Effect of Using a Universal Adhesive on Tooth Discoloration After Simulated Regenerative Endodontic Procedures (An in-vitro Study)

Objectives: To evaluate the effects of a universal adhesive agent (UA) prior to the use of either Mineral trioxide aggregate (MTA) or Bio-aggregate (BA) as cervical plug materials on preventing tooth discoloration following simulated Regenerative procedures.
Methods: Fifty-eight anterior teeth were prepared to simulate immature permanent teeth then assigned to 24 well plates. Blood was injected till one millimeter cervical to the CEJ. Teeth were randomly assigned to four groups; two received two layers of a Single Bond UA (3M. ESPE, MN, USA) which were cured prior to the cervical plug material while the other two did not. Group I received either MM-MTA (MicroMega, Besançon, France) or BA (Innovative,BioCeramix, Vancouver, Canada) without UA, while group II received either MTA or BA with UA. The teeth were restored using composite. Color change represented as Delta E was measured using a spectrophotometer (Easyshade). The measurements were done before all procedures, immediately after, one and two months after. Cervical, middle and incisal measurements were recorded for each tooth.

Results: There was no statistically significant difference between the measurements of the teeth with a UA across the different intervals in any third of the teeth. However, there was a statistically significant difference between MTA and BA particularly in the middle third MTA (mean= 30.12, SD=4.77) and BA (mean=22.43, SD=8.68) but only in the 2nd months’ readings (P=0.001)

Conclusions: The use of a universal adhesive did not reduce discoloration. However, the use of Bio-aggregate instead of MTA may help minimize discoloration of teeth following REs.