Can a dentin bonding agent prevent color change in regenerative endodontic procedures? An in vitro evaluation

Chaves, Eduardo Trota; Morel, Laura Lourenço; Pappen, Fernanda Geraldo; Demarco, Flávio Fernando; Santos, Luciane Geanini Pena

doi:10.1590/0103-6440202405550

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Article • Braz. Dent. J. 35 • 2024 • https://doi.org/10.1590/0103-6440202405550 copy

Can a dentin bonding agent prevent color change in regenerative endodontic procedures? An in vitro evaluation

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

This in vitro study aimed to determine the efficacy of dentin bonding agents in preventing color changes following Regenerative Endodontic Procedures. One hundred twenty bovine incisors were endodontically prepared and randomly assigned to a two main factors design: application of a dentin bonding agent (Scotchbond Adper, 3M ESPE, St Paul, MN, USA) in the pulp chamber (Group 1, n=60) versus no bonding intervention (Group 2, n=60), and five levels of intracanal medication (n=12/subgroup): Triple antibiotic paste (TAP), double antibiotic paste (DAB), calcium hydroxide (CH), modified triple antibiotic paste (TAPM), and Control (CTL). Color changes were measured over 28 days at multiple time points (1, 3, 7, 14, 21, and 28 days) using the CIEDE2000 formula to calculate the color difference (ΔE00) from baseline (T0). The ΔE00 quantifies the perceptible color difference between the initial and final tooth color, with lower values indicating less discoloration. The results were analyzed using repeated measures ANOVA-2 and post-hoc Holm-Sidak tests. The TAP subgroups, both with and without the bonding agent, exhibited the highest color variation. However, a pulp chamber seal with a bonding agent showed a protective effect against discoloration compared to no seal, even though complete prevention was not achieved. All groups demonstrated ΔE00 values beyond acceptable interpretation thresholds for clinical application, primarily driven by a reduction in lightness (L*) and a decrease in redness (a* value, shifting towards green). In conclusion, while the pulp chamber seal with a bonding agent mitigated TAP-induced discoloration, it did not eliminate it.

Key Words:
dental pulp; regenerative endodontics; tooth discoloration; triple antibiotic paste

	TAP		TAPM		DAB		CH		Control
	WOBA	BA	WOBA	BA	WOBA	BA	WOBA	BA	WOBA	BA
1d	3.04±1.8^aA	3.48±1.7^aA	3.48±2.2^aA	2.55±2.9^aA	3.83±2.6^aA	3.04±2.2^aA	2.71±1.8^aA	3.31±2.0^aA	2.43±1.4^aA	2.49±1.0^aA
3d	6.24±2.8^aA	3.56±2.0^aAC	3.89±1.8^aAC	3.07±2.7^acCF	4.38±2.9^aAC	2.67±1.9^aCD	2.93±1.5^aC	2.88±1.5^aCE	2.34±1.5^aCF	2.19±1.2^aCF
7d	5.95±2.9^aA	4.18±1.8^aAB	3.44±1.7^aAB	2.98±1.7^adBC	4.51±2.3^aAB	2.38±1.1^aBC	2.95±1.5^aB	4.45±1.6^aAB	2.04±1.0^aBC	1.76±1.0^aBC
14d	6.58±2.6^adA	4.56±2.1^aABC	5.04±3.0^aABC	4.89±3.3^acdeABC	4.48±2.7^aABC	3.64±1.7^aABC	3.95±2.0^aABc	4.50±2.3^aABC	4.03±1.8^aABC	2.57±0.9^aBC
21d	8.61±2.7^cdeBC	5.33±2.7^aAC	4.77±1.5^aA	4.28±2.8^aeA	4.52±3.8^aA	4.06±2.1^aA	4.23±1.2^aA	4.27±3.5^aA	2.59±1.7^aA	2.74±1.6^aA
28d	7.06±2.5^aeA	4.36±2.5^aABC	3.10±1.5^aB	4.09±3.0^aeB	4.58±2.1^aAB	3.63±1.9^aB	2.78±1.2^aB	3.67±2.1^aB	2.41±1.3^aB	3.42±1.3^aB

