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Table of Contents
ORIGINAL ARTICLE
Year : 2018  |  Volume : 8  |  Issue : 1  |  Page : 1-4

Spectrophotometric Analysis of Tooth Discoloration after Bracket Debonding Induced by Coffee and Tea Grown in South India: An In vitro Study


1 Department of Periodontics, Pushpagiri College of Dental Sciences, Medicity Pathanamthitta, Kerala, India
2 Department of Prosthodontics and Crown and Bridge, Pushpagiri College of Dental Sciences, Medicity Pathanamthitta, Kerala, India

Date of Web Publication5-Mar-2018

Correspondence Address:
Jacob George
Department of Periodontology, Pushpagiri College of Dental Sciences Medicity, Pathanamthitta - 689 107, Kerala
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jid.jid_91_17

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   Abstract 


Aim: To evaluate the staining produced on dental enamel after bracket debonding on exposure to 2 different types of coffee and tea produced in South India. Materials and Methods: Fifty premolars extracted for orthodontic purposes were randomly assigned to five groups .Orthodontic brackets were placed and debonded on the test side. Tooth surfaces were exposed to 2 different types of coffee and tea and color changes were recorded with a spectrophotometer. Results: All solutions of coffee and tea produced statistically significant color changes in both the test and control group with more pronounced color changes in the test group. Conclusion: Scaling and polishing should be advised for all patients after bracket debonding to reduce the impact of staining on tooth surfaces.

Keywords: Coffee tea stains, debonding, spectrophotometer


How to cite this article:
George J, Mathews T A. Spectrophotometric Analysis of Tooth Discoloration after Bracket Debonding Induced by Coffee and Tea Grown in South India: An In vitro Study. J Interdiscip Dentistry 2018;8:1-4

How to cite this URL:
George J, Mathews T A. Spectrophotometric Analysis of Tooth Discoloration after Bracket Debonding Induced by Coffee and Tea Grown in South India: An In vitro Study. J Interdiscip Dentistry [serial online] 2018 [cited 2018 May 25];8:1-4. Available from: http://www.jidonline.com/text.asp?2018/8/1/1/226642




   Clinical Relevance to Interdisciplinary Dentistry Top


Clinical Relevance-Placement of brackets can cause penetration of resin tags in to the enamel surface and can discolor the tooth surface. Routine scaling and polishing of tooth surfaces may be advised to patients undergoing orthodontic treatment.


   Introduction Top


Orthodontic treatment is extremely popular in modern society. There are millions of patients around the world who undergo orthodontic treatment every year and get their teeth properly aligned. Bonding of orthodontic attachments to enamel is based on acid etching, resulting in microporosity that allows microretention of resin infiltrating into the enamel. After active orthodontic treatment, brackets are mechanically debonded and residual adhesive must be mechanically removed; resin remnants can act as a nidus and can accumulate dental plaque and discolor the tooth surface.[1] Tooth discoloration can be classified according to the location of the stains and are divided into extrinsic, intrinsic, or internalized. Extrinsic discoloration is deposited on the tooth surface or in the acquired pellicle. The compounds that are incorporated into the pellicle produce a stain due to either their basic color or chemical interaction at the tooth surface. Intrinsic stains occur when the tooth structure is penetrated by pigmented materials, usually during tooth development. Internalized discoloration is the incorporation of extrinsic stain within the tooth substance following dental development.[2] Billions of people around the world start their day with a cup of coffee or tea. Tannins present in coffee and tea can cause staining of the teeth to varying extends. The aim of this study was to assess the color changes of dental enamel after bracket debonding following exposure to two different types of coffee and tea produced in India.


   Material and Methods Top


Fifty maxillary and mandibular premolars, extracted for orthodontic purposes, were collected for the study. All teeth had visually intact occlusal, buccal, and lingual enamel surfaces, without any visual discoloration. The tooth was then polished with a prophylaxis paste using a polishing brush. After preparation, the samples were stored in isotonic 0.9% saline solution. Buccal surfaces of all teeth were vertically divided into two halves by an imaginary line; one half was assigned as the test site and the other as control. Two orthodontic brackets were bonded to each test site, while the control sites were left untouched. The teeth were randomly assigned to five groups of ten teeth each, which were immersed into two varieties of coffee (Arabica and Robusta) and tea (Organic and Green tea), and the remaining ten teeth were kept aside as the control group to compare the staining produced by different solutions.

Test sites were etched with 35% phosphoric acid gel and then were thoroughly washed with running water and air-dried for 20 s. A thin uniform coat of resin primer was applied to test sites and cured with a light curing device for 10 s. Two orthodontic premolar brackets were bonded vertically in test sites using adhesive composites.

After bonding, the teeth were kept in normal saline solution for a day and then the brackets were removed with debonding pliers. The remaining adhesive composites were removed by a carbide flat fissure burr rotating.

Each tooth was placed in the corresponding solution for 2 min, four times a day for 10 days. The color was assessed before and after staining on the test and the control sites, according to the CIE L*a*b* system with a spectrophotometer (VITA easy shade compact). After each immersion for 2 min in the corresponding solution, the teeth were washed in running water and kept in the isotonic solution for the next immersion. Results were statistically analyzed using an SPSS software (SPSS version 19.0, Chicago IL, USA).


   Results Top


Paired t-test was used to compare the color change between baseline and test group and between baseline and control group. Unpaired t-test was used to compare color changes between test and control group. ANOVA was carried out to compare the staining caused by different types of coffee and tea.

