Professional Documents
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Color Stability of Denture Acrylic Resins and A Soft Lining Material Against Tea, Coffee, and Nicotine
Color Stability of Denture Acrylic Resins and A Soft Lining Material Against Tea, Coffee, and Nicotine
Pervin Imirzalioglu, DDS, PhD, Ozgul Karacaer, DDS, PhD, Burak Yilmaz, DDS, PhD, &
4
Ilknur
Ozmen, MSc
1
Department of Prosthodontics, Baskent University Faculty of Dentistry, Ankara, Turkey
2
Section of Restorative and Prosthetic Dentistry, The Ohio State University, College of Dentistry, Columbus, OH
Department of Statistics and Computer Sciences, Baskent University Faculty of Science and Letters, Ankara, Turkey
Abstract
Keywords
Color; acrylic resin; tea; coffee; nicotine; soft liner.
Correspondence
Burak Yilmaz, Section of Restorative and Prosthetic Dentistry, The
th
impact and
transverse
1
strength.
Dimension
Poly(methyl methacrylate) (PMMA)al stability
resin has been successfully used foris of
various applications in dentistry forconsider
many years. It has many advantages,able
particularly its appearance and ease ofimportance
manipulation,butitstillhascertainpooras
a
mechanical properties. Fractures mayclinical
occur during use due to unsatisfactory
Purpose: The
purpose of this
study was to
investigate the
effect of four
solutions [saliva
(control group),
saliva+tea,
saliva+coffee,
saliva+nicotine]
on the color of
different denture
base acrylic
resins (heat
polymerized,
injectionmolded,
autopolymerized)
andasoftdenture
liner.
Materials and
Methods:
Twenty
specimens from
each type of test
material were
prepared (2.5
mm diameter, 2
mm thickness).
Five specimens
from each test
material (heat
polymerized,
chemically
polymerized,
injectionmolded
acrylicresin,soft
solutionin37 Cinadarkenvironment.
Colorimetric measurementsweredone
on the 1st, 7th, and 30th days. Color
differences among specimens
immersedinsaliva(controlgroup),and
stainingsolutionswereevaluatedover
time. Data were statistically analyzed
with oneway analysis of variance
(ANOVA) ( = 0.05). ANOVA was
followedbyTukey testto find which
groupsdifferedfromeachother.
Results: Significant color shifts
occurred in heatpolymerized and
injectionmolded acrylic resins in
coffeeandinsoftlinerinnicotineover
time(p<0.05)(E>1).Thecolorshift
of soft liner in nicotine was
significantly different than that of the
remainder of the test materials in
nicotine (p < 0.05). The color shift
magnitudes of each test material in
coffee and tea were not significantly
different when compared among the
testmaterialgroups(p>0.05).
Conclusions: The effect of staining
solutions on the color of each test
material in each session was
perceivablebythehumaneye(E>1);
however, the color shifts of all test
materialswereclinicallyacceptable(E
<3.7)exceptforsoftlinerinnicotine,
which was not clinically acceptable
over time. Therefore, minimizing
drinkingofsuchbeveragesanduseof
tobacco,particularlywhensoftlineris
applied, may be advantageous for
denture wearers for longterm color
stability.
problem as well.chemically to
Therefore, in the clinicalinitiate
the
practiceofdentistry,therepolymerization
aremanycircumstancesinreaction; however,
which the need to adjustphysicalproperties
denture base acrylic resinof these materials
is necessary. Chemicallyhavebeenfoundto
activatedresinsarewidelybe unfavorable in
used to reduce thepreviousstudies.2
processing time and
provide rapid delivery.
These materials react
To overcome
some of these
disadvantages of
conventional
compression
molding, an
injectionmolded
technique was
attempted for
introducing
118
Journal of Prosthodontics
118124
method
morelow
free
35monomer con
commonly used. tent, and good
Injectionmoldeddentureimpact strength,
bases have thebut have the
advantages
ofdisadvantages of
dimensional accuracy,capitalequipment
is
College of
Prosthodontists
69
Imirzalioglu et al
1 18
mostimportantclinicalpropertiesforalldentalmaterials,
and Although the color
color changes are indicators of aging or damaging of thestability of denture base
19
materials. Severalfactorsmaycontributetothediscolorationofresins and soft liners have
dental materials after longterm use. These factors include stainbeen evaluated in the
Acrylic resin
Heat-polymerizing
Injection-molded (autopolymerizing)
Autopolymerizing
Soft liner
Symbol
Product name
Manufacturer
H
I
A
S
Meliodent
PalaXpress
Wertex
Ufi Gel
Journal of
119
Imirzalioglu et al
differences(E)betweenspecimensindifferentsolutionswere
calculatedaccordingtotheequationmentionedabove.Inthe
presentstudy,aEvalueover1wasconsideredperceivableby
thehumaneye,andvaluesbelow3.7wereconsideredtobe
clinicallyacceptable.
