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PRESENTED BY
MEENAKSHI DIXIT JR1
ASSESMENT OFTOOTH DISCOLORATION INDUCED BY
BIODENTINE AND WHITE MINERALTRIOXIDE AGGREGATE IN
THE PRESENCE OF BLOOD
Alireza Adl1,2, Samane Javanmardi2, Abbas Abbaszadegan2
1

INTRODUCTION
POOR
ESTHETIC
APPEARAN
CE
AFFECTS
PATIENTS
QUALITY
OF LIFE
ENDODO
NTICALLY
TREATED
TEETH
ASSESMENT OF TOOTH DISCOLORATION INDUCED BY BIODENTINE AND WHITE MINERAL TRIOXIDE AGGREGATE IN THE
PRESENCE OF BLOOD
2

PRESENCE OF BLOOD
Esthetic
Biological
Functional
3

AIM AND OBJECTIVE
WMTA
BIODENTI
NE
PRESENCE OF BLOOD
4

? MTA was first introduced in a gray form
MTA (gMTA), which was associated with
discoloration.To overcome this
shortcoming, white MTA (wMTA) was
developed.
Grey MTA
and white
MTA
? Biodentine, a new calcium silicate-based
material, is a bioactive dentine substitute
with endodontic indications similar to
those of white MTA
Biodentine
PRESENCE OF BLOOD 5

MATERIALS AND METHOD
ASSESMENT OF TOOTH DISCOLORATION INDUCED BY BIODENTINE AND WHITE MINERAL TRIOXIDE AGGREGATE IN THE PRESENCE OF BLOOD
70 permanent
maxillary anterior
teeth and mandibular
premolar teeth
extracted
Teeth were disinfected
by 5.25%sodium
hypochlorite and kept
in normal saline
Root end were
sectioned to obtain
standard root length of
10mm
Root canals were
prepared from apical
aspect to most coronal
aspects of the pulp
chamber
Canal enlargement
done by k type file
followed by 2-6 gate
glidden drill
And the end size 7 para
post drill was used to
prepare canal
6

PRESENCE OF BLOOD
Blood collection
Whole fresh blood sample was collected from
a healthy, consenting volunteer .
The blood collection tubes were sterile and
coated with K2EDTA.
7

4experimental groups
and 2 control group
Biodentine
/saline
Wmta/saline
Saline
moistened
cotton
Biodentine
/blood
Wmta/blood
Blood moistened
cotton
PRESENCE OF BLOOD 8

? Experimental groups, either Angelus MTA or
biodentine was packed through the apical aspect to the most
coronal aspect of the standardized preparation up to the buccal
cemento-enamel junction
? Sterile, customized cylindrical cotton pellets were loosely placed
within the canals from the apical access and saturated with
normal saline solution or blood
PRESENCE OF BLOOD 9

? control groups,
Only cotton pellets were placed within the canals and then
saturated with 0.5 mL of normal saline or blood.
The apical openings were sealed with sticky wax. Every specimen
was placed into a single vial-containing 1 mL of saline .
The vials were stored in an incubator at 37��C during the
experiment.
PRESENCE OF BLOOD
10

11
ASSESMENT OF TOOTH DISCOLORATION INDUCED BY BIODENTINE AND WHITE MINERAL TRIOXIDE AGGREGATE IN
THE PRESENCE OF BLOOD
STATICAL ANALYSIS
Color measurements were carried out by a single operator and repeated three
times for each sample and the mean values were calculated
The color change between two
measurements was calculated
using the following formula:
?E*= ([L1?L0*] + [a1?a0*] +
[b1?b0*]?)?

