When a tooth shows discoloration and does not respond to the cold test or electric pulp test (EPT) after a traumatic injury, its diagnosis can be even more difficult due to the lack of proper diagnostic methods to evaluate its vitality. In these case reports, we hope to demonstrate that ultrasound Doppler might be successfully used to evaluate the vitality of the tooth after trauma, and help reduce unnecessary endodontic treatments. In all three of the present cases, the teeth were discolored after traumatic injuries and showed negative responses to the cold test and EPT. However, they showed distinctive vital reactions in the ultrasound Doppler test during the whole observation period. In the first case, the tooth color returned to normal, and the tooth showed a positive response to the cold test and EPT at 10 wk after the injury. In the second case, the tooth color had returned to its normal shade at 10 wk after the traumatic injury but remained insensitive to the cold test and EPT. In the third case, the discoloration was successfully treated with vital tooth bleaching.
Diagnosis ; Hope ; Methods ; Tooth Bleaching ; Tooth Discoloration ; Tooth* ; Ultrasonography*

The treatment of stained teeth has been one of the striking aspects of stomatology and esthetic dentistry. Based on detailed data and references, this article introduces the types of stained teeth and the main treatment methods including strong point, weakness, limitation of the usage, result, and the relevant mechanisms. It addresses the researches on problems in the treatment of stained teeth. Also in this paper is envisaged what will be done to treat the stained teeth in future.
Dental Veneers ; Humans ; Tooth Bleaching ; Tooth Discoloration ; etiology ; therapy

OBJECTIVE: Three kinds of zirconia specimens were made respectively by milling of the prisintered blocks and by three dimensional (3D) gel deposition for in vitro evaluation of their optical translucency under three different thicknesses and their color masking effect on discolored teeth. The study aims for establishing the principle for guiding the materials selection in clinical practice. METHODS: Ninety A2-colored zirconia disc specimens with diameter of 14 mm were prepared and were divided into three groups (n=30). (1) Group CZ, by milling of the presintered blanks; (2) Group NZW, by 3D gel deposition, without a color masking opaque inner layer; (3) Group NZY, by 3D gel deposition, with a color masking opaque inner layer. Furthermore, each group was divided into three sub-groups (n=10) according to the sample thickness, i.e., 0.6, 1.0 and 1.5 mm, respectively. The maxillary anterior teeth with severe discoloration, extracted owing to periodontal disease, were collected and embedded. By gentle gridding and polishing a plane, larger than 6 mm2×6 mm², was generated on the labial surface of each tooth. Chromatic values(CIE1976-L^*a^*b^*) of the zirconia samples in the nine sub-groups were measured by the spectrophotometer Crystaleye in front of the black or white background in a cassette, and the translucency parameter (TP) values were calculated for each sample. Thereafter the zirconia specimens were bonded onto the labial surface of the polished teeth for measuring the chromatic values, using the chromatic value of the medium 1/3 of the standardized Vita A2 as a control. The color aberration ΔE between each zirconia specimen and the control value was calculated, respectively. The results were statistically analyzed by One-way ANOVA and Bonferroni. RESULTS: (1) The optical transparency of the three kinds of zirconia disc specimens with the thickness of 0.6, 1.0 and 1.5 mm was 14.09, 12.31 and 10.45 for group CZ; 19.84, 16.54 and 12.44 for group NZW;14.81, 13.16 and 11.92 for group NZY. In each group, the degree of optical transparency of the specimens showed a clear tendency as in the sub-group 0.6 mm >1.0 mm >1.5 mm. The TP value of the specimens in the three groups with the same thickness showed a tendency of the group NZW >group NZY >group CZ. (2) After bonding onto the polished labial surface of the teeth, the color aberration ΔE of the specimens with the thickness of 0.6, 1.0 and 1.5 mm was calculated to be 10.77, 9.94 and 8.50 for group CZ; 6.84, 5.89 and 5.29 for group NZW; 4.16, 3.92 and 3.67 for group NZY. In each group, the color aberration of the specimens showed a clear tendency as in the sub-group 0.6 mm >1.0 mm >1.5 mm; the color aberration of the three groups with the same thickness was in the order of the group CZ >group NZW >group NZY. CONCLUSION In all the specimen groups with a fixed specimen thickness, the optical translucency of the specimen was the highest in group NZW made by 3D gel deposition, and the best color masking effect was obtained in specimens with a color masking opaque inner layer in group NZY, where a thickness of 0.6 mm was sufficient enough for obtaining the ideal color masking effect.
Ceramics ; Color ; Humans ; Materials Testing ; Tooth Discoloration ; Zirconium

