Abstract
-
Objectives
This study investigated the effect of red and white wine on color changes of nanofilled and nanohybrid resin composite.
-
Materials and Methods
Sixty specimens of each resin composite were prepared. Baseline data color values were recorded using a spectrophotometer. Three groups of discs (n = 20) were then alternately immersed in red, white wine, and deionized water (as a control) for twenty five minutes and artificial saliva for five minutes for four cycles. Specimens were then stored in artificial saliva for twenty two hours. This process was repeated for five days following immersion in artificial saliva for two days. Subsequently, the process was repeated again. Data were analyzed by two-way repeated ANOVA, one-way ANOVA, and Tukey's HSD.
-
Results
Red wine caused significantly higher color change (ΔE* > 3.3) than did white wine and deionized water (p < 0.05). Nanohybrid resin composites had significantly more color changes than nanofilled resin composite (p < 0.05).
-
Conclusions
The effect of red and white wine on the color changes of resin composite restorative materials depended upon the physical and chemical composition of the restorative materials and the types of wine.
-
Keywords: Resin composite; Stainability; Wine
Introduction
Resin-based composites (RBCs) have been used in restorative dentistry since the 1960s.
1 New classes of RBCs, so-called nanocomposites (known as nanofilled and nanohybrid resin composites), have been developed during recent years. Nanocomposites are becoming popular in esthetic restorative dentistry. They are widely used in restoring both anterior and posterior teeth because of the great advantages in the material compositions and the physical and mechanical properties.
2,
3 Nanocomposites compose of two types, nanofilled and nanohybrid RBCs. Nanofilled RBCs contain nanomers and nanoclusters. The particle size of nanomers are 5 to 75 nm. Nanoclusters are 0.6 to 1.4 µm and they are agglomerates of primary zirconia/silica nanoparticles (5 to 20 nm in size) fused together at points of contact, and the resulting porous structure is infiltrated with silane.
3 Nanohybrid types contain milled glass fillers and discrete nanoparticles (40 - 50 nm).
2 Although nanocomposites are used in both direct and indirect restorations at present and several studies have shown that nanofilled and nanohybrid resin composites have high color stability and can retain high surface luster,
4,
5 problems of color changes of nanofilled and nanohybrid resin composites have been found after a long time.
6
One of the main factors that affect the longevity of esthetic restorations is the discoloration of restorations. Esthetic restoration with an unacceptable color match with other teeth is a main factor for replacement restoration.
7 Color change in RBCs may be caused by extrinsic and intrinsic factors.
8,
9 The intrinsic factors involve the discoloration of the esthetic restorative material by itself. Chemical discoloration has been attributed to a change or oxidation in the amine accelerator for polymerization of resin.
10,
11 The extrinsic factors, such as adsorption or absorption of stains, may cause discoloration of esthetic restorative materials.
12 Previous studies reported that coffee, Coca-Cola, red wine, and tea may affect the color stability of resin composite and giomer.
13,
14,
15,
16 At present, wine is frequently consumed with food, between meals, or at social gatherings, thereby predisposing RBCs for discoloration.
15 Consumption of wine has demonstrated color change in RBCs.
17,
18
Previous studies have evaluated the color stability of RBCs after immersion in wine.
7,
17,
18 However, a comparative study on the effect of both red and white wine on color stability of nanofilled and nanohybrid resin composites has not yet been documented. Therefore, the objective of this study was to evaluate the effect of red and white wine on color changes of nanofilled and nanohybrid resin composites. The null hypothesis of this study were that there was no difference in color change between the two types of wines (red and white wines), and types of resin composites (nanofilled and nanohybrid RBCs) would not affect the color changes after being immersed in wine.
