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Effect of various polishing agents on the color stability of provisional crowns

Article  in  Drug Invention Today · May 2018

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 Research Article

Effect of various polishing agents on the color stability of

provisional crowns
Saloni Kachhara1, Bennis Marian Anand1, M. Dhanraj2, Ashish R. Jain2*

ABSTRACT

Background: Provisional crowns and fixed partial dentures are a very significant part of prosthodontic treatment. A temporary
restoration should protect the prepared teeth, provide comfort and function, and be esthetically acceptable and color stable. The
prognosis of a fixed restoration depends on the quality of this interim restoration. Aim: The purpose of the study was to evaluate
the effect of different polishing methods on the color stability of provisional crowns. Materials and Methodology: A total of
15 samples of central incisor were made using autopolymerizing polymethylmethacrylate and putty index. Samples were
divided into five groups of different polishing techniques, namely pumice (P), prophylaxis paste (PP), polishing discs (standard
deviation), dental varnish (DV), and the control group (C). The specimens were dipped in coffee solution for 30 min. The
shade of all specimens was measured before and after dipping in the coffee solution using VITA spectrophotometer. The
data were analyzed using SPSS software and paired t-test was conducted. Results: Significant difference in color was seen
only in DV group and the control group. All other groups did not show any significant difference in the color. On comparing
the other groups, group polished using PP showed least color change followed by DV group and then the pumice alone.
Conclusions: The use of PP after polishing with pumice significantly reduced the staining in autopolymerizing resin. The
highest color change values were obtained in groups polished with DV, polishing disks, and pumice.

KEY WORDS: Color stability, Polishing techniques, Provisional crowns, Spectrophotometer, Staining

INTRODUCTION of service. Discoloration of these crowns may lead

Provisional crowns and fixed partial dentures are a very
significant part of prosthodontic treatment.[1] A temporary
restoration should protect the prepared teeth, provide
comfort and function, and be esthetically acceptable
and color stable.[2] The prognosis of a fixed restoration
depends on the quality of this interim restoration.[3]
Provisional crowns can be made from various materials
such as autopolymerizing polymethylmethacrylate,
polyethylene methacrylate, polyvinyl methacrylate,
urethane methacrylate, bis-acryl, and microfilled
resin.[4,5] These materials can be polymerized by
chemical, light, or both chemical and light activation.
In esthetically critical areas, the provisional restoration
must maintain its esthetic appearance over the period
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to patient dissatisfaction and additional cost for
replacement. Hence, stainability may be a significant
criterion in the selection of a particular provisional
material.[6] Discoloration can be evaluated with
various instruments such as spectrophotometers and
colorimeters.[5]
The provisional restorations can be finished using a
variety of techniques such as burs and polishing disk
to achieve a smooth, polished surface.[7] Pumice and
polishing materials are suggested for the polishing of
visible light-polymerized composite PR materials.[8,9]
Currently, the clinician can choose a variety of PR
materials. It is possible that the traditional methods
of finishing provisional restorations do not work
well for all material types available. The effect of
polishing on staining of provisionals during long-term
use is not clearly stated.[5] The purpose of this study
was to investigate the effect of different polishing
methods on the color stability of autopolymerizing
polymethylmethacrylate.

1
Department of Prosthodontics and Implant Dentistry, Saveetha Dental College, Saveetha University, Chennai, Tamil Nadu,
India, 2Department of Prosthodontics, Saveetha Dental College and Hospitals, Saveetha University, Chennai, Tamil Nadu, India

*Corresponding author: Dr.  Ashish R. Jain, Department of Prosthodontics, Saveetha Dental College and Hospital,
Saveetha University, Ponamalle High Road, Chennai – 600  127, Tamil Nadu, India. Phone: +91-9884233423.
E-mail: dr.ashishjain_r@yahoo.com

