Color Match of Composite Resin and Remaining Tooth Structure over a Period of 28 Days Using Spectrophotometer-A Randomized Clinical Trial

Abstract

Objectives: The tooth and the composite restoration can undergo a change in color after the restorative procedure over time. The purpose of this randomized clinical trial was to evaluate the color difference (ΔE) of two types of composite resins and remaining tooth structure over a period of 28 days.

Methods and materials: A total of 40 teeth in 30 patients with Class IV caries or EllisClass II fracture in maxillary incisors were randomized into two groups based on the type of composite resin used for restoration: IPS Empress (n=20 teeth) and Filtek Z250 (n=20 teeth). Shade selection was done using a spectrophotometer. Restorations were performed using an anatomical layering technique, and finishing and polishing was done after 48 hours. Baseline spectrophotometer color values for the remaining tooth structure were measured before isolation and for composite restorations, 10 minutes after light cure. Further color evaluations using a spectrophotometer for the remaining tooth structure and composite restorations were done at 48 hours (both before and immediately after finishing and polishing), 7days, 14 days, and 28 days, and color difference (ΔE) from baseline values for remaining tooth structure and restorations and ΔE between remaining tooth structure and restorations were calculated. Descriptive statistics including mean, standard deviation, and frequencies were computed. Mann-Whitney U test was done to compare spectrophotometer values.

Results: There was a significant reduction in mean color difference (ΔE) from baseline values for both tooth (p<0.05) and composite restoration (p<0.05) at all evaluation periods in both groups. Filtek Z250 showed significantly lower mean ΔE between the tooth and the composite resin restoration than IPS Empress at 48 hours (before and after finishing and polishing), 7 days and 14 days (p<0.05). At the 28 day recall, mean ΔE value of IPS Empress restorations to tooth structure was 3.5, while the mean ΔE value of Filtek Z250 restorations to tooth structure was 3.6, which was not statistically different (p>0.05).

Conclusion: The remaining tooth structure as well as the composite restorations showed color changes at all evaluation periods, compared to baseline values in both the composite resin groups. Filtek Z250 exhibited less ΔE with remaining tooth structure at 48 hours, 7 days, and 14 days, when compared to IPS Empress. The composite restorations of both the groups reached clinically acceptable color match (mean ΔE<3.7) with the remaining tooth structure 28 days after the procedure.