Materials and Methods
Specimen preparations
Sixty disc-shaped specimens of nanofilled and nanohybrid resin composites (shade A2,
Table 1) were prepared in a polytetrafluoroethylene cylindrical mold (10.0 mm in diameter and 2.0 mm in thickness) on a glass plate. The cylindrical mold was covered with a mylar matrix strip. A second glass plate was placed over the mylar strip. A static load of approximately 200 g was applied to extrude excess resin composites and to obtain a smooth and flat surface on each specimen. The specimens were then polymerized for 40 seconds with a light-activated polymerization unit (Elipar 2500, 3M ESPE, St. Paul, MN, USA). The light intensity (452.1 ± 7.2 mW/cm
2) was verified with a measuring device (Cure Rite, L.D. Caulk, Milford, DE, USA). After polymerization, the mylar strip and the glass plate on the top and bottom of the mold were removed, and the specimen was removed from the cylindrical mold. No mechanical preparation or abrasions of the specimens were performed.
The pH and titratable acidity measurements
Red and white wine were used in this study and their compositions are shown in
Table 2. The pH of each wine was determined using a pH meter (Orion 900A, Orion Research, Boston, MA, USA). Ten pH readings of each beverage were obtained so as to give a mean pH measurement for each wine.
To verify titratable acidity (buffering capacity),
19 20 mL of each wine was added by 0.05 mL increments of 1 mol/L sodium hydroxide (NaOH). The amount of NaOH required to reach pH levels of 5.5, 7.0, and 10.0 were recorded. The titrations for each beverage were also repeated ten times to achieve a mean value.
Storage agent immersions and color measurements
Sixty discs of nanofilled and nanohybrid resin composites were divided into 3 groups of 20 specimens for immersion in red, white wine, and deionized water (served as a control). For baseline color measurement, each group was subjected to a spectrophotometer (ColorQuest XE, Hunter Associates Laboratory Inc., Reston, VA, USA) for assessing the Commission Internationale de l'Eclairege L*a*b* (CIELAB) color. L* indicates the lightness of the color measured from black (L* = 0) to white (L* = 100), a* determines the color in the red (a* > 0) and green (a* < 0) dimension, and b* determines the color in the yellow (b* > 0) and blue (b* < 0) dimension. Three measurements were obtained from each disc and the mean L*, a*, and b* values were used for the final analyses.
The specimens were then alternately immersed in 25 mL of a storage agent for 25 minutes and in 25 mL of artificial saliva for 5 minutes conducted over 4 cycles at room temperature (about 25℃).
20 After the cyclic immersion, specimens were returned to the artificial saliva (daily changed) and kept overnight at 37℃. This process was repeated for five days following immersion in artificial saliva for two days. Subsequently, the process was repeated again. After immersion, specimens were evaluated on day 7 and 14. The same protocol was used with the different storage agents in this study. In order to maintain the original pH level of the storage agents, they were refreshed daily throughout the experiment. For blinding the evaluators to reduce the bias in color measurement, one author immersed the specimens throughout the experiment and the other author evaluated the color measurement of the specimens that were not labeled the storage agent immersed. After the immersion sequence was completed, the specimens were rinsed with deionized water, blotted dry against filter paper and subjected to post-immersion color measurement.
Overall color change (ΔE*) was calculated using the following equation: ΔE* = ([ΔL*]2 + [Δa*]2 + [Δb*]2)½. Mean ΔE* values for the experimental groups were calculated between baseline and after immersion at day 7 and 14.
Statistical analysis
The ΔE* values were subjected to two-way ANOVA, one-way ANOVA and Tukey's Honestly Significant Difference (HSD) for multiple comparisons (at α = 0.05).
Results
The mean pH, standard deviations (SD) and titratable acidity of beverages with 1 mol/L NaOH are shown in
Table 3. White wine had the lowest pH (2.97 ± 0.02) and red wine had the highest pH (3.32 ± 0.02). The titratable acidity was lowest for red wine (1.55 ± 0.05 mL) and highest for white wine (1.64 ± 0.07 mL). The ΔE
* values of the materials used before and after immersion are presented in
Table 4. Overall, red wine which had the highest pH caused significantly higher color change (ΔE
* > 3.3) than did white wine and deionized water (
p < 0.05). Nanohybrid resin composites had significantly more color changes than nanofilled resin composite (
p < 0.05).
Discussion
On the basis of the data, the null hypothesis tested in the present study is rejected. This study showed that types of wines, red and white wine, significantly affected the color changes of resin composite materials (p < 0.05). Types of resin composites, nanofilled and nanohybrid RBCs, also significantly affected the color changes after immersion in wine (p < 0.05).