OBJECTIVES: The objective of this study was to assess coronal discoloration induced by the following intracanal medicaments: calcium hydroxide (CH), a mixture of CH paste and chlorhexidine gel (CH/CHX), and triple antibiotic paste (3Mix). MATERIALS AND METHODS: Seventy extracted single-canal teeth were selected. Access cavities were prepared and each canal was instrumented with a rotary ProTaper system. The specimens were randomly assigned to CH, CH/CHX, and 3Mix paste experimental groups (n = 20 each) or a control group (n = 10). Each experimental group was randomly divided into 2 subgroups (A and B). In subgroup A, medicaments were only applied to the root canals, while in subgroup B, the root canals were completely filled with medicaments and a cotton pellet dipped in medicament was also placed in the pulp chamber. Spectrophotometric readings were obtained from the mid-buccal surface of the tooth crowns immediately after placing the medicaments (T1) and at 1 week (T2), 1 month (T3), and 3 months (T4) after filling. The ∆E was then calculated. Data were analyzed using 2-way analysis of variance (ANOVA), 3-way ANOVA, and the Scheffé post hoc test. RESULTS: The greatest color change (ΔE) was observed at 3 months (p < 0.0001) and in 3Mix subgroup B (p = 0.0057). No significant color change occurred in the CH (p = 0.7865) or CH/CHX (p = 0.1367) groups over time, but the 3Mix group showed a significant ΔE (p = 0.0164). CONCLUSION: Intracanal medicaments may induce tooth discoloration. Use of 3Mix must be short and it must be carefully applied only to the root canals; the access cavity should be thoroughly cleaned afterwards.
Calcium Hydroxide ; Chlorhexidine ; Dental Pulp Cavity ; Reading ; Tooth Crown ; Tooth Discoloration ; Tooth

A recent treatment option for non-vital immature teeth in young patients is revascularization with triple antibiotic paste (TAP). However, tooth discoloration was reported with the use of conventional minocycline-containing TAP. In this case report, amoxicillin-containing TAP was used for revascularization of non-vital immature teeth to prevent tooth discoloration. At the 1 yr follow up, the teeth were asymptomatic on clinical examination and showed slight discoloration of the crown due to mineral trioxide aggregate (MTA) filling rather than amoxicillin-containing TAP. Radiographic examination revealed complete resolution of the periapical radiolucency, and closed apex with obvious periodontal ligament space. However, the root growth was limited, and the treatment outcome was more like apexification rather than revascularization. These results may be due to unstable blood clot formation which could not resist the condensation force of MTA filling, whether or not a collagen matrix was in place. These cases showed that although revascularization was not successful, apexification could be expected, resulting in the resolution of the periapical radiolucency and the closure of the apex. Therefore, it is worthwhile attempting revascularization of non-vital immature teeth in young patients.
Amoxicillin ; Apexification* ; Collagen ; Crowns ; Follow-Up Studies ; Humans ; Periodontal Ligament ; Tooth Discoloration ; Tooth* ; Treatment Outcome ; Pemetrexed

OBJECTIVETo investigate the mechanism of discoloration and the efficacy of bleaching in non-infected traumatically discolored teeth.

METHODSIn vitro model of discolored teeth: sample of fresh erythrocytes was placed in the pulp cavity of 20 extracted teeth and centrifuged for 3 consecutive days. These discolored teeth were divided equally and randomly into two groups: group A (control group); group B (bleaching group), bleached with 10% carbamide peroxide gel for 4 weeks. And then all teeth were prepared for histological examination and subjected to a series of histochemical tests to analyze some of the biochemical changes following haemorrhage into the pulp chamber and post-bleaching.

RESULTSHaemoglobin and haematin were detected in the dentinal tubules of discolored teeth from group A and no evidence of ferric or haemosiderin. Specimens from group B demonstrated a negative response to histochemical tests.

