Proclin Department, School of Dentistry, Rio de Janeiro State University, Boulevard 28 de Setembro, 157, Vila Isabel, Rio de Janeiro, RJ, 20551-030, Brazil.
Clin Oral Investig. 2019 Mar;23(3):1281-1286. doi: 10.1007/s00784-018-2557-0. Epub 2018 Jul 9.
This study aimed to quantitatively assess the ability of two single-step restorative materials to avoid crown darkening caused by the use of minocycline as an intracanal medicament.
After coronal access and instrumentation, 120 maxillary incisors were divided into four groups (n = 30). Two experimental groups according to the restorative material applied to the inner walls of the access cavity: OB, OptiBond All-In-One + minocycline intracanal paste; U200, RelyX U200 + minocycline intracanal paste. Two control groups without restorative materials: MIN, minocycline intracanal paste and SL, saline intracanal. Color determination was performed using a spectrophotometer at five time points, immediately after materials were applied (baseline), and at 7, 14, 21, and 28 days from the baseline.
Decrease in the mean values of L* (luminosity) was observed after insertion of minocycline paste in all groups at all time points. Statistically significant differences were absent between the time points (P > .05). After 28 days, MIN showed significantly more darkening (ΔL*) (- 10.6 ± 7.3) than OB (- 5.4 ± 6.2), U200 (- 5.8 ± 3.9) and SL (- 2.3 ± 1.2) (P < .05).
Crown darkening can be minimized by the previous application of RelyX U200 or OptiBond All-In-One to the inner walls of the access cavity before a minocycline-containing paste is applied as an intracanal medication.
The American Association of Endodontists Clinical Considerations for Regenerative Procedures in necrotic immature teeth suggests the triple antibiotic paste as an intracanal medication (2018). However, discoloration and crown darkening are common unfavorable outcomes. The clinical protocol suggested in this paper has shown to be able to minimize crown darkening, predictably leading to a better patient-centered clinical success.
本研究旨在定量评估两种一步法修复材料避免使用米诺环素作为根管内药物引起牙冠变色的能力。
在进行牙冠向面开髓和根管预备后，将 120 颗上颌切牙分为四组（n=30）。根据应用于开髓腔内壁的修复材料分为两组实验组：OB，OptiBond All-In-One+米诺环素根管糊剂；U200，RelyX U200+米诺环素根管糊剂。两组无修复材料的对照组：MIN，米诺环素根管糊剂；SL，生理盐水根管冲洗液。在五个时间点（立即应用材料后（基线），以及从基线开始的 7、14、21 和 28 天）使用分光光度计进行颜色测定。
所有组在所有时间点插入米诺环素糊剂后，L*值（亮度）的平均值均下降。各时间点之间无统计学显著差异（P＞.05）。28 天后，MIN 组（-10.6±7.3）的牙冠变色程度明显大于 OB 组（-5.4±6.2）、U200 组（-5.8±3.9）和 SL 组（-2.3±1.2）（P＜.05）。
在应用含米诺环素的糊剂作为根管内药物之前，在开髓腔内壁预先应用 RelyX U200 或 OptiBond All-In-One，可以最大程度地减少牙冠变色。
美国牙髓病学会在 2018 年提出将三联抗生素糊剂作为根管内药物。然而，变色和牙冠变色是常见的不利结果。本文提出的临床方案已被证明能够最大程度地减少牙冠变色，可预测地提高以患者为中心的临床成功率。
