Evaluation of tooth discoloration after treatment with mineral trioxide aggregate, calcium‑enriched mixture, and Biodentine® in the presence and absence of blood

Calcium silicate cements in treatments such as revascularization and apexogenesis are adjacent to blood and pulp tissues. This study evaluated tooth discoloration after treatment with mineral trioxide aggregate (MTA), calcium‑enriched mixture (CEM) cement, and Biodentine® in the presence and absence of blood using spectrophotometric analysis.

In this experimental study, A total of 68 extracted permanent anterior teeth were prepared and randomly divided into two groups as follows: the sponge embedded in access cavities was saturated with fresh blood or normal saline using insulin syringe, and then each group was subdivided into the following three cement subgroups: MTA‑Angelus®, CEM cement, and Biodentine; these materials with a thickness of 3 mm were placed in the access cavity on the sponge. In the control group, the sponges were saturated in saline and blood in the absence of cements. Discoloration rate was measured by spectrophotometer within the following four intervals: after preparing the cavity and 1 day, 1 month, and 6 months after material placement. ANOVA and Tukey’s test were used to assess the effect of blood and materials and time on discoloration. (P < 0.05).

In general, discoloration rate is significantly higher in blood group than saline group (P < 0.05) and an increase in ∆ E is observed over time for the materials in all groups. In this study, discoloration rate in the presence and absence of blood in Biodentine group was lower, and this difference was statistically significant compared to that of MTA group (P < 0.05) but not significant compared to that of the CEM group.

This study indicated that Biodentine induces the lowest tooth discoloration in the presence and absence of blood, and its discoloration rate is significantly lower than that of MTA. Therefore, it can be suggested that Biodentine can be used more confidently for endodontic treatments with coronal blood contamination such as regeneration and cervical perforation repair in esthetic zone of teeth.