Color change between baseline and control group for Robusta coffee is 00098; color change between baseline and test group for Robusta coffee is <00001. Color change between the test and control was <00001. All the values were found to be statistically significant [Table 1].
Table 1: Robusta coffee

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Color change between baseline and control group for Green tea was <00001; color change between baseline and test group for Robusta coffee is <00001. Color change between the test and control was <00001. All the values were found to be statistically significant [Table 2].
Table 2: Green tea

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Color change between baseline and control group for Arabica coffee was 0.0023; color change between baseline and test group for Arabica coffee is <00001. Color change between the test and control was 00013. All the values were found to be statistically significant [Table 3].
Table 3: Arabica coffee

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Color change between baseline and control group for Organic tea was 0.00001, color change between baseline and test group for organic tea is <00001. Color change between the test and control was <00001. All the values were found to be statistically significant [Table 4].
Table 4: Organic coffee

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ANOVA test was carried out to identify the drink that caused the maximum staining. All solutions produced statistically significant differences when compared with the baseline, Robusta coffee produced maximum staining, and the changes were found to be statistically significant [Table 5].
Table 5: Comparison between coffee and tea

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   Discussion Top


The effect of coffee and tea in this study showed marked changes in color of the teeth in both control and test enamel surfaces. Robusta coffee produced maximum staining among the different solutions used. Studies conducted by Türkün and Türkün had compared the staining effects of different types of coffee and tea on veneers.[3] Our study took into consideration the staining potential of tea and coffee produced in South India. Ertaş et al.[4] had studied on the staining potential of different drinks on composite resin and had found that coffee caused greater staining than tea which is in accordance with our study. Statistically differences were seen from the baseline to the final value in both the test and control sites in our study which is in accordance with the studies conducted by Oikarinen and Nieminen.[5]

Studies by Karadas and Seven et al.[6] showed that statistically significant enamel colour changes where produced by tea and cola and not by coffee on immersion which is contrary to our study where both coffee and tea produced statistically significant enamel color changes and coffee stained the tooth surface the most. Different varieties of tea and their staining potential were compared in a study by Abdulwahab et al. and had shown that red tea caused the maximum staining.[7] Our study had statistically significant differences across all the groups. The differences in results when compared with other studies could be due to the differences in tea and coffee produced across the world.

Many factors have to be taken in to consideration when the changes in enamel discoloration are discussed, (a)Decrease in facial enamel thickness above the cemento-enamel junction,[8] (b) Enamel surfaces in elderly people are darker and have more cracks than the teeth of young people[9] being some of the factors. Our samples were orthodontically extracted teeth, from young individuals so these changes were overlooked. Our observationswould have been probably different if adult teeth were used in the study.

Studies have shown that after debonding there is irreversible penetration of resin tags into the enamel structure and the presence of food dyes or ultraviolet irradiation could discolor the adhesives.[10]


   Conclusion Top


The exposure of enamel surfaces to tea and coffee, for 10 days, changed the color of these surfaces. The discoloration was more obvious in enamel surfaces that had been subjected to bracket bonding and debonding. Maximum staining was seen with Robusta coffee.

Awareness should be created among patients about the staining causative agents and maintenance, and regular checkups should be promoted. Further studies should be done to evaluate the extent of these stains in bonded and debonded surfaces to avoid the damaging effect of bonding and debonding procedures and subsequently develop a bonding material with high color stability.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Joo HJ, Lee YK, Lee DY, Kim YJ, Lim YK. Influence of orthodontic adhesives and clean-up procedures on the stain susceptibility of enamel after debonding. Angle Orthod 2011;81:334-40.  Back to cited text no. 1
    
2.
Watts A, Addy M. Tooth discolouration and staining: A review of the literature. Br Dent J 2001;190:309-16.  Back to cited text no. 2
    
3.
Türkün LS, Türkün M. Effect of bleaching and repolishing procedures on coffee and tea stain removal from three anterior composite veneering materials. J Esthet Restor Dent 2004;16:290-301.  Back to cited text no. 3
    
4.
Ertaş E, Güler AU, Yücel AC, Köprülü H, Güler E. Color stability of resin composites after immersion in different drinks. Dent Mater J 2006;25:371-6.  Back to cited text no. 4
    
5.
Oikarinen KS, Nieminen TM. Influence of acid-etched splinting methods on discoloration of dental enamel in four media: An in vitro study. Scand J Dent Res 1994;102:313-8.  Back to cited text no. 5
    
6.
Karadas M, Seven N. The effect of different drinks on tooth color after home bleaching. Eur J Dent 2014;8:249-53.  Back to cited text no. 6
  [Full text]  
7.
Abdulwahab BA, Enezi MA, Hati MA, Dulijan JA, Babidan S. The staining potential of different tea products available in the Saudi Market. Int Dent Med J Adv Res 2015;1:1-5.  Back to cited text no. 7
    
8.
Atsu SS, Aka PS, Kucukesmen HC, Kilicarslan MA, Atakan C. Age-related changes in tooth enamel as measured by electron microscopy: Implications for porcelain laminate veneers. J Prosthet Dent 2005;94:336-41.  Back to cited text no. 8
    
9.
Hartmann R, Müller F. Clinical studies on the appearance of natural anterior teeth in young and old adults. Gerodontology 2004;21:10-6.  Back to cited text no. 9
    
10.
Faltermeier A, Rosentritt M, Reicheneder C, Behr M. Discolouration of orthodontic adhesives caused by food dyes and ultraviolet light. Eur J Orthod 2008;30:89-93.  Back to cited text no. 10
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5]



 

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