With the improvement of RBCs and demand for esthetic restorations, nanofilled and nanohybrid RBCs have become popular restorations. However, the success and failure of any esthetic restoration depends on the color match and color stability of the material.
21 Color change determination in dentistry can be evaluated by visual and instrumental techniques.
22 A spectrophotometer is more exact than the naked eye in repeatedly measuring slight ΔE
* in objects on flat surfaces, providing better sensitivity and objectivity. This present study used a spectrophotometer and the CIE L
*a
*b
* coordinates system, one of the most common color measurement systems in dentistry with precise results for several color parameters.
23 Any ΔE
* greater than 3.3 was taken as clinically perceptible color differences.
24,
25
The results of this study showed that after soaking in red wine from baseline until the first week that ΔE* greater than 3.3 was seen in all groups of resin composites. However, after soaking in red wine from the first week until the second week, ΔE* greater than 3.3 was found only in nanohybrid groups of resin composite (Estelite Sigma Quick, Premise, Herculite Ultra), except the nanofilled group of resin composite (Filtek Z350 XT). Likewise after soaking in white wine, the results showed that from baseline until the first week, ΔE* greater than 3.3 was found in nanohybrid groups of resin composite (Estelite Sigma Quick, Premise, Herculite Ultra) except nanofilled group of resin composite (Filtek Z350 XT). While after soaking in white wine from the first week until the second week, ΔE* less than 3.3 was found in all groups of resin composite.
Moreover, the staining ability of RBCs is related to resin matrix, the percentage of filler
8 and size of the filler. Stain susceptibility of RBCs can be a result of the type of resin matrix and water absorption of the resin matrix,
26 which TEGDMA absorbs the highest amount of water. Bis-GMA leads to the formation of the most rigid network, which absorbs less water than the resin made by TEGDMA but it absorbs more water than the resins made by UDMA and Bis-EMA.
27 Excessive water sorption could decrease the longevity of RBCs by expanding and plasticizing the resin matrix, hydrolyzing the silane coupling agent, and producing microcrack formations. Consequently, the microcracks at the interface between filler particles and the resin matrix permit surface degradation acid, staining solution penetration and increase surface roughness (Ra).
28 In addition, surface roughness is related to the size of the filler particles, as larger filler particles will produce a rougher surface.
29 Surface roughness results from penetration and adsorption of staining agents to the RBCs surface. RBCs used in this study were Filtek Z350 XT (nanofilled RBCs), which have an average filler particle size of 0.005 - 0.02 µm and are even smaller than nanohybrid RBCs (Estelite Sigma Quick, 0.2 µm; Premise, 0.4 µm; Herculite Ultra, 0.4 µm). This is related to the results of this study as it found that nanofilled RBCs had color changes less than nanohybrid RBCs after immersion in wine.
This study result indicates that wine's acidity has a pH ranging from 2.97 - 3.32, which is close to an earlier study.
30 In the present study, wine had low pH compared to other alcoholic beverages. Wine composed of main acid constituents which are 1 - 4 g/L maleic acid, 1 - 5 g/L tartaric acid and other acids comprising succinic acid, citric acid, acetic acid, and lactic acid.31 The pH of the beverage reproduces the strength of acidity, while titratable acidity indicates the amount of acid present in a solution and is measured by titration against a standard solution of sodium hydroxide. Red wine had the highest pH (3.32 ± 0.02) but had the lowest titratable acidity (1.55 ± 0.05 mL). However, red wine caused significantly higher color change (ΔE
* > 3.3) than did white wine and deionized water (
p < 0.05). The pH and titratable acidity value are not the only factor to affect color changes.
Color change in RBCs usually occurs due to three factors. The first factor for color change is that external discolorations form accumulation of plaque and stains. The second factor is that alterations on the surface of RBCs promote surface roughness, slight penetration and adsorption staining agents on the RBCs surfaces. The last factor is intrinsic discolorations from physiochemical reactions of RBCs.
25 The stain susceptibility of RBCs depends on the type of stain solution. The red wine promoted a marked color change of RBCs, probably because the red wine has higher concentration of pigments than white wine.