? ASSESMENT OF TOOTH DISCOLORATION INDUCED BY BIODENTINE AND WHITE MINERAL TRIOXIDE AGGREGATE IN THE
PRESENCE OF BLOOD 12
Color change was evaluated with a
spectrophotometer (Spectroshade MHT S.p.A.,
Verona, Italy) at four-time points:
Immediately before materials placement, and at 1
week, 1 month, and 3 months after material
placement. :
Emitted light: 410�C680 nm, Lighting: 2�� 45��;
polarized and telecentric, Resolution: 640 �� 480,
Sensor: CCD B/W

Means and standard deviations of color
changes (?E*)at each period are shown in
The experimental groups showed a similar trend of color changes over time.
Regardless of the effect of time, the color change in the biodentine/saline
group was significantly less than that of MTA/saline and MTA/blood group
(P < 0.05
RESULTS
ASSESMENT OF TOOTH DISCOLORATION INDUCED BY BIODENTINE AND WHITE MINERAL TRIOXIDE AGGREGATE IN THE PRESENCEOF BLOOD 14

DISCUSSION

This method provides a closed system that
prevents the potential complication of coronal
microleakage and also allows standardization of
the thickness and volume of the tested
materials.
It has been reported that irradiation with a
curing light causes discoloration in wMTA but
not in biodentine.
PRESENCE OF BLOOD
16

Means and standard deviations of color changes (?E*)at
each period are shown.
THE PRESENCE OF BLOOD 13

POSITIVE CONTROL GROUP
The greatest color change was observed
ASSESMENT OF TOOTH DISCOLORATION INDUCED BY BIODENTINE AND WHITE MINERAL TRIOXIDE
AGGREGATE IN THE PRESENCE OF BLOOD 17

NEGATIVE CONTROL GROUP
Some degree of discoloration, although not
perceptible for human eyes, was also observed in the
negative control
ASSESMENT OF TOOTH DISCOLORATION INDUCED BY BIODENTINE AND WHITE MINERAL TRIOXIDE AGGREGATE
IN THE PRESENCE OF BLOOD 18

BIODENTINE /SALINE
? Biodentine/saline exhibited the lowest ?E* value which did
not exceed the human eye perceptibility threshold at any
time interval.
THE PRESENCE OF BLOOD 19

BIODENTINE/BLOOD
? The mean ?E* value for the biodentine/blood group exceeded
the human perceptible threshold of 3.7 after 3 months.

WMTA/SALINE AND WMTA/BLOOD
? in contrast to gMTA and wMTA, biodentine did not induce
perceptible color changes in the tooth structure when left in the
canal for extended periods.
ASSESMENT OF TOOTH DISCOLORATION INDUCED BY BIODENTINE AND WHITE MINERAL TRIOXIDE
AGGREGATE IN THE PRESENCE OF BLOOD 21

? CONCLUSION
Within the limitations of this ex vivo study, the
tooth discoloration induced by biodentine/saline
may not be clinically noticeable and it was less than
those induced by MTA/saline and MTA/blood.
Irrespective of the presence or absence of blood,
MTA caused a clinically perceptible color change.
ASSESMENT OF TOOTH DISCOLORATION INDUCED BY BIODENTINE AND WHITE MINERAL TRIOXIDE AGGREGATE
IN THE PRESENCE OF BLOOD 22

REFERENCES
? 1. DugasNN, Lawrence HP,TeplitskyP,FriedmanS.Qualityoflifeandsatisfaction outcome of
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inducedby endodonticmaterials: Aliterature review.DentTraumatol 2013;29:2-7.
? 3. Bortoluzzi EA,Ara��jo GS, GuerreiroTanomaru JM,Tanomaru-Filho M. Marginal gingiva
discoloration by gray MTA:A case report. J Endod 2007;33:325-7.
? 4. Karabucak B,LiD,Lim J,IqbalM.Vitapulptherapywithmineraltrioxideaggregate. Dent Traumatol
2005;21:240-3.
? 5. AsgaryS,ParirokhM,EghbalMJ,BrinkF.Chemicaldifferences betweenwhite and gray
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? 6. Belobrov I, Parashos P.Treatment of tooth discoloration after the use of white mineral trioxide aggregate. J
Endod 2011;37:1017-20.
? 7. Ioannidis K, Mistakidis I, Beltes P, KaragiannisV. Spectrophotometric analysisofcoronal
discolourationinduced by grey and white MTA.IntEndod J 2013;46:137-44.
? 8. Felman D, Parashos P. Coronal tooth discoloration and white mineral trioxide aggregate. J Endod
2013;39:484-7
23

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Tooth discoloration induced by MTA and BIODENTINE

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Tooth discoloration induced by MTA and BIODENTINE