Journal of Dental Medicine

Background and Aim: With the introduction of porcelain veneers to fulfill patients’ esthetic needs, question raises about the ability of the veneers to cover the substructure discoloration. It seems that using shade modifiers under the porcelain veneers can neutralize the discoloration. The goal of this study was to determine the efficacy of shade modifiers in correcting tooth discoloration, when used with resin cements under porcelain veneers.

Materials and Methods: In this experimental study, 60 porcelain discs with two thicknesses of 0.7 mm and 2 mm (30 porcelain of each thickness) were made from ceramco porcelain powder. 40 of them were in A2 shade and 20 were made by the mixture of A2 shade porcelain powder and porcelain stain to represent tooth discoloration. Then all the laminate discs (0.7 mm) were cemented over the 2 mm thick discs to make groups of 10 samples as followed: 1- The first group: laminate discs + resin cement + 2mm thick discs with A2 shade. 2- The second group: laminate discs + resin cement + 2mm thick discolored discs. 3- The third group: laminate discs+ resin cement+ shade modifier+ 2mm thick discolored discs. The color of 30 specimens was measured by spectrophotometer in 2 conditions. 1- To include the specular reflection (SCI). 2- To exclude specular reflection (SCE). In each condition the specimens were measured on both a white background (W) and a black one (B). The mean color differences (E) of each specimen in the second and third group with the specimens of the first group were calculated. Data were analyzed using Paired sample t-test and P<0.05 of significance.

Results: Color measurements showed that in SCIW condition L was significantly different among the three groups except the first and the third. In SCEW condition all the parameters showed significant differences. In SCIB condition, E was not significantly different between the second and the third groups. Hue (h) parameter wasn’t different between groups one and three neither was chroma (c) among the three groups. In SCEB condition, E was not statistically different between groups two and three.

Conclusion: Considering the statistical results, shade modifier couldn’t completely match the color of the specimens in the third group with the first one. But, the lower E for the third group comparing to the second one means that shade modifier was successful in reducing the effect of substructure discoloration.

Background and Aim: Black staining after taking iron drops on the primary teeth is always concern of parents. There is not an exact explanation for the mechanism of iron black staining. The purpose of this study was to compare tooth discolorations, atomic absorption and structural changes of primary teeth enamel caused by two kinds of iron drops[ Kharazmi(Iran) and Fer-in-sol(USA)].

Materials and Methods: In this ex-vivo study, 93 sound primary teeth in normal color range were divided into five groups. Two groups of samples were immersed into the Artificial Caries Challenge(ACC) for two weeks before getting exposured to iron drops: Group 1 Control(NS): sound enamel teeth which were kept in Normal Saline environment(NS)(13teeth). Group 2 (NS-KH): NS, kharazmi iron drop (20 teeth). Group 3 (ACC-KH): ACC, Kharazmi iron drop (20teeth). Group 4 (NS-F-in-S): NS, Fer-in-Sol iron drop (20teeth). Group 5 (ACC-F-in-S): ACC, Fer-in-Sol iron drop. Visual tooth discolorations were determined by a specialist in operative dentistry who was not aware of experimental groups. The iron concentration was measured by ICP system (Vista-pro, Australia) and the structural changes were studied by SEM (Philips, Netherland). The data of discoloration were studied with Kruskal-Wallis test and multiple comparison using Bonferroni type test, and with the data of atomic absorption were studied with oneway ANOVA test and Tukey HSD test.

Results: The discoloration in the teeth immersed into the ACC (ACC-KH, ACC-F-in-S) was more severe than the sound enamel surface (NS-KH, NS-F-IN-S) (p<0.001) and Kharazmi iron drop caused more discoloration in the teeth immersed into the ACC (p=0.018). The teeth immersed into the ACC, absorbed more iron than the sound enamel surface (p<0.001) and also the teeth immersed into the ACC absorbed more Kharazmi iron drop (p<0.001). In the Scanning Electron Microscopy study, at low magnification in the sound teeth the perikymata was arranged regular. At low magnification in the teeth immersed into the ACC, many fractures were observed. The fractures in group 3(ACC-KH) were more and deeper.

Conclusion: Being immersed into the ACC, caused more iron absorption, severe discoloration and structural changes in the enamel of primary teeth. Such changes were more distinct in the teeth exposed to Kharazmi iron drop than the teeth exposed to Fer-in-Sol iron drop.