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不同根管封闭剂导致牙冠变色的比较分光光度法评估

Comparative Spectrophotometric Assessment of Crown Discoloration from Diverse Endodontic Sealers.

作者信息

Alobaid Adel S, Mkhreb Shahrah S, Ali Ahmed Babiker Mohamed, Alobaid Mohammed A, Dubey Surekha Anil, Elmahdi Asim Elsir, Chaturvedi Saurabh

机构信息

Department of Endodontics, College of Dentistry, King Khalid University, Abha, Saudi Arabia.

Department of Restorative Dental Sciences, College of Dentistry, King Khalid University, Aabha, Saudi Arabia.

出版信息

Med Sci Monit. 2025 Jun 23;31:e947874. doi: 10.12659/MSM.947874.

Abstract

BACKGROUND Crown discoloration is a significant aesthetic concern in endodontics, particularly following the use of obturation sealers. Using spectrophotometric analysis, this study evaluated the extent of discoloration caused by 4 types of sealers: mineral trioxide aggregate (MTA)-based, zinc oxide eugenol (ZnOE)-based, calcium hydroxide (Ca(OH)2)-based, and resin-based sealers. MATERIAL AND METHODS We randomly divided 75 extracted maxillary central incisors into 5 groups: 4 experimental groups and 1 control group. Standardized endodontic treatment was performed, with the respective sealers placed according to the manufacturer's instructions. Coronal discoloration was measured using a spectrophotometer at baseline, immediately after treatment, and at 1 and 6 months. Chromatic parameters (CIE L*, a*, b*) and total color difference (ΔE) were analyzed. Statistical analysis included repeated-measures ANOVA and post hoc tests. RESULTS All sealers caused significant crown discoloration over time. The MTA-based sealer exhibited the least discoloration, while ZnOE-based sealers had the highest ΔE values. Significant changes were noted in chromatic parameters across materials and time. ΔL (lightness change) ranged from 1.53±1.67 for MTA to 4.06±1.96 for Resin-based sealers at baseline to immediately after treatment. Resin-based sealers had the highest mean change (2.18±2.40) in Δb. For ΔE, significant differences were found between materials, with Ca(OH)₂ showing the highest mean change (5.04±2.59). CONCLUSIONS Endodontic sealers can induce varying degrees of crown discoloration, with ZnOE-based sealer causing the most significant changes. Clinicians should consider the aesthetic impact of sealer selection, particularly for anterior teeth.

摘要

背景

牙冠变色是牙髓病学中一个重要的美学问题,尤其是在使用根管充填封闭剂之后。本研究采用分光光度法分析了4种类型的封闭剂(基于三氧化矿物凝聚体(MTA)的、基于氧化锌丁香酚(ZnOE)的、基于氢氧化钙(Ca(OH)₂)的和基于树脂的封闭剂)导致的变色程度。

材料与方法

我们将75颗拔除的上颌中切牙随机分为5组:4个试验组和1个对照组。进行标准化的牙髓治疗,按照制造商的说明放置相应的封闭剂。在基线、治疗后即刻、1个月和6个月时使用分光光度计测量牙冠变色情况。分析色度参数(CIE L*、a*、b*)和总色差(ΔE)。统计分析包括重复测量方差分析和事后检验。

结果

随着时间推移,所有封闭剂均导致牙冠显著变色。基于MTA的封闭剂变色最少,而基于ZnOE的封闭剂ΔE值最高。在不同材料和时间的色度参数上有显著变化。基线至治疗后即刻,ΔL(明度变化)范围从基于MTA的1.53±1.67到基于树脂的封闭剂的4.06±1.96。基于树脂的封闭剂在Δb上平均变化最大(2.18±2.40)。对于ΔE,不同材料之间存在显著差异,Ca(OH)₂显示出最大的平均变化(5.04±2.59)。

结论

牙髓封闭剂可导致不同程度的牙冠变色,基于ZnOE的封闭剂引起的变化最为显著。临床医生在选择封闭剂时应考虑其美学影响,尤其是对于前牙。

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