	TAP non-BA				TAPM non-BA				DAB non-BA				CH non-BA				Control non-BA
SAMPLE	1D	14D	28D	SAMPLE	1D	14D	28D	SAMPLE	1D	14D	28D	SAMPLE	1D	14D	28D	SAMPLE	1D	14D	28D
1	A1	A1	A1	1	B1	B1	A1	1	B2	B2	A1	1	A1	B1	A1	1	A1	B1	A1
2	A1	B1	B1	2	B1	A1	A1	2	A1	B1	B1	2	A1	A1	A1	2	A1	A1	A1
3	A1	A1	B2	3	A1	A1	A1	3	A1	B1	A1	3	A1	A1	B2	3	B1	B1	B1
4	A1	A1	A1	4	A1	B1	A1	4	A1	B1	B2	4	B1	B1	B1	4	A1	A1	A1
5	A1	A1	A1	5	B1	A1	B1	5	A1	B1	A1	5	A1	B1	A1	5	A1	A1	A1
6	A1	A1	A1	6	A1	B1	A2	6	B1	A1	A1	6	B1	B1	B1	6	A1	A1	A1
7	A1	A1	D2	7	B1	B1	B1	7	A1	A1	B2	7	A1	A1	B2	7	B1	B1	B1
8	A1	B1	B1	8	A1	B1	A1	8	A2	A1	B2	8	B1	B1	B1	8	A1	B1	A1
9	A1	A1	A1	9	A1	B1	A1	9	A3,5	B4	A4	9	B1	B1	A1	9	A1	B1	B1
10	A1	A1	A1	10	A1	B1	A1	10	A1	A1	A1	10	A1	A1	A1	10	B1	B1	B1
11	B1	B1	A1	11	A1	A1	A1	11	B1	B1	B1	11	A1	B1	B1	11	A2	A1	A1
12	A1	A1	A1	12	A1	A1	A1	12	A3,5	B1	A1	12	B1	B1	B1	12	A1	B1	A1

	TAP BA				TAPM BA				DAB BA				CH BA				CTL BA
SAMPLE	1D	14D	28D	SAMPLE	1D	14D	28D	SAMPLE	1D	14D	28D	SAMPLE	1D	14D	28D	SAMPLE	1D	14D	28D
1	B1	B1	A1	1	A1	B1	B1	1	B1	B1	B1	1	A1	A1	A3	1	A1	A1	C3
2	B1	B1	A1	2	A1	A1	A1	2	A1	B1	B1	2	A3	A1	B2	2	A1	A1	B1
3	A1	B1	A1	3	A1	B1	A1	3	A1	A1	A1	3	A1	A1	B1	3	B1	B1	A4
4	B1	B1	A1	4	A1	B1	B1	4	A1	A1	B2	4	A1	B1	A1	4	A1	A1	B2
5	A1	B1	B1	5	B1	B1	B1	5	B1	B1	A1	5	A1	B1	B1	5	A1	B1	A1
6	B1	B1	B1	6	B1	B1	A1	6	A1	B1	A1	6	B2	A1	A1	6	A1	B1	A1
7	B1	A1	A1	7	B2	B1	A1	7	A1	B1	A1	7	A1	A1	A1	7	A1	A1	A1
8	B1	B1	B1	8	A1	B1	A1	8	A1	B1	B1	8	A3	A3	B3	8	B1	B1	A1
9	B1	B1	B1	9	B1	B1	A1	9	A1	B1	A1	9	A1	A1	A1	9	B1	B1	A1
10	A1	B1	A1	10	B3	B1	A1	10	A1	B1	A1	10	B1	A1	A1	10	B1	B1	A1
11	A1	A1	A1	11	B1	B1	A1	11	A1	A1	B1	11	A1	B1	A1	11	A1	B1	A1
12	A1	B1	A1	12	A1	A1	A1	12	A1	A1	A1	12	B1	B1	B2	12	A1	A1	B1

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[1] Correspondence: Fernanda Geraldo Pappen - Graduate Program in Dentstry, Federal University of Pelotas, Pelotas, RS, Brazil Address: Gonçalves Chaves 457 - Pelotas, RS - 96015-360; Phone: +55 53 32256741. e-mail: ferpappen@yahoo.com.br