3 years ago

Discoloration of the mucosa caused by different restorative materials – a spectrophotometric in vitro study

Daniel S. Thoma, Jürg Hüsler, Elena Cathomen, Vincent Fehmer, Ronald E. Jung, Alexis Ioannidis
Objectives To evaluate the discoloration of the mucosa caused by different ceramic and metal-based materials. Material and Methods On six pig maxillae, trap-door flaps were prepared bilaterally. Different ceramic and metal-based specimens were placed underneath the flap. To simulate increasing mucosal thicknesses (MC), connective tissue grafts (CTGs) were harvested. Spectrophotometric measurements were performed prior to flap elevation (TBL) and for each material under the flap alone (1 mm MC) (TMC1), with a 1-mm CTG (2-mm MC) (TMC2) and with a 2-mm CTG (3-mm MC) (TMC3). Tested materials were as follows: Zr1 (zirconia), Zr2 (zirconia + pink ceramic), Zr3 (zirconia), Zr4 (fluorescent zirconia), Zr5 (zirconia), Zr6 (high translucent zirconia), Zr7 (low translucent zirconia) and Zr8 (low translucent zirconia), Gol (gold alloy), Ti1 (titanium alloy), Ti2 (anodized gold-shaded titanium alloy) and Ti3 (anodized pink-shaded titanium alloy). Color differences (ΔE) were calculated comparing the measurement of the native tissue (TBL) and the measurements with varying mucosal thicknesses (TMC1-3). Results For ceramic materials, the median ΔE values for the different time-point comparison ranged as follows: 3.80 (Zr4) – 7.47 (Zr2) (pooled); 3.15 (Zr4) – 8.13 (Zr2) (TBL-TMC1); 3.39 (Zr4) – 7.24 (Zr2) (TBL-TMC2); 4.31 (Zr8) – 6.99 (Zr2) (TBL-TMC3). For metal-based materials, the median ΔE values were as follows: 4.20 (Gol) – 5.82 (Ti3) (pooled); 3.21 (Gol) – 13.56 (Ti1) (TBL-TCM1); 4.0 (Ti1) – 5.27 (Gol) (TBL-TCM2); 3.11 (Ti1) – 5.11 (Gol) (TBL-TCM2). The comparison of the materials and the time points showed in the nonparametric linear mixed model a significant interaction effect between material and time point (P < 0.001). The side was not a significant main effect, nor as term in an interaction with the other two effects. Conclusions Reconstructive materials result in an evident discoloration of the mucosal tissue, tending to decrease with increasing mucosal thickness. The use of fluorescent zirconia (ceramic materials) or gold alloy (metal-based materials) lead to the least discoloration.

Publisher URL: http://onlinelibrary.wiley.com/resolve/doi

DOI: 10.1111/clr.12928

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