Top

Clinical Oral Investigations

Published in:

01-03-2021 | Antibiotic | Original Article

Spectrophotometric insights: calcium hydroxide influences tooth discolorations induced by short-term application of antibiotic/corticosteroid pastes

Authors: Florin Eggmann, Jeremy Rihs, Patrik Lenherr, Roland Weiger, Gabriel Krastl, Lucia K. Zaugg

Published in: Clinical Oral Investigations | Issue 3/2021

Abstract

Objectives

This in vitro study aimed to assess the influence of a calcium hydroxide dressing regarding the relative color change (ΔE) of enamel–dentin specimens previously exposed to antibiotic/corticosteroid pastes.

Materials and methods

Eighty bovine enamel–dentin specimens with a cylindrical central cavity were randomly allocated to four groups: NEG (empty), POS (blood), LED (Ledermix), and ODO (Odontopaste) (n = 20 each). The materials were applied and sealed with self-adhesive resin luting material. After 3 weeks, the materials were removed and a calcium hydroxide (Ca(OH)₂) dressing was placed in all cavities. After a further 3-week storage period, the cavities were restored with resin-based composite. Spectrophotometric color measurements were taken over 6 months, and ΔE values were calculated. A Tukey’s multiple comparison test was performed to assess significant differences within the treatment groups (p < 0.05).

Results

Tooth discolorations were present after 3 weeks in LED (ΔE 29.14 ± 6.55) and POS (ΔE 18.05 ± 7.03); NEG and ODO remained color stable (ΔE 3.2 ± 1.36 and ΔE 2.3 ± 1.16). The 3-week Ca(OH)₂ dressing decreased discolorations of POS (ΔE 15.93 ± 6.63; p = 0.37), whereas LED showed a further significant increase (ΔE 39.55; p < 0.0001). Between the end of the Ca(OH)₂ dressing and the final restoration no significant color changes were observed in any group (p > 0.9).

Conclusions

Discolorations induced by LED progressed during the Ca(OH)₂ dressing despite careful removal of all residues.

Clinical relevance

Calcium hydroxide might negatively affect the discoloring potential of Ledermix. This highlights the need for direct intracanal application methods of Ledermix ensuring a material-free access cavity or alternative antibiotic/corticosteroid pastes such as Odontopaste should be used.

Abbott PV (2016) Prevention and management of external inflammatory resorption following trauma to teeth. Aust Dent J 61(Suppl 1):82–94. https://doi.org/10.1111/adj.12400CrossRefPubMed

Trope M (2000) Luxation injuries and external root resorption—etiology, treatment, and prognosis. J Calif Dent Assoc 28(11):860–866PubMed

Andersson L, Andreasen JO, Day P, Heithersay G, Trope M, Diangelis AJ, Kenny DJ, Sigurdsson A, Bourguignon C, Flores MT, Hicks ML, Lenzi AR, Malmgren B, Moule AJ, Tsukiboshi M (2012) International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 2. Avulsion of permanent teeth. Dent Traumatol 28(2):88–96. https://doi.org/10.1111/j.1600-9657.2012.01125.xCrossRefPubMed

Pierce A, Lindskog S (1987) The effect of an antibiotic/corticosteroid paste on inflammatory root resorption in vivo. Oral Surg Oral Med Oral Pathol 64(2):216–220. https://doi.org/10.1016/0030-4220(87)90094-6CrossRefPubMed

Abbott PV, Heithersay GS, Hume WR (1988) Release and diffusion through human tooth roots in vitro of corticosteroid and tetracycline trace molecules from Ledermix paste. Endod Dent Traumatol 4(2):55–62. https://doi.org/10.1111/j.1600-9657.1988.tb00295.xCrossRefPubMed

Chen H, Teixeira FB, Ritter AL, Levin L, Trope M (2008) The effect of intracanal anti-inflammatory medicaments on external root resorption of replanted dog teeth after extended extra-oral dry time. Dent Traumatol 24(1):74–78. https://doi.org/10.1111/j.1600-9657.2006.00483.xCrossRefPubMed

An P, Heithersay G, Lindskog S (1988) Evidence for direct inhibition of dentinoclasts by a corticosteroid/antibiotic endodontic paste. Endod Dent Traumatol 4(1):44–45. https://doi.org/10.1111/j.1600-9657.1988.tb00292.xCrossRef

Thong YL, Messer HH, Siar CH, Saw LH (2001) Periodontal response to two intracanal medicaments in replanted monkey incisors. Dent Traumatol 17(6):254–259. https://doi.org/10.1034/j.1600-9657.2001.170603.xCrossRefPubMed

Bryson EC, Levin L, Banchs F, Abbott PV, Trope M (2002) Effect of immediate intracanal placement of Ledermix Paste on healing of replanted dog teeth after extended dry times. Dent Traumatol 18(6):316–321. https://doi.org/10.1034/j.1600-9657.2002.00142.xCrossRefPubMed

10.