Todeterminethecolorchangeinthe1st,7thand30thdays,
mean E values of specimens in each staining solution were
evaluated with oneway ANOVA. The significant differences
wereanalyzedwithTukeytesttofindoutwhichgroupdiffered
fromeachother.Ifnormalitybutnottheequationofvariances
wasobtained,BrownForsytheFstatisticswereusedforstatis
ticalanalysis.Statisticallysignificantdifferenceswereanalyzed
withGamesHowelltest.Whenneithernormalitynorequation
of the variances was obtained, KruskalWallis test was used.
MannWhitneytestwasusedforsignificantdifferences.
Results
Theeffectofdurationanddifferentstainingsolutionsonthe
colorshiftofthreetypesofacrylicresinsandasoftlinerwas
observedinthepresentstudy.TheEresultswerecalculated
betweenspecimensofeachtestmaterialinthecontrolgroup
(saliva)andthespecimensofsamematerialsindifferentcol
orants(Table3).
ForHacrylicgroup,thecolordifferencesbetweencontrol
groupandcoffeeweresignificantlydifferentbetweenthe1st
dayand7thdayand7thdayand30thday(p=0.001).The
remainingcolordifferencesinothercolorantswerenotstatis
ticallysignificant(p>0.05).ForIacrylicresin,significant
differenceswerenotedonlyinthecoffeegroupbetweenthe7th
day and 30th day (p = 0.033). For A acrylic resin, all color
differences in all colorants were not statistically significantly
differentovertime(p>0.05).ThecolordifferencesforSwere
onlysignificantinnicotinebetweenthe1stdayand7thdayand
1stdayand30thday(p=0.001)(Fig1).
In1stdaycoloranalysis,thecolordifferencemagnitudeswere
notstatisticallysignificantlydifferentamongacrylicresingroups
when evaluated in each colorant. In the 7th day analysis, the
colorofthesoftlinerinteachangedsignificantlydifferentlythan
thecolorshiftinAandHacrylicresins(p = 0.004forH; p =
0.002 for A). The color shift in soft liner in coffee was
significantlydifferentfromAandIacrylicresins(p=0.001for
I;p=0.008forA).Thecolorshiftofsoftlinerinnicotinewas
significantly different from the color change in each type of
acrylicresin(p<0.05).Inthe30thdayanalysis,thecolorshift
ofsoftlinerinnicotinewassignificantlydifferentthanthecolor
shiftineachtypeofacrylicresin(p=0.003forA;p<0.05forH
andI).Thecolorshiftineachtestgroupwasnotsignificantly
differentinteaandcoffee(Fig2).
Discussion
Significantcolorshiftsoccurredineachtestgroupineach
staining solution over time. Moreover, the color shift in
different test groups was significantly different when the
magnitudesofcolordifferenceswithinthetestgroupswere
comparedinthe7thdayand30thday(p<0.05).
