immersion at each specified time interval (T2, T5, T7, T10, T15) were measured three times by placing each specimen on the measuring head and covering with the black cover. The mean values of ΔL*, Δa*, Δb* after three measurements were automatically calculated by the spectrophotometer and recorded. Color difference ΔE was calculated from the mean ΔL*, Δa*, Δb* values for each specimen with the formula:

ΔE = (ΔL* 2 + Δa* 2 + Δb* 2 ) 1/2

where ΔL*, Δa*, Δb* are the differences in L*, a* and b* values before (T0) and after immersion at each time interval T2, T5, T7, T10, T15). The repeatability of measurements was evaluated by computing the mean and standard deviation of 10 repeated measurements of 12 randomly selected specimens.

The mean and standard deviation estimated from the specimens for each subgroup was statistically analyzed. Mean values were compared by one-way analysis of variance (ANOVA). Multiple range test by Tukey-HSD procedure was employed to identify the significant groups at 5% level. In the present study, p≤0.05 was considered as the level of significance. Reliability of the values obtained for color change was assessed by estimating the Intraclass correlation coefficient.


   Results Top


Mean, standard deviation and test of significance of mean values of color change between different subgroups for Group I (DPI)), Group II (Protemp), Group III (Systemp) and Group IV (Revotek LC) are shown in [Table 1], [Table 2], [Table 3] and [Table 4] respectively. Revotek LC provisional restorative material was found to be the most color stable followed by Protemp, Systemp and DPI. Revotek LC showed clinically acceptable color change (ΔE<3.7) with all staining solutions over 15-day period. Protemp and Systemp showed clinically acceptable color change (ΔE<3.7) with all staining solutions except turmeric and artificial saliva over the 15-day period. DPI showed clinically acceptable color change (ΔE<3.7) with all staining solutions except turmeric and artificial saliva only till 7 days. After 7 days till 15 days, staining with tea and artificial saliva and coffee and artificial saliva was clinically unacceptable (ΔE>3.7). Staining with turmeric solution was clinically unacceptable at all time periods. The staining solution with maximum staining potential was turmeric solution with artificial saliva followed by coffee and artificial saliva and tea and artificial saliva and Pepsi and artificial saliva at all time intervals.
Table 1: Mean, standard deviation and test of significance of mean values of color change between different subgroups for group I (DPI)

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Table 2: Mean, standard deviation and test of significance of mean values of color change between different subgroups for group II (Protemp)

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Table 3: Mean, standard deviation and test of significance of mean values of color change between different subgroups for group III (Systemp)

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Table 4: Mean, standard deviation and test of significance of mean values of color change between different subgroups for group IV (Revotek LC)

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Reliability of the values obtained for color change was assessed by estimating the intraclass correlation coefficient. These values had extremely high reproducibility as indicated by interclass correlation coefficients (L*= 1.000, a*= 0.9344, b*=1.000).


   Discussion Top


Discoloration can be evaluated visually and by instrumental techniques (spectrophotometer and colorimeter). [5] Color evaluation by visual comparison has been shown to be unreliable as a result of inconsistencies in color perception specifications among observers. Since instrumental measurements eliminate the subjective interpretation of visual color comparison, Colorimeters and spectrophotometers have been most commonly used to measure color change in dental materials. [6],[7]

Spectrophotometers have been shown to be more accurate in measuring the color change than colorimeters as spectrophotometers contain monochromators and photodiodes that measure the reflectance curve of a product's color every 10 nm or less. [8]

Various studies have reported different thresholds of color difference values above which the color change is perceptible to the human eye. These values ranged from ΔE equal to 1, [9] between 2 and 3, [10] greater than or equal to 3.3 [10] and greater than or equal to 3.7. [5] Values of ΔE between 0 and 2 were imperceptible, values of ΔE in the range of 2 to 3 were just perceptible, values from 3 to 8 were moderately perceptible and the values above 8 were markedly perceptible. [10] A ΔE value of 3.7 or less is considered to be clinically acceptable. [5],[11]

The results of the present study showed that Revotek LC provisional restorative material was most color stable followed by Protemp, Systemp and DPI. There was statistically significant difference in the color change values (ΔE) between the four provisional restorative materials used.