Wong KS, Sae-Lim V (2002) The effect of intracanal Ledermix on root resorption of delayed-replanted monkey teeth. Dent Traumatol 18(6):309–315. https://doi.org/10.1034/j.1600-9657.2002.00137.xCrossRefPubMed

11.

Day PF, Duggal MS, High AS, Robertson A, Gregg TA, Ashley PF, Welbury RR, Cole BO, Westland S (2011) Discoloration of teeth after avulsion and replantation: results from a multicenter randomized controlled trial. J Endod 37(8):1052–1057. https://doi.org/10.1016/j.joen.2011.04.014CrossRefPubMed

12.

Lenherr P, Allgayer N, Weiger R, Filippi A, Attin T, Krastl G (2012) Tooth discoloration induced by endodontic materials: a laboratory study. Int Endod J 45(10):942–949. https://doi.org/10.1111/j.1365-2591.2012.02053.xCrossRefPubMed

13.

Kim ST, Abbott PV, McGinley P (2000) The effects of Ledermix paste on discolouration of mature teeth. Int Endod J 33(3):227–232. https://doi.org/10.1046/j.1365-2591.2000.00278.xCrossRefPubMed

14.

Kim ST, Abbott PV, McGinley P (2000) The effects of Ledermix paste on discolouration of immature teeth. Int Endod J 33(3):233–237. https://doi.org/10.1046/j.1365-2591.2000.00277.xCrossRefPubMed

15.

Ahmed HMA, Abbott PV (2012) Discolouration potential of endodontic procedures and materials: a review. Int Endod J 45(10):883–897. https://doi.org/10.1111/j.1365-2591.2012.02071.xCrossRefPubMed

16.

Athanassiadis M, Jacobsen N, Nassery K, Parashos P (2013) The effect of calcium hydroxide on the antibiotic component of Odontopaste ® and Ledermix ® paste. Int Endod J 46(6):530–537. https://doi.org/10.1111/iej.12021CrossRefPubMed

17.

Chen BK-J, George R, Walsh LJ (2012) Root discolouration following short-term application of steroid medicaments containing clindamycin, doxycycline or demeclocycline. Aust Endod J 38(3):124–128. https://doi.org/10.1111/aej.12000CrossRefPubMed

18.

Dettwiler CA, Walter M, Zaugg LK, Lenherr P, Weiger R, Krastl G (2016) In vitro assessment of the tooth staining potential of endodontic materials in a bovine tooth model. Dent Traumatol 32(6):480–487. https://doi.org/10.1111/edt.12285CrossRefPubMed

19.

Chen BK-J, George R, Walsh LJ (2014) Discoloration of roots caused by residual endodontic intracanal medicaments. ScientificWorldJournal 2014:404676–404677. https://doi.org/10.1155/2014/404676CrossRefPubMedPubMedCentral

20.

Athanassiadis M, Jacobsen N, Parashos P (2011) The effect of calcium hydroxide on the steroid component of Ledermix® and Odontopaste®. Int Endod J 44(12):1162–1169. https://doi.org/10.1111/j.1365-2591.2011.01940.xCrossRefPubMedPubMedCentral

21.

Douglas RD, Steinhauer TJ, Wee AG (2007) Intraoral determination of the tolerance of dentists for perceptibility and acceptability of shade mismatch. J Prosthet Dent 97(4):200–208. https://doi.org/10.1016/j.prosdent.2007.02.012CrossRefPubMed

22.

Johnston WM, Kao EC (1989) Assessment of appearance match by visual observation and clinical colorimetry. J Dent Res 68(5):819–822. https://doi.org/10.1177/00220345890680051301CrossRefPubMed

23.

Sánchez AR, Rogers RS, Sheridan PJ (2004) Tetracycline and other tetracycline-derivative staining of the teeth and oral cavity. Int J Dermatol 43(10):709–715. https://doi.org/10.1111/j.1365-4632.2004.02108.xCrossRefPubMed

24.

Eisenberg E (1975) Anomalies of the teeth with stains and discolorations. J Prev Dent 2(1):7–14 16-20PubMed

25.

