Evaluation of the discoloration of cold ceramic, ortho mineral trioxide aggregate, and retro mineral trioxide aggregate in the presence of blood and normal saline: An in vitro study

Abstract

Background: Coronal discoloration is a common complication when using calcium silicate-based cements
in esthetic zones. An ideal endodontic cement should provide favorable esthetic results alongside optimal
biological and mechanical properties. This study aims to evaluate the discoloration of three calcium silicatebased
cements—Cold Ceramic, Ortho MTA, and Retro MTA—in the presence of blood and normal saline.
Materials and Methods: In this experimental study, 48 human anterior teeth were prepared and
randomly divided into six groups (n = 8) based on the type of cement (Cold Ceramic, OrthoMTA,
RetroMTA) and environment (blood or normal saline). Color analysis of tooth crowns was
performed using a spectrophotometer before applying the cements and at 30 and 60 days after
application. Repeated measures analysis of variance was used to evaluate the effects of blood,
material type, and time on discoloration (ΔE). As the data showed a non-normal distribution, the
Kruskal-Wallis test was used for intergroup comparisons, and the Wilcoxon test was applied for
intragroup analyses over time (P-value < 0.05).
Results: After one month, specimens exposed to blood exhibited greater discoloration than those
exposed to normal saline. All groups showed noticeable discoloration at two months, with blood
exposure exacerbating the effect. Across different times and environments, OrthoMTA caused more
discoloration than the other materials. However, the differences were not significant. (P-value > 0.05).
Conclusion: IIn all three groups, blood-exposed and normal saline environments caused clinically
noticeable discoloration over time. These materials are, therefore, not recommended for use in
esthetic zones.
Key Words: Blood, mineral trioxide aggregate, saline solution, tooth discoloration

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Samira Khalifezade Esfahani: Pubmed,Google Scholar