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Tooth discoloration potential of different pulp capping materials in direct and indirect pulp capping procedures: a
Celalettin Topbaş1, Elif Aslan2, Hülya Nur Nalbant2
1Department of Endodontics, Hamidiye Faculty of Dentistry, University of Health Sciences, Istanbul, Türkiye. dt.c.topbas@gmail.com.
Background:
This study aimed to evaluate and compare the discoloration potential of four bioceramic pulp-capping materials in the presence of blood or 0.9% normal saline (NS) under in vitro conditions.
Methods:
Extracted maxillary central incisors were prepared with standardized Class I cavities and allocated to blood or NS environments. Each medium was further subdivided according to the pulp-capping material used: Biodentine, NeoMTA, TotalFill Putty (TFP), and TheraCal PT (TPT). Following composite restoration, color measurements were obtained using a spectrophotometer at baseline, 1 week, 1 month, 3 months, and 6 months. All specimens were stored in phosphate-buffered saline at 37 °C throughout the experimental period. Color change (ΔE) was analyzed using nonparametric tests (α = 0.05).
Results:
All materials demonstrated significant time-dependent increases in discoloration in both environments (p < 0.05). In NS, NeoMTA and TFP exhibited significantly lower ΔE values than Biodentine and TPT across all time points. In the presence of blood, Biodentine showed the greatest discoloration at each time point (p < 0.05), whereas NeoMTA and TFP maintained significantly lower values. TPT demonstrated comparable discoloration in blood and NS, with no significant differences between media (p > 0.05). Across all groups and evaluation periods, ΔE values ranged from 0.31 to 1.52.
Conclusions:
Blood contamination appears to be an important factor influencing the esthetic performance of bioceramic pulp-capping materials. Therefore, esthetic behavior should be considered alongside biological properties when selecting materials for vital pulp therapy, particularly in clinically visible regions where discoloration may affect treatment outcomes.
Clinical Relevance:
Blood contamination may increase discoloration in certain bioceramic materials; NeoMTA, TFP, and TPT may better preserve color in esthetically sensitive cases.
