Six-month Evaluation of Tooth Discoloration Induced by Bioceramic Sealers using Spectrophotometer and Digital Image Analysis: An In Vitro Study.

INTRODUCTION

This study aimed to evaluate the discoloration potential of 3 calcium silicate-based endodontic sealers using spectrophotometer and cross-polarized digital image analysis.

MATERIALS AND

METHODS

Twenty-eight extracted maxillary anterior teeth were randomly allocated to 3 sealer groups (VDW.1Seal, Bio-C Sealer, and CeraSeal) and a control group (n = 7). Color measurements were performed before treatment, immediately after treatment, and at 1 day, 1 week, 1 month, 2 months, 3 months, and 6 months post-treatment using spectrophotometer and standardized digital image analysis with cross-polarization. Measurements were obtained from the cervical, middle, and incisal regions. Color differences were calculated using the CIEDE2000 (ΔE00) formula. Repeated-measures data were analyzed using Aligned Rank Transform analysis of variance (ANOVA) followed by Bonferroni-adjusted post hoc tests (α = 0.05).

RESULTS

Both measurement methods demonstrated a significant increase in ΔE values over time in all groups (P < .05). The control group consistently showed significantly lower ΔE values than all material-treated groups at all time points. Spectrophotometric analysis revealed no significant differences among the experimental sealers. In contrast, digital image analysis detected significant inter-material differences at selected time points, with the Bio-C Sealer group exhibiting the highest overall discoloration. Measurements also revealed greater discoloration in the cervical region compared with the middle and incisal regions.

CONCLUSION

Within the limitations of this in vitro study, all evaluated calcium silicate-based sealers were associated with tooth discoloration. Color changes became more evident after the third month and remained within clinically perceptible limits at 6 months. While both spectrophotometric analysis and cross-polarized digital imaging demonstrated similar trends, digital imaging showed greater sensitivity in detecting color changes.