32 Tannin, anthocyanin and its pigments in red wine may have a significant effect on the color change of RBCs during aging, resulting in more color change of RBCs in red wine than white wine. Deionized water served as a control in this study. Consistent in this study, was that after soaking in deionized water from baseline until the first week and from the first week until the second week, ΔE
* less than 3.3 was found in all groups of resin composite. In addition, alcohol is also thought to act as a plasticizer of the polymer matrix.
32 The softening effect of alcohol on the RBCs may be due to the susceptibility of Bis-GMA and UDMA based polymers.
33 Red wine has a higher ethanol concentration (13.5 vol%) than white wine (12.5 vol%) which might be a cause of color change. However, further investigation is required. All of the above, result in red wine more than white wine promoting surface roughness, slight penetration and adsorption of staining agents on RBCs surfaces after specimen immersion.
The results of the present study provided information of the stain susceptibility on direct esthetic restorations in some people who commonly consume wine in daily life. However, the present study evaluated only the in vitro effects with some limitations. The dilution effects of saliva and other fluids including pH change in the oral cavity should also be considered. Therefore, further studies are required to examine the effects of wines in vivo. Finally, the authors suggest that the management of color changes of resin composite restorations in people who commonly drink wine was polishing external discolorations to remove accumulations of plaque and stains. However, if slight penetration and adsorption of staining agents on the RBCs surfaces or intrinsic discolorations from physiochemical reactions of RBCs have been found, refilling of resin composite restorations may be needed.
Conclusions
Within the limitations of this study, the following conclusions could be drawn. Red wine significantly affected the color change of nanofilled and nanohybrid RBCs after evaluation at the end of the 14 days immersion period. The effect of red and white wine on the color changes of resin composite restorative materials depended upon the physical and chemical composition of the restorative materials and the types of wine.
Acknowledgement
This study was supported by a grant from Faculty of Dentistry Research Fund, Prince of Songkla University.
ARTICLE INFORMATION
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Conflict of Interest: No potential conflict of interest relevant to this article was reported.
REFERENCES
- 1. Bowen RL, Rodriguez MS. Tensile strength and modulus of elasticity of tooth structure and several restorative materials. J Am Dent Assoc 1962;64:378-387. ArticlePubMed
- 2. Mitra SB, Wu D, Holmes BN. An application of nanotechnology in advanced dental materials. J Am Dent Assoc 2003;134:1382-1390. ArticlePubMed
- 3. Moszner N, Klapdohr S. Nanotechnology for dental composites. Int J Nanotechnol 2004;1:130-156.Article
- 4. Janda R, Roulet JF, Kaminsky M, Steffin G, Latta M. Color stability of resin matrix restorative materials as a function of the method of light activation. Eur J Oral Sci 2004;112:280-285. ArticlePubMed
- 5. Chen MH. Update on dental nanocomposites. J Dent Res 2010;89:549-560. ArticlePubMedPDF
- 6. Nuaimi HO, Ragab HM. Effect of aggressive beverage on the color stability of different nano-hybrid resin based composite. Eur J Gen Dent 2014;3:190-193.Article
- 7. Samra AP, Pereira SK, Delgado LC, Borges CP. Color stability evaluation of aesthetic restorative materials. Braz Oral Res 2008;22:205-210. ArticlePubMed
- 8. Um CM, Ruyter IE. Staining of resin-based veneering materials with coffee and tea. Quintessence Int 1991;22:377-386. PubMed
- 9. Yannikakis SA, Zissis AJ, Polyzois GL, Caroni C. Colour stability of provisional resin restorative materials. J Prosthet Dent 1998;80:533-539. PubMed
- 10. Ruyter IE. Composites-characterization of composite filling materials: reactor response. Adv Dent Res 1988;2:122-129. ArticlePubMedPDF
- 11. Asmussen E. Factors affecting the colour stability of restorative resins. Acta Odontol Scand 1983;41:11-18. PubMed
- 12. 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. ArticlePubMed
- 13. Al Kheraif AA, Qasim SS, Ramakrishnaiah R, Ihteshamur Rehman. Effect of different beverages on the color stability and degree of conversion of nano and microhybrid composites. Dent Mater J 2013;32:326-331. ArticlePubMed
- 14. Yousef M, Abo El Naga A. Color stability of different restoratives after exposure to coloring agents. J Am Sci 2012;8:20-26.
