Atik Ezgi, Kalyoncuoğlu Ülkü Tuğba
Department of Orthodontics, Faculty of Dentistry, Hacettepe University, Ankara, 06100, Turkey.
Department of Prosthodontics, Gülhane Faculty of Dentistry, University of Health Science, Keçiören, Ankara, 06018, Turkey.
Clin Oral Investig. 2025 Apr 4;29(4):221. doi: 10.1007/s00784-025-06298-1.
This study aimed to verify the effects of whitening agents on the color stability of aligner attachments made from flowable and packable composite resins after staining with coffee and wine.
Two composite groups were used for attachment preparation on epoxy resin master models: G-ænial Universal Injectable flowable (Group 1, N = 42) and G-ænial Posterior packable (Group 2, n = 42). Initial staining of samples was performed with coffee and red wine respectively, with a total period of 6 days representing 6 months of consumption. After staining, each main group was randomly divided into 3 groups related to distilled water as the control (Distilled Water (DW), n = 14) and whitening agents (Whitening Oral Rinse (WR), n = 14) (Carbamide Peroxide 22% (CP), n = 14) for a 14-day test period. Before staining (T0), after staining (T1), and after whitening (T2), color measurements were made with Vita Easy Shade V. ΔE formula was used to determine color differences between T0-T1 (ΔE), T1-T2 (ΔE) and T0-T2 (ΔE) color measurement periods. Also, attachments' whiteness change before and after whitening procedures was calculated using the Whiteness Index for Dentistry (WI) formula considering as ΔWI = WI(T2) - WI(T0) and ΔWI = WI(T2) - WI(T1).
After immersion in staining solutions, ΔE values of Group 2 were significantly higher than of values of Group 1 (p < 0.001). In Group 1, ΔWI values in the WR and CP groups were found to be significantly higher than measurements in the DW group (p = 0.049 and p = 0.001). In Group 2, the value of ΔE for subgroup CP was significantly higher than that for DW group (p = 0.023). Also, the ΔE measurement of the WR group was higher than the measurement of the CP group (p < 0.001). In Group 2, the ΔWI measurement of the CP group was lower than the measurements of the DW (p < 0.001) and WR (p = 0.014) groups. According to ΔWI measurement in Group 2, CP measurements were higher than DW (p < 0.001) and WR (p = 0.024) measurements. Statistically significant differences were determined between the composite types for DW, WR, CP whitening types in terms of ΔE and ΔWI measurements and between the composites for CP whitening type in terms of ΔWI measurements (p < 0.05). For all significant differences, measurements for Group 2 were found to be higher than for Group 1.
The color change of packable composite was more pronounced than that of the flowable composite after staining. Between whitening and staining stages, especially in packable composite group, carbamide peroxide whitening agent significantly effected the color and whiteness of the attachments compared to control distilled water group.
本研究旨在验证美白剂对经咖啡和葡萄酒染色后，由可流动复合树脂和可压实复合树脂制成的矫治器附件颜色稳定性的影响。
在环氧树脂母模上制备附件时使用了两组复合树脂：G-ænial Universal Injectable可流动树脂（第1组，N = 42）和G-ænial Posterior可压实树脂（第2组，n = 42）。样本分别用咖啡和红酒进行初始染色，共6天，相当于6个月的摄入量。染色后，每个主要组随机分为3组，分别以蒸馏水作为对照（蒸馏水（DW），n = 14）和美白剂（美白漱口水（WR），n = 14）（22%过氧化脲（CP），n = 14）进行为期14天的测试期。在染色前（T0）、染色后（T1）和美白后（T2），使用Vita Easy Shade V进行颜色测量。采用ΔE公式确定T0 - T1（ΔE）、T1 - T2（ΔE）和T0 - T2（ΔE）颜色测量期之间的颜色差异。此外，使用牙科白度指数（WI）公式计算美白程序前后附件的白度变化，记为ΔWI = WI（T2） - WI（T0）和ΔWI = WI（T2） - WI（T1）。
浸泡在染色溶液中后，第2组的ΔE值显著高于第1组（p < 0.001）。在第1组中，发现WR组和CP组的ΔWI值显著高于DW组的测量值（p = 0.049和p = 0.001）。在第2组中，CP亚组的ΔE值显著高于DW组（p = 0.023）。此外，WR组的ΔE测量值高于CP组（p < 0.001）。在第2组中，CP组的ΔWI测量值低于DW组（p < 0.001）和WR组（p = 0.014）。根据第2组的ΔWI测量值，CP测量值高于DW组（p < 0.001）和WR组（p = 0.024）。在DW、WR、CP美白类型的ΔE和ΔWI测量方面，以及CP美白类型的复合材料在ΔWI测量方面，复合类型之间存在统计学显著差异（p < 0.05）。对于所有显著差异，发现第2组的测量值高于第1组。
染色后，可压实复合树脂的颜色变化比可流动复合树脂更明显。在美白和染色阶段之间，特别是在可压实复合树脂组中，与对照蒸馏水组相比，过氧化脲美白剂对附件的颜色和白度有显著影响。
