Evaluation of the Discoloration of Cold Ceramic, Ortho Mineral Trioxide Aggregate, and Retro Mineral Trioxide Aggregate in the Presence of Blood and Normal Saline: An in Vitro Study Publisher



H Hemati HAMIDREZA ; F Honarmand FAEZE ; M Abolhasani MAJID ; H Mollahasani HASSAN ; P Iranmanesh PEDRAM ; Msa Kashani Melika Sadat ARAGHBIDI ; Sk Esfahani Samira KHALIFEZADE
Source: Dental Research Journal Published:2025

Abstract

Background: Coronal discoloration is a common complication when using calcium silicate-based cements in esthetic zones. An ideal endodontic cement should provide favorable esthetic results alongside optimal biological and mechanical properties. This study aims to evaluate the discoloration of three calcium silicate-based cements - Cold Ceramic, Ortho MTA, and Retro MTA - in the presence of blood and normal saline. Materials and Methods: In this experimental study, 48 human anterior teeth were prepared and randomly divided into six groups (n = 8) based on the type of cement (Cold Ceramic, OrthoMTA, RetroMTA) and environment (blood or normal saline). Color analysis of tooth crowns was performed using a spectrophotometer before applying the cements and at 30 and 60 days after application. Repeated measures analysis of variance was used to evaluate the effects of blood, material type, and time on discoloration (ΔE). As the data showed a non-normal distribution, the Kruskal-Wallis test was used for intergroup comparisons, and the Wilcoxon test was applied for intragroup analyses over time (P-value < 0.05). Results: After one month, specimens exposed to blood exhibited greater discoloration than those exposed to normal saline. All groups showed noticeable discoloration at two months, with blood exposure exacerbating the effect. Across different times and environments, OrthoMTA caused more discoloration than the other materials. However, the differences were not significant. (P-value > 0.05). Conclusion: IIn all three groups, blood-exposed and normal saline environments caused clinically noticeable discoloration over time. These materials are, therefore, not recommended for use in esthetic zones. © 2025 Elsevier B.V., All rights reserved.