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. 2018 Jan;30(1):51-58.
doi: 10.1111/jerd.12344. Epub 2017 Nov 11.

In-office bleaching efficacy on stain removal from CAD/CAM and direct resin composite materials

Amal Alharbi  1   2 , Stefano Ardu  1 , Tissiana Bortolotto  1 , Ivo Krejci  1
Affiliations

In-office bleaching efficacy on stain removal from CAD/CAM and direct resin composite materials

Amal Alharbi et al. J Esthet Restor Dent. 2018 Jan.

Abstract

Objective: To evaluate the efficacy of in-office bleaching on stain removal from stained resin composite and ceramic computer-assisted design/computer-assisted manufacturing (CAD/CAM) blocks and direct resin composites.

Methods: Forty disk-shaped samples were fabricated from each of nine materials: six CAD/CAM (VITABLOCS Mark II, Paradigm MZ100, Exp Vita Hybrid Ceramic, VITA ENAMIC, Exp Kerr, and LAVA Ultimate) and three direct resin composites (Filtek Supreme, Venus Diamond, and Filtek Silorane). Samples were randomly divided into five groups (n = 8), each stained with a particular staining solution. Using a calibrated spectrophotometer and a black background, L*a*b* values were assessed before and after 120 days of staining. Samples were subjected to in-office bleaching using 40% hydrogen peroxide gel for one hour. At subsequent assessment, color change (ΔE) was calculated as the difference between L*a*b* values. Both ANOVA and the Duncan test were used to identify differences between groups (α = 0.05).

Results: Bleaching resulted in significant differences in ΔE values for all materials (P < .001). Bleaching efficacy was highly influenced by material composition and staining solution. Residual color values after bleaching for ceramic and hybrid ceramics ranged from -0.49 to 2.35, within the clinically acceptable maximum of 3.3. Values after bleaching for resin-based CAD/CAM ranged from -0.7 to 7.08 while direct resin composites values ranged from -1.47 to 25.13. Coffee left the greatest residual color on all materials.

Conclusions: Based on material nature, 40% hydrogen peroxide bleaching can remove staining. The new resin-based CAD/CAM blocks showed promising results in terms of color stability.

Clinical significance: Bleaching using 40% hydrogen peroxide can be an effective method to remove stains from dental restorations. In this way, restoration replacement as a result of discoloration may no longer be necessary.

Keywords: bleaching; resin-based CAD/CAM; stain removal.

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