Tooth Discoloration Induced by Endodontic Sealers of Different Chemical Bases: A Systematic Review

The present study aimed to assess the tooth discoloration induced by endodontic sealers and establish a correlation between their distinct chemical compositions and this aesthetic concern. Five electronic databases and grey literature were systematically screened to identify studies comparing the tooth discoloration potential of endodontic sealers with different chemical bases. Studies that did not evaluate human teeth or did not employ spectrophotometry as a method for color measurement were excluded. The risk of bias in the included studies was assessed using a modified version of the JBI Critical Appraisal Checklist for Experimental Studies. Data were grouped according to the chemical composition of the sealers and analyzed qualitatively. Fourteen studies were included. None of the studies met all domains of the risk of bias checklist. Qualitative synthesis suggested that zinc oxide and eugenol-based sealers have a greater potential for tooth discoloration. Silicone-based and calcium hydroxide-based sealers demonstrated less potential for tooth discoloration than resin-based sealers and salicylate resin-based sealers containing calcium silicate. All investigated endodontic sealers induced tooth discoloration, which is chemical and time dependent. Zinc oxide and eugenol-based sealers exhibited a greater potential for tooth discoloration, whereas silicone and calcium hydroxide-based sealers showed less potential.