Tooth discoloration induced by calcium-silicate based materials: a literature review

INTRODUCTION: Endodontic therapy may not focus only on biological and functional aspects, but should take esthetic considerations into account as well. It is common knowledge that calcium-silicate based materials may cause discoloration and thus impair the esthetic outcome of the treated tooth. The purpose of this review is to summarize the existing knowledge on the discoloration potential of these materials used for endodontic procedures. EVIDENCE ACQUISITION: A comprehensive literature search covering the period from 2000 to 2015 was conducted on PubMed and Google Scholar, using different keyword combinations including "tooth", "color", "discoloration", "staining", "endodontic", "root canal", "calcium silicate", "MTA", "portland cement", "Endocem" and "biodentine". Any relevant literature in the English language was considered for inclusion. In addition, previous review articles were hand-searched, and reference lists from endodontic textbooks were also reviewed. Articles were excluded if only single clinical reports or conference reports were included or if the topic was not related to the subject. EVIDENCE SYNTHESIS: For a wide range of these materials currently available in the market, only scarce or no evidence exist regarding their discoloration potential. CONCLUSIONS: The need for further research in this field and development of non-staining calcium silicate based materials is evident.