Bleaching Versus Color Change Resistant Adhesive in the Discoloration of Bracket-Bonded Tooth Surfaces: An in Vitro Study

Abstract

Objectives The aim of this study was to compare the effect of office bleaching of teeth bonded with Transbond XT (TM) (3M Unitek, Monrovia, CA, USA) (TRXT) and the use of color change resistant Orthocem (FGM, Joinville, Brazil) in bracket bonding on coffee-induced enamel discoloration. Materials and methods Eighty premolars were distributed in equal numbers (n=20) to group 1 (TRXT+distilled water), group 2 (TRXT+coffee solution), group 3 (TRXT+coffee solution+bleaching), and group 4 (Orthocem+coffee solution). Color was measured using a SpectroShade Micro (MHT, International, Verona, Italy) device at the beginning (T0), after coloring (T1), after bleaching (T1B), and after debonding (T2). Delta E color change values were calculated as T1-T0, T1B-T0 and T2-T0 differences. The conformity of the data to the normal distribution was examined with the Shapiro-Wilk test. Multiple comparisons were made with Tamhane's T2 test and Tukey's HSD test using one-way analysis of variance in the comparison of normally distributed data, and multiple comparisons were made with Dunn's test using the Kruskal-Wallis H test for comparison of non-normally distributed data. The significance level was set at p<0.050. Results A statistically significant (p<0.001) difference was found between the T1-T0 and T2-T0 stages for group 1-4 Delta E values. A statistically significant (p<0.001) difference was also found when the T1B-T0 Delta E values of group 3 were compared with the T1-T0 Delta E values of groups 1, 2, and 4. Conclusions After coffee-induced enamel discoloration, bleaching of teeth bonded with TRXT produced acceptable color difference of the incisal, middle, and gingival regions of the crown. In teeth bonded with Orthocem, acceptable color difference was seen only in the middle of the crown.