Tanase S, Tsuchiya H, Yao J, Ohmoto S, Takagi N, Yoshida S (1998) Reversed-phase ion-pair chromatographic analysis of tetracycline antibiotics. Application to discolored teeth. J Chromatogr B Biomed Sci Appl 706(2):279–285. https://doi.org/10.1016/s0378-4347(97)00563-xCrossRefPubMed

26.

Marin PD, Bartold PM, Heithersay GS (1997) Tooth discoloration by blood: an in vitro histochemical study. Endod Dent Traumatol 13(3):132–138. https://doi.org/10.1111/j.1600-9657.1997.tb00026.xCrossRefPubMed

27.

van der Burgt TP, Eronat C, Plasschaert AJM (1986) Staining patterns in teeth discolored by endodontic sealers. J Endod 12(5):187–191. https://doi.org/10.1016/S0099-2399(86)80152-2CrossRefPubMed

28.

Zaugg LK, Lenherr P, Zaugg JB, Weiger R, Krastl G (2016) Influence of the bleaching interval on the luminosity of long-term discolored enamel-dentin discs. Clin Oral Investig 20(3):451–458. https://doi.org/10.1007/s00784-015-1545-xCrossRefPubMed

29.

Davis MC, Walton RE, Rivera EM (2002) Sealer distribution in coronal dentin. J Endod 28(6):464–466CrossRef

30.

Freccia WF, Peters DD (1982) A technique for staining extracted teeth: a research and teaching aid for bleaching. J Endod 8(2):67–69CrossRef

31.

Pearsons JR, Walton RE, Ricks-Williamson L (2001) In vitro longitudinal assessment of coronal discoloration from endodontic sealers. J Endod 27(11):699–702CrossRef

32.

Wegehaupt FJ, Widmer R, Attin T (2010) Is bovine dentine an appropriate substitute in abrasion studies? Clin Oral Investig 14(2):201–205. https://doi.org/10.1007/s00784-009-0283-3CrossRefPubMed

33.

Schilke R, Lisson JA, Bauss O, Geurtsen W (2000) Comparison of the number and diameter of dentinal tubules in human and bovine dentine by scanning electron microscopic investigation. Arch Oral Biol 45(5):355–361. https://doi.org/10.1016/s0003-9969(00)00006-6CrossRefPubMed

34.

Diangelis AJ, Andreasen JO, Ebeleseder KA, Kenny DJ, Trope M, Sigurdsson A, Andersson L, Bourguignon C, Flores MT, Hicks ML, Lenzi AR, Malmgren B, Moule AJ, Pohl Y, Tsukiboshi M (2012) International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 1. Fractures and luxations of permanent teeth. Dent Traumatol 28(1):2–12. https://doi.org/10.1111/j.1600-9657.2011.01103.xCrossRefPubMed

35.

Trope M (2002) Clinical management of the avulsed tooth: present strategies and future directions. Dent Traumatol 18(1):1–11. https://doi.org/10.1046/j.1600-4469.2001.00001.xCrossRefPubMed

Title: Spectrophotometric insights: calcium hydroxide influences tooth discolorations induced by short-term application of antibiotic/corticosteroid pastes
Authors: Florin Eggmann
Jeremy Rihs
Patrik Lenherr
Roland Weiger
Gabriel Krastl
Lucia K. Zaugg
Publication date: 01-03-2021
Publisher: Springer Berlin Heidelberg
Keyword: Antibiotic
Published in: Clinical Oral Investigations / Issue 3/2021
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-020-03414-1

At a glance: The STEP trials

Springer Medicine

Spectrophotometric insights: calcium hydroxide influences tooth discolorations induced by short-term application of antibiotic/corticosteroid pastes

Abstract

Objectives

Materials and methods

Results

Conclusions

Clinical relevance

At a glance: The STEP trials

Springer Medicine

Abstract

Objectives

Materials and methods

Results

Conclusions

Clinical relevance

Please log in to get access to this content

Other articles of this Issue 3/2021

Effect of root surface treatment with denusomab after delayed tooth replantation

Incidence of cleft-related speech problems in children with an isolated cleft lip

Probiotic strains of Lactobacillus brevis and Lactobacillus plantarum as adjunct to non-surgical periodontal therapy: 3-month results of a randomized controlled clinical trial

Pulpal upregulation of connexin 43 during pulpitis

Relationship of Porphyromonas gingivalis and Alzheimer’s disease: a systematic review of pre-clinical studies

Effectiveness of a nutraceutical agent in the non-surgical periodontal therapy: a randomized, controlled clinical trial