CONCLUSIONSIn the absence of bacterial invasive, haemoglobin and haematin could cause discoloration of non-infected traumatized teeth. Peroxide bleaching agent can effectively remove haemoglobin and haematin.

Adolescent ; Child ; Humans ; In Vitro Techniques ; Random Allocation ; Tooth Bleaching ; methods ; Tooth Discoloration ; etiology ; therapy

Regenerative endodontics has a potential to heal a partially necrotic pulp, which can be beneficial for the continued root development and strengthening of immature teeth. For this purpose, triple antibiotic mixture of ciprofloxacin, metronidazole, and minocycline was recommended as intracanal medicament in an attempt to disinfect the root canal system for revascularization of a tooth with a necrotic pulp. However, discoloration of the tooth was reported after applying this. This case shows the idea for preventing the tooth discoloration using a delivery syringe (SW-O-01, Shinwoo dental) to avoid the contact between the clinical crown and the antibiotics.
Anti-Bacterial Agents ; Ciprofloxacin ; Crowns ; Dental Pulp Cavity ; Endodontics ; Metronidazole ; Minocycline ; Syringes ; Tooth ; Tooth Discoloration

There are several causes of tooth discoloration following root canal treatment. In this study, we evaluated the effects of sealers on tooth discoloration and internal bleaching. Twenty-four teeth were divided into 4 groups: control group, AH plus, Endosequece BC, and MTA fillapex group. Root canal filling was performed using each sealer conventionally and non-vital bleaching was performed with sodium perborate. The L, a, and b values were measured using Vita easyshade. Tooth discoloration after root canal treatment occurs irrespective of the type of sealers and may cause discoloration with only gutta-percha cone. The effect of non-vital bleaching following the use of calcium silicate-based sealers such as Endosequece BC and MTA fillapex was higher than that of AH plus. Therefore, it needs careful use of sealers in endodontics and calcium silicate-based sealers have advantages of bleaching in case of discolored tooth.
Calcium ; Dental Pulp Cavity ; Endodontics ; Gutta-Percha ; Pemetrexed ; Sodium ; Tooth Discoloration ; Tooth

OBJECTIVETo evaluate the effects of all-ceramic veneers in clinic fabricated by computer aided design/computer aided manufacturing (CAD/CAM) system and veneered with Vita VM9.

METHODS54 all-ceramic veneers were made for 12 patients. The patients were divided into three groups: Tetracycline staining group, fluorosis group and devitalization group. The color of patients' teeth was checked before and after laminates with Shade Eye. All-ceramic veneers was checked on the white background and abutment background. The value of L*, a* and b* were calculated to compare the color difference among 3 groups. The color, fitness and fracture of all-ceramic veneers were checked in clinic after restoration every 3 months.

RESULTSAll-ceramic veneers as a replacement for discolored teeth showed good appearance. The substructures and veneers showed significant color difference between white background and abutment background in tetracycline staining group and devitalization group, but there was no significant color difference in fluorosis group. All veneers had good esthetic effect, excellent marginal fit, good gingival and adjacent condition. The fracture was not found in clinic.

CONCLUSIONThe effects of all-ceramic veneers were perfect in color, fitness and stability to fracture. Fluorosis teeth is the best indication for all-ceramic veneers. To tetracycline teeth and devital teeth, the fundic porcelain with deep color should be chosen, or an opaquing material be applied as fundus in all-ceramic veneers repairing.

Ceramics ; Color ; Computer-Aided Design ; Dental Porcelain ; Dental Veneers ; Humans ; Tooth Discoloration

OBJECTIVEThe aim of this study was to evaluate the clinical application of the thinner porcelain laminate restoration, which is initiated in the West China College of Stomatology, Sichuan University.

METHODSThe color of 51 ceramic veneers was evaluated using the chromatic instrument and visual observation.

RESULTSAmong factors affecting the clinical results of the porcelain laminate, the hue of ceramic materials and bond composites played a more important role than the dentition. The brightness of ceramic materials and bond composites were closely correlated with the whole restoration brightness. There was also a close correlation between the brightness and the bond composite.

CONCLUSIONSatisfactory restoration results can be achieved by clinical application of thinner porcelain laminate.

Adult ; Color ; Dental Porcelain ; Dental Restoration, Permanent ; Dental Veneers ; Evaluation Studies as Topic ; Humans ; Tooth Discoloration ; therapy