Whenthecolorofheatpolymerizedacrylicresinwaseval
uated,itwasobservedthatthecolordifferencebetweenspec
imensinthecontrolgroupandeachstainingsolutionwasall
perceivable by human eye; however, only coffee statistically
significantly affected the color of specimens over time (p <
0.05).Thecolordifferenceobservedinspecimensofinjection
molded acrylic resin in the control group and each staining
solution was all perceivable by the human eye. The color of
specimens in coffee changed significantly over time, particu
larly after the 7th day (p < 0.05). The changes in color of
autopolymerizing acrylic resin were all perceivable in each
measurementtime;however,thecolorchangesovertimewere
not statistically significant in any staining solution. The color
shiftsinsoftlinerspecimenswereallperceivableineach
Heat-polymerized
(H)
Injection-molded
(I)
Autopolymerized
(A)
Solution
Duration
Mean
SD
Mean
SD
Mean
SD
Mean
SD
Tea-control group
1st day
7th day
30th day
1st day
7th day
30th day
1st day
7th day
30th day
2.08
2.33
2.08
1.76
2.72
1.77
2.24
2.47
2.42
0.84
1.11
0.87
0.72
0.76
0.98
1.01
1.27
1.08
2.13
2.05
2.21
2.39
3.03
2.12
2.07
2.38
2.49
1.20
1.13
1.25
1.45
1.06
1.19
1.13
1.12
1.11
2.25
2.52
2.23
2.35
2.87
2.41
2.27
2.52
2.63
1.01
0.89
1.06
1.02
1.00
1.18
1.00
1.00
1.19
2.02
1.69
1.66
1.74
2.06
1.95
2.11
3.73
3.46
0.90
0.77
0.44
0.60
0.56
0.44
0.62
0.63
0.39
Coffee-control group
Nicotine-control group
120
Journal of
2009 by The
Imirzalioglu et al
injectionmoldedacrylicresins
(p < 0.05). The effect of
nicotine was significantly dif
ferent and more on soft liner
than on each type of acrylic
resin (p < 0.05). Similarly,
after 30th day measurements,
nicotine solution changed the
colorofsoftlinermorethanit
changed the color of acrylic
groups.Consequently,itcanbe
stated that the color of soft
liner was affected particularly
from nicotine more than the
acrylicgroupswereaffectedon
the 7th and 30th days;
however,theeffectofteaand
coffee was less on soft liner
thanitwasondifferentacrylic
groups.Teachangedthecolor
and
College of
Prosthodontis ts
121
measurement
times between
specimens in
control groups
and staining
solutions.
Imirzalioglu et al
during
theeffectofcoffeewasmoreonthecolorofautopolymerizingpolymerization. The favorable
and injectionmolded acrylic resins. The color shifts of test physical properties of
groupswereallclinicallyacceptable(E < 3.7),exceptfortheinjectionmolded acrylic resin
colorchangeofsoftlinerinnicotinesolutiononthe7thday(E could be a reason for a
= 3.73).Thecolorchangeofsoftlinerinnicotinesolutionon prediction of intended color
the30thdaywasclosetotheclinicalacceptabilitythreshold(E stability.Thepolishabilityand
lack of porosity of injection
=3.47).
moldedacrylicresinshasbeen
Many materials used for prosthetic treatment, such as fixed
42
reported in the literature.
27,28
2931
partialdentureacrylicresins,
interimprostheses,
andsoftAccordingly, low surface
32
dentureliners, aresubjecttosorption,aprocessofabsorption roughness of the material,
and adsorption of liquids dependent upon environmental which can affect staining by
conditions. The materials absorb liquid slowly over a period of
time. The absorption is undoubtedly due primarily to the polarfoodsandplaqueretention,can
propertiesoftheresinmolecules.Becauseofthisproperty,these be predicted as well;14
materialsareknowntoundergostainingthroughtheuseofdenture
however, the color of
21,28
cleansersandfromtheintakeoffluidsandfoods.
injectionmolded arcylic resin
There is evidence that beverages like tea and coffee signif was significantly affected by
32
icantlyincreasethedevelopmentofstainsondentalmaterials. coffee solution after 7th day
37
37
Chan et al compared the staining properties of four foodsmeasurements(p<0.05).This
(coffee,soysauce,tea,cola).Theytestedtwocommercialbrands may be attributed to the
ofcompositeresinandshowedthatthesebeveragesincreasedthe autopolymerizing character of
35
developmentofstain.Cooleyetal reportedthatresinrestorativethe injectionmolded acrylic
materialsexhibitedstainingafterimmersioninacoffeesolutionforresin, which is considered to
7days.Similarlyinthepresentstudy,coffeecausedaconsiderablehave unfavorable physical
magnitudeofcolorchangeonsomeresinbaseddentureacrylicsproperties.38 The clinically
after7days.
unacceptable color change
Autopolymerizingdenturebaseresinshavebeenfoundtobeless
magnitudeofsoftliner,which
38
stablethanconventionalacrylicresinsinpreviousstudies. Thewasobservedinnicotineafter
color stability of autopolymerizing denture base acrylic resins7thdaymeasurements,maybe
varieswiththechemicalcompositionofthemonomer.Austinand attributedtotherelativelyhigh
41
Basker explained thatdenture basematerials processedby ansurface roughness of the
autopolymerizedmethodhavedemonstrateduptoseventimesthe material.
levelofresidualmonomerfoundinconventionalheatpolymerized Tea leaves contain a
materials.Theresidualmonomercontentmayberesponsibleforconsiderable amount of
flavonoid, which gives tea its
39
the color changes observed. Purnaveja et al also showed that
functional properties and
autopolymerizedresinshavecolorstabilityinferiortothatofheat
flavor; however, teaflavins in
polymerized materials. Heatpolymerized acrylic resins are
tea leaves are reported to be
consideredmorecolorstablethanautopolymerizingacrylicresins
the cause of discoloration.