There is no study comparing DPI (polymethyl methacrylate) provisional restorative material with Systemp, Protemp (bis-acrylic composites) and Revotek LC (light cured composite). However, in a study done by Koumjian J and Firtell D, [12] an autopolymerizing methylmethacrylate resin (cold pack) was less color stable than bis-acryl composite (Protemp) whereas two other autopolymerizing methylmethacrylates (Truekit and Duralay) were more color stable than Protemp.

The lower color stability of DPI (polymethyl methacrylate-based resin) may be due to higher resin content [13] and higher porosity [14] of these materials over bis-acryl composites (Systemp and Protemp). According to Turker SB et al, [1] fluid pigment from food and beverages cause higher discoloration in acrylic resins, which are more porous than resin composites. Moreover, Systemp (bis-acryl composite) is automixed by the dispenser gun supplied by the manufacturer instead of hand spatulation. This reduces the amount of air entrapment and porosity leading to higher color stability. [15]

The more significant color change exhibited by the methyl acrylates in comparison to bis-acryl methacrylate resins may be due to higher water sorption (either or both of the processes of adsorption and absorption.). According to Braden M et al, [16] uptake of water by a resin composite is a diffusion-controlled process and occurs largely in resin matrix. Diffusion coefficients are generally lower in composites based on difunctional methacrylates (Systemp and Protemp) compared with methyl methacrylates (DPI) because of higher cross-linked nature of former leading to low water sorption. According to Sham et al, [15] chemical discoloration is caused due to the oxidation of the polymer matrix or oxidation of unreacted double bonds in the residual monomers and the subsequent formation of degradation products from water diffusion. According to Dietschi D et al, [17] materials exhibiting high water sorption values are more easily stained by hydrophilic colorings in aqueous solutions, the water presumably acting as a penetration vehicle.

Moreover, according to the manufacturer [18] Protemp utilizes modified Bowen resin, which corresponds to derivatives of the bis-acryl compounds that have been rendered hydrophobic. This provides for a major reduction in water absorption of these materials and might be the reason for highest color stability of Protemp in all staining solutions. [19]

The highest color stability of light polymerized Revotek LC seems to indicate matrix resin stability of the composites. Highly cross-linked resins exhibit less water absorption. [14]

In the present study, the staining solution with maximum staining potential was turmeric solution and artificial saliva followed by coffee and artificial saliva and tea and artificial saliva at all time intervals. These results are in concurrence with the study done by Stober T and Glide H [20] who showed that turmeric solution and red wine caused the most severe discoloration (ΔE>10) than tea, coffee and mouth rinse over 4 and 8 weeks. Scotti et al,[4] stated that the solution of synthetic saliva and coffee produced greater darkening than tea and artificial saliva at 10 and 30 days period. Also Yannikakis et al, [21] used coffee and tea as staining agents and found that coffee-stained provisional resin restorative materials more than tea.

Staining of resins by fluid pigments and beverages is caused by adsorption or absorption (the uptake of substances into or through tissues) of colorants by resins. [7] Conjugated diarylhepnoids like curcumin are responsible for orange color and highest staining of turmeric solution. According to Hersek N et al, [22] staining by tea and coffee is due to the presence of tannic acid colorant in them. According to Um C and Ruyter E [7] discoloration by tea is due to adsorption of polar colorants from tea whereas discoloration from coffee is due to both the surface adsorption and absorption of colorants. This might be the reason for coffee to be less color stable than tea.

Other factors like surface roughness, wear resistance and polishability can also affect color stability. These should be considered areas of future study.

Thus, in a clinical situation, light cured composites like Revotek LC like should be preferred for long-term provisional restorations (15 days). When provisional restorative materials have to be given for shorter time period (less than 7 days), polymethylmethacrylate resins like DPI and bis-acryl composites like Protemp and Systemp can be used.


   Conclusions Top


Revotek LC (light polymerized composite) is the most color stable provisional restorative material followed by Protemp, Systemp (bis-acryl composites) and DPI (methylmethacrylate resin). Turmeric solution has the maximum staining potential followed by coffee, tea and Pepsi.


   Acknowledgement Top


I am thankful to Dr. H Annapoorani (Professor & HOD, Dept. of Prosthodontics) for her constant support and guidance for my dissertation during Post Graduation. This research work is the further continuation of my dissertation.

 
   References Top

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Correspondence Address:
Gaurav Gupta
Gaurav Dental Care and Implant Centre, Amardeep Hospital, Basant Pura, Nabha - 147201 District Patiala, Punjab
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-0707.85818

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    Tables

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