To Determine Tooth Discolouration After Treatment with Various Endodontic Materials using Spectrophotometric Analysis-An In-Vitro Study

Introduction: Various materials have been tried to minimise tooth discolouration over the years. Calcium silicate-based cements have been available for many years. These biomaterials have been used in various endodontic treatments including repair of tooth perforations, as root end restorations, in conditions of open apices, as pulp capping agent and in apexification procedures. Calcium-based materials have shown discolouration with time, minimising the discolouration has become a necessity especially in the teeth in the aesthetic zone. Biomaterial are non-viable material that can be implanted to replace or repair lost tissue, which can be bone substitute, collagen membrane and matrices which are commonly used in regenerative dentistry. Mineral Trioxide Aggregate (MTA) is a biomaterial which has shown discolouration over time. There are various radio-opacifiers like zirconium oxide, tantalum oxide which are been introduced to replace the bismuth oxide which is supposed to be the main reason for discolouration. The study is conducted to compare the rate of discolouration among three different materials over a period of three months. Aim: To determine the tooth discolouration between the ProRoot MTA, ENDOCEM-Zr, and EndoSequence Root Repair Material (ERRM) at baseline, one week, one month and three months using Spectrophotometric analysis. Materials and Methods: A total of 40 extracted human maxillary central incisors were collected for the in-vitro study. Experimental group consisted of ProRoot MTA (Group 1), Endocem-Zr (Group 2), ERRM (Group 3) and one control group. Three different root end filling materials (ProRoot MTA, Endocem-Zr, ERRM) were placed in retrograde pattern after chemomechanical preparation of root canal system whereas in the control group, the pulp tissue was extirpated from the teeth, which were then only sealed with composite resin. Colour assessment was done immediately after the placement of material in the cavity (baseline) and at one week (T1), one month (T2) and three months (T3). Colour values were recorded by a single operator using a spectrophotometer (X-rite i1 pro spectrophotometer). Repeated measures analysis of variance was carried out to determine the significant difference in the discolouration among the four groups namely, ProRoot MTA, ENDOCEM-Zr, ERRM and control across the three time points. Results: It was found that statistically significant difference existed between reading taken from baseline and 30 days, than 30 days to 90 days. MTA had shown steady increase in discolouration over a period of three months and showed statistically significant results whereas the other two materials had decreased discolouration over the period of three months and showed less distinct values. Conclusion: EndoSequence Root Repair Material and Endocem-Zr had shown lesser discolouration over a period of three months, Endocem-Zr showed lesser discolouration when compared to that of EndoSequence Repair material which showed rapid decrease in discolouration from one month to three months whereas MTA showed steady increase in discolouration with time. Endocem-Zr showed lesser discolouration than ERRM in a period of three months.