16
duetoexistenceofanamineaccelerator. Inthisstudy,whiletheSimilarly,caffeineandcaffeic
color of heatpolymerizing resin significantly changed in coffeeacid in coffee may lead to
afterthe1stday(p < 0.05),nostatisticallysignificantcolorshift discoloration in polymeric
wasobservedinautopolymerizingacrylicresinovertimeineach
25
36
stainingsolution;however,whenthemagnitudeofcolorshiftsin materials. Um and Ruyter
allacrylicresinsineachsolutionwereconsidered,itcanbestated reported that tea caused more
thatthecolordifferencevalueswerelimitedwithinarange(1.06to discolorationthancoffeeafter
3.03) considered perceivable by human eye, but clinically 48hoursstorageoffiveresin
acceptable. Therefore, color shifts in autopolymerizing acrylic based materials in coffee and
resinsincoffeemaybeconsideredminor.Thisminorcolorshiftin tea solutions. It was reported
autopolymerizingresinshouldnotbeconsideredasanindicator that discoloration due to tea
thatthisresinistobeacceptedastheoptionofdenturebasein can be easily removed,
termsofcolorstability.
dependingontheadsorptionof
Beforeanydentalrestorationorapplianceisplacedpermanentlythefoodcolorantsfromteaat
in the mouth, it should be highly polished. If there is a rough thesurfaceofthematerials.In
surfaceonarestorationordenture,itisuncomfortableasfoodand contrast, with coffee, the
31
otherdebrisclingtoit.CrispinandCaputo foundthatcolorofdiscoloration is probably due
specimenswithroughsurfacessignificantlychanged.Accordingtotobothsurfaceadsorptionand
21
absorptionofcolorants.Itwas
Mayetal, colorchangemaybeas
also reported that fewer polar
colorants from coffee had
penetrated deeper into the
122
Journal of
Prosthodontics 19 (2010)118124
materialsbecausethecolorants
weremorecompatiblewiththe
polymer matrices of the
compositeresinmaterials.
43
(hydrophilic
40
material),
except for
autopolymerizing resin over
time (p < 0.05). Moreover,
the effect of coffee was not
significant on soft liner,
which is a hydrophobic
40
material, whiletheeffectof
nicotine was considerable
overtime(p<0.05).
Tristumuluscolorimetersare
widelyusedinstrumentsforthe
color analysis of dental
materials; however, these
devices are not errorproof,
depending on the small
window sizes. The edgeloss
effect occurs due to loss of a
considerable fraction of the
lightenteringtheobjectasthe
light emerges on the surface
outside the window of
44
measurement. Translucent
objects can be a reason for
44
measurementerrors aswell.
Since the materials used in
this study were translucent in
structure, some errors might
have occurred during color
measurements. To minimize
sucherrors,animmobilizerfor
thespecimensandcolorimeter
wasusedduringmeasurements
with a standardized neutral
graybackground.Besides,one
experienced
examiner
performed the colorimetric
measurements.
Prosthodontists
Imirzalioglu et al
Conclusions
Withinthelimitationsofthisstudy,itcanbeconcludedthat:
1) Theeffectofstainingsolutionsonthecolorofeachtest
2)
3)
4)
5)
6)
materialineachsessionwasperceivablebyhumaneye
(E>1).
Coffee affected the color of heatpolymerized and
injectionmoldedacrylicresinsovertime(p<0.05).
Theeffectofteaonthecoloroftestmaterialsdidnot
significantlychangeovertime.
The color of autopolymerizing acrylic resin did not
significantlychangeovertimeineachsolution.
The color of soft liner was affected by the nicotine
solutionmorethanbyteaandcoffee(p<0.05).
Thecolorshiftsofalltestmaterialswereclinicallyac
ceptable,exceptforsoftlinerinnicotine,whichwasnot
clinicallyacceptableovertime(E>3.7).
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