- 15. Tekçe N, Tuncer S, Demirci M, Serim ME, Baydemir C. The effect of different drinks on the color stability of different restorative materials after one month. Restor Dent Endod 2015;40:255-261. PubMedPMC
- 16. Moon JD, Seon EM, Son SA, Jung KH, Kwon YH, Park JK. Effect of immersion into solutions at various pH on the color stability of composite resins with different shades. Restor Dent Endod 2015;40:270-276. ArticlePubMedPMC
- 17. Omata Y, Uno S, Nakaoki Y, Tanaka T, Sano H, Yoshida S, Sidhu SK. Staining of hybrid composites with coffee, oolong tea, or red wine. Dent Mater J 2006;25:125-131. ArticlePubMed
- 18. Ertaş E, Güler AU, Yücel AC, Köprülü H, Güler E. Color stability of resin composites after immersion in different drinks. Dent Mater J 2006;25:371-376. ArticlePubMed
- 19. Cairns AM, Watson M, Creanor SL, Foye RH. The pH and titratable acidity of a range of diluting drinks and their potential effect on dental erosion. J Dent 2002;30:313-317. ArticlePubMed
- 20. Wongkhantee S, Patanapiradej V, Maneenut C, Tantbirojn D. Effect of acidic food and drinks on surface hardness of enamel, dentine, and tooth-coloured filling materials. J Dent 2006;34:214-220. ArticlePubMed
- 21. Abu-Bakr N, Han L, Okamoto A, Iwaku M. Color stability of compomer after immersion in various media. J Esthet Dent 2000;12:258-263. ArticlePubMed
- 22. Yap AU, Tan KB, Bhole S. Comparison of aesthetic properties of tooth-colored restorative materials. Oper Dent 1997;22:167-172. PubMed
- 23. Johnston WM. Color measurement in dentistry. J Dent 2009;37(Supplement 1):e2-e6. PubMed
- 24. Inokoshi S, Burrow MF, Kataumi M, Yamada T, Takatsu T. Opacity and color changes of tooth-colored restorative materials. Oper Dent 1996;21:73-80. PubMed
- 25. Asmussen E, Hansen EK. Surface discoloration of restorative resins in relation to surface softening and oral hygiene. Scand J Dent Res 1986;94:174-177. ArticlePubMed
- 26. Gray A, Ferguson MM, Wall JG. Wine tasting and dental erosion. Case report. Aust Dent J 1998;43:32-34. ArticlePubMedPDF
- 27. Hernández-Orte P, Cacho JF, Ferreira V. Relationship between varietal amino acid profile of grapes and wine aromatic composition. Experiments with model solutions and chemometric study. J Agric Food Chem 2002;50:2891-2899. ArticlePubMed
- 28. Ferracane JL, Marker VA. Solvent degradation and reduced fracture toughness in aged composites. J Dent Res 1992;71:13-19. ArticlePubMedPDF
- 29. Kao EC. Influence of food simulating solvents on resin composites and glass ionomer restorative cement. Dent Mater 1989;5:201-208. ArticlePubMed
- 30. Toledano M, Osorio R, Osorio E, Fuentes V, Prati C, Garcia-Godoy F. Sorption and solubility of resin-based restorative dental materials. J Dent 2003;31:43-50. ArticlePubMed
- 31. Sideridou I, Tserki V, Papanastasiou G. Study of water sorption, solubility and modulus of elasticity of light-cured dimethacrylate-based dental resins. Biomaterials 2003;24:655-665. ArticlePubMed
