Assessment of tooth discoloration induced by root canal filling materials in pediatric dentistry

Gonçalves, Fabiana Vitória Ananias; Guedes, Orlando Aguirre; Kachiyama, Sávio Akio; Flauzino, Larissa Pinzan; Silva Júnior, Aurélio Rosa da; Aranha, Andreza Maria Fábio

doi:10.1590/0103-6440202405838

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ARTICLE • Braz. Dent. J. 35 • 2024 • https://doi.org/10.1590/0103-6440202405838 copy

Assessment of tooth discoloration induced by root canal filling materials in pediatric dentistry

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

This study investigated the potential for tooth discoloration of root canal filling pastes used in pediatric dentistry. Sixty bovine incisors were sectioned 2 mm apical to the cementoenamel junction and allocated into 6 groups (n = 10) according to the type of filling material used: G1- Zinc oxide-eugenol sealer; G2- Zinc oxide-eugenol and iodoform paste; G3- Calcium hydroxide (CH) and zinc oxide paste; G4- CH, zinc oxide, and iodoform paste; G5- CH and iodoform paste; and G6- Control. Polyethylene glycol 400 was used as a vehicle for CH-containing pastes. Color measurements were taken at specific intervals: preceding endodontic treatment (T0) and at successive points of 1 month (T1), 2 months (T2), 3 months (T3), and 1 year (T4) after the placement of the filling material. The color change (∆E) was calculated using the CIELab formula. Statistical analysis was performed using ANOVA, followed by Tukey's post hoc test (α = 5%). Significant differences were observed among the filling materials and time intervals (p <0.001). All groups exhibited color changes over time, except G1 and G5, which showed color changes only after 1 year. G1 and G2 demonstrated the highest ∆E values, with a statistically significant difference observed only at T2 when compared to G3 (p = 0.008). Root canal filling materials used in primary teeth have the potential to induce tooth discoloration.

Key Words:
Primary tooth; tooth discoloration; root canal filling material; pediatric dentistry

Variation	Sum of squares	*P value**
Root canal filling material	432.7	< 0.001
Time interval	700.0	< 0.001
Root canal filling paste _* Time interval	62.3	0.981

Filling materials*		Time intervals (∆E Mean ± SD)**
Filling materials*	Baseline	1 month	2 months	3 months	1 year
	L₀	L₁	L₂	L₃	L₄
ZO:E	L₀	88.8 ± 3.9^A,a	87.6 ± 4.6^A,a	85.6 ± 6.2^A,a	81.3 ± 9.0^B,a
ZO:IOD:E	89.4 ± 3.9^A,a	89.8 ± 2.8^A,a	90.1 ± 3.3^A,a	88.9 ± 3.9^A,a	90.6 ± 3.1^A,a
CH:ZO:PEG400	89.8 ± 4.6^A,a	89.4 ± 1.8^A,a	89.8 ± 3.8^A,a	91.0 ± 1.9^A,a	89.4 ± 4.2^AB,a
CH:ZO:IOD:PEG400	89.8 ± 4.0^A,a	88.6 ± 2.7^A,a	89.1 ± 2.4^A,a	90.6 ± 3.1^A,a	91.7 ± 2.8^A,a
CH:IOD:PEG400	89.4 ± 3.9^A,a	88.3 ± 5.1^A,a	89.1 ± 4.9^A,a	89.1 ± 5.9^A,a	90.2 ± 6.1^A,a
Control	87.8 ± 4.5^A,a	89.2 ± 1.7^A,a	89.4 ± 3.6^A,a	88.0 ± 1.9^A,a	88.7 ± 4.2^AB,a
	89.1 ± 3.9^A,a	a₁	a₂	a₃	a₄
ZO:E	a₀	0.9 ± 2.2^A,a	2.4 ± 1.6^A,ab	2.7 ± 2.0^A,ab	4.5 ± 2.8^A,b
ZO:IOD:E	0.9 ± 2.9^A,a	-0.3 ± 1.0^A,a	0.7 ± 1.4^A,ab	1.0 ± 1.6^A,ab	1.8 ±1.3^B,b
CH:ZO:PEG400	-0.3 ± 1.3^A,a	0.8 ± 1.8^A,a	1.7 ± 1.5^A,a	1.1 ± 1.9^A,a	2.2 ± 1.1^AB,a
CH:ZO:IOD:PEG400	0.7 ± 2.3^A,a	1.1 ± 1.8^A,a	2.3 ± 1.5^A,a	1.9 ± 1.7^A,a	2.2 ± 1.1^AB,a
CH:IOD:PEG400	1.3 ± 2.1^A,a	-0.5 ± 0.8^A,a	1.4 ± 2.0^A,a	1.3 ± 2.2^A,a	1.7 ± 2.1^B,a
Control	-0.5 ± 1.1^A,a	0.8 ± 1.8^A,a	1.7 ± 1.5^A,a	1.1 ± 1.9^A,a	2.2 ± 1.1^AB,a
	0.9 ± 2.4^A,a	b₁	b₂	b₃	b₄
ZO:E	b₀	15.9 ± 4.3^A,a	21.9 ± 3.0^A,b	22.0 ± 3.3^A,b	24.8 ± 3.5^A,b
ZO:IOD:E	15.6 ± 5.7^A,a	13.2 ± 4.3^A,a	17.8 ± 3.6^AB,ab	18.3 ± 4.4^AB,ab	25.1 ± 3.4^A,c
CH:ZO:PEG400	13.0 ± 6.6^A,a	16.0 ± 4.5^A,a	17.4 ± 4.0^AB,ab	17.4 ± 5.5^AB,ab	23.2 ± 5.6^A,b
CH:ZO:IOD:PEG400	15.7 ± 5.3^A,a	14.7 ± 3.2^A,a	18.4 ± 4.1^AB,ab	17.3 ± 4.4^AB,ab	22.5 ± 4.9^A,b
CH:IOD:PEG400	14.3 ± 5.6^A,a	14.3 ± 6.2^A,a	16.4 ± 4.3^B,a	15.4 ± 4.8^B,a	20.4 ± 4.9^A,a
Control		15.7 ± 4.5^A,a	16.8 ± 4.0^AB,ab	17.1 ± 5.5^AB,ab	22.2 ± 5.6^A,b

Filling materials*	Time intervals (∆E Mean ± SD)
Filling materials*	1 month	2 months	3 months	1 year	P value
ZO:E	7.97 ± 3.95^A,a	8.44 ± 4.99^A,a	9.13 ± 3.85^A,a	13.32 ± 6.06^A,a	0.067
ZO:IOD:E	5.99 ± 3.02^A,a	7.42 ± 3.53^A,a	8.56 ± 2.76^A,a	12.55 ± 2.97^A,b	<0.001
CH:ZO:PEG400	4.04 ± 1.29^A,ab	3.13 ± 1.62^B,a	5.92 ± 2.48^A,bc	8.20 ± 2.44^A,c	<0.001
CH:ZO:IOD:PEG400	5.30 ± 2.66^A,a	5.71 ± 2.10^AB,a	8.22 ± 3.35^A,ab	9.58 ± 4.07^A,b	0.011
CH:IOD:PEG400	6.3 ± 5.47^A,a	6.89 ± 5.70^AB,a	7.70 ± 5.32^A,a	10.80 ± 5.52^A,b	0.181
Control	7.83 ± 2.32^A,a	10.93 ± 2.46^A,a	7.43 ± 5.43^A,a	7.54 ± 3.40^A,a	0.060
P value	0.223	0.008	0.364	0.067

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