- 32. Bagheri R, Burrow MF, Tyas M. Influence of food-simulating solutions and surface finish on susceptibility to staining of aesthetic restorative materials. J Dent 2005;33:389-398. ArticlePubMed
- 33. Guler AU, Yilmaz F, Kulunk T, Guler E, Kurt S. Effects of different drinks on stainability of resin composite provisional restorative materials. J Prosthet Dent 2005;94:118-124. ArticlePubMed
Table 1Resin composites used in this study
Material |
Trade name |
Manufacturer |
Composition |
Average particle size (µm) |
Matrix |
Filler |
Nanofilled resin composite |
Filtek Z350 XT |
3M ESPE, St. Paul, MN, USA |
Bis-EMA, UDMA, PEGDMA |
Zirconia, silica |
Silica 0.02, Zirconia 0.004 - 0.011 |
Nanohybrid resin composite |
Estelite Sigma Quick |
Tokuyama Corp., Taitou-ku, Tokyo, Japan |
Bis-GMA, TEGDMA |
Prepolymerized filler, barium glass, silica |
Super-nano spherical fillers 0.2 |
Premise |
Kerr Corp., Orange, CA, USA |
Bis-EMA, UDMA, TEGDMA |
Prepolymerized filler, barium glass |
Prepolymerized filler, barium glass filler 0.4 |
Herculite Ultra |
Kerr Corp., Orange, CA, USA |
Bis-EMA, UDMA, TEGDMA |
Prepolymerized filler, barium glass, silica |
Prepolymerized filler, barium glass filler 0.4, silica filler 0.02 - 0.05 |
Table 2Red and white wine used in this study
Beverage |
Trade name |
Manufacturer |
Composition |
Percent alcohol |
Red wine |
Mouton Cadet Rouge 2011 |
Baron Philippe De Rothschild, S.A. (1902 - 1988), Bordeaux, France |
Merlot (65%), Cabernet Suvignon (20%), Cabernet France (15%) |
13.5 |
White wine |
Mouton Cadet Blanc 2011 |
Baron Philippe De Rothschild, S.A. (1902 - 1988), Bordeaux, France |
Sauvignon Blanc (65%), brings fresh, fruity, floral aroma, flavor, and semillon (30%), roundness, refinement, and muscadelle (5%) |
12.5 |
Table 3The mean pH and standard deviation (SD) and titratable acidity (volume of NaOH [mL]) to bring the pH to 5.5, 7.0, and 10.0) in red and white wine
Beverage |
Mean pH ± SD |
Cumulative volume of NaOH solution used to titrate to each pH (mL) |
5.5 |
7.0 |
10.0 |
Red wine |
3.32 ± 0.02 |
1.01 ± 0.05 |
1.19 ± 0.06 |
1.55 ± 0.05 |
White wine |
2.97 ± 0.02 |
1.23 ± 0.04 |
1.43 ± 0.05 |
1.64 ± 0.07 |
Table 4Overall color changes (ΔE*) of nano-filled and nanohybrid resin composites from baseline to after immersion
Storage agent |
Material |
ΔE*
|
Baseline to first wk |
First to second wk |
Red wine |
Filtek Z350 XT |
6.98 ± 2.33b,B
|
2.91 ± 0.97*,b,B
|
Estelite Sigma Quick |
11.50 ± 0.14a,A
|
3.74 ± 1.72*,a,A
|
Premise |
8.63 ± 1.03a,A
|
3.73 ± 1.73*,a,A
|
Herculite Ultra |
10.88 ± 1.29a,A
|
3.73 ± 1.95*,a,A
|
White wine |
Filtek Z350 XT |
2.28 ± 0.66b,D
|
1.82 ± 0.90*,b,D
|
Estelite Sigma Quick |
3.20 ± 0.62a,C
|
2.61 ± 0.82*,a,C
|
Premise |
3.13 ± 0.67a,C
|
2.53 ± 1.34*,a,C
|
Herculite Ultra |
3.16 ± 0.74a,C
|
2.56 ± 0.75*,a,C
|
Deionized water |
Filtek Z350 XT |
1.24 ± 0.75E
|
1.28 ± 0.41E |
Estelite Sigma Quick |
1.36 ± 0.11E
|
1.37 ± 0.54E |
Premise |
1.25 ± 0.17E
|
1.28 ± 0.60E |
Herculite Ultra |
1.33 ± 0.19E
|
1.34 ± 0.19E |