Received on: 24-02-2018; Revised on: 21-04-2018; Accepted on: 21-05-2018

796 Drug Invention Today | Vol 10 • Issue 5 • 2018

 Saloni Kachhara, et al.
MATERIALS AND
METHODOLOGY
In the present study, commonly used autopolymerizing
polymethylmethacrylate (DPI Self cure tooth molding
powder) was used to evaluate the effect of various
polishing techniques on this material. 15 central
incisor-shaped specimens were prepared of tooth
molding powder using a putty index of maxillary
central incisor tooth (Acry Rock size 18). Material
was dispensed and manipulated according to the
manufacturers’ instructions. All the specimens were
wet ground with 600-grit silicon carbide abrasive
paper for 10 s on a 300-rpm grinding machine.
The 15  specimens were further divided into five
groups of three specimens each for the different
surface polishing procedures. The first was the control
group (C), the second was group pumice (P) where
specimens were polished using pumice ---------, and
a rag wheel mounted on an electric handpiece at
15,000 rpm for 15 s. The third was group prophylaxis
paste (PP) where the specimens were polished with
a prophylactic cup mounted on an electric handpiece
at 15,000  rpm using PP (Protec) for 15 s. In the
fourth group of polishing discs (standard deviation
[SD]), the specimens were polished with a series of
polishing discs (Sof-Lex) with an electric handpiece at
15,000 rpm for 15 s for each disk in the series (coarse,
medium, fine, and superfine). In the fifth group of
dental varnish (DV) (Easy Glaze), a layer of varnish
was applied on the specimens and light cured with a
light intensity of 400 mW/cm2 for 20 s with the light
tip approximately 1 mm away from the specimen.
Before exposure to the staining agent, baseline color
measurement of all specimens was recorded with a
spectrophotometer (Vita Easyshade Advance 4.0).
The instrument was angled at the center of the facial
surface and measurements were recorded. After this,
specimens were stored in 100  mL of coffee (Bru
Table 1: Paired samples test
Colour change Paired differences
after exposure to
Mean SD SEM
staining agent
Pair 1
Control A-ControlB 2.8333 0.6658 0.3844
Pair 2
Pa-Pb 2.3333 1.2897 0.7446
Pair 3
PPa-PPb 0.7333 3.0288 1.7487
Pair 4
DVa-DVb 0.8667 2.7755 1.6024
Pair 5
SDa-SDb 2.0667 0.4041 0.2333
SD: Standard deviation, SEM: Standard error of the mean
Drug Invention Today | Vol 10 • Issue 5 • 2018
Instant) for 30  min at 37°C. The coffee (3.6  g) was
dissolved in 300 mL of boiling distilled water according
to the manufacturer’s suggested concentration. After
10  min of stirring, the solution was filtered through
a filter paper. After 30  min in the coffee solution,
the specimens were rinsed with distilled water for
5 min and blotted dry with tissue paper before color
measurement. At this point, color readings were made
again using the spectrophotometer in the manner
described for baseline readings.
Paired t-test was conducted with the collected data
using the statistical software (IBM SPSS 20 for
windows) as only color difference was measured
of one material with different polishing techniques
before and after.
RESULTS
According to the paired t-test, a significant difference
in the color change was seen only in the control group
and the specimens polished with polishing discs
(P < 0.05). There was no significant difference in the
color change between the specimens before and after
dipping in the coffee solution in the other groups.
Among the other three groups, least color change was
observed in the PP group, closely followed by the
DV group. There was color change observed in the
pumice group. Mean values and SDs of color changes
of the autopolymerizing polymethylmethacrylate
provisional material are listed in Table  1. The
difference in the mean color records of each before
and after dipping in the solution is given in Table 2.
DISCUSSION
Color reproduction is an important entity for
restoration in esthetic region. Color stability is very
critical for the esthetics of long-term provisional
restorations and has been previously studied in vitro
for a variety of provisional restorative materials.[2,5]
t df Sig. (two-tailed)
95% confidence
interval of the
difference
Lower Upper
1.1793 4.4874 7.370 2 0.018
−0.8705 5.5371 3.134 2 0.089
−6.7905 8.2572 0.419 2 0.716
−6.0280 7.7614 0.541 2 0.643
1.0627 3.0706 8.857 2 0.013
797
 Saloni Kachhara, et al.
Table 2: Mean difference in the color after exposure to
staining agent in all the groups
Groups Mean difference
Ca-Cb 2.8
Pa-Pb 2.2
PPa-PPb 0.7
DVa-DVb 0.8
SDa-SDb 2.1
Ideally, dental resins should not change in color or
appearance subsequent to fabrication. Material that
undergoes significant discoloration may be a source
of embarrassment for both the patient and dentist.[11]
The present study thus evaluated the effect of various
polishing techniques on the color stability of
provisional crowns made up of tooth molding powder.
Staining of resin composite surface is a complex
phenomenon that can involve several mechanisms.[17]
Finishing and polishing procedures may also influence
surface smoothness, which is related to early
discoloration. Rough surfaces mechanically retain
surface stains more than smooth surfaces.[18,19] To
reduce the color change, the smoothest surface
finish should be obtained. Sen et al.[8] reported that
the polishing pastes removed surface material more
effectively and produced smoother surfaces, and
smoother surfaces of bis-acryl composite specimens
were produced with diamond pastes rather than
aluminum oxide pastes.
Since instrument measurements eliminate the
subjective interpretation of visual color comparison,
spectrophotometer has been used to measure color
change in this study.[10] Data collected by it can be
significantly altered by its inability to read translucent
materials, standardized illuminating light emitted
from the device, and background.[13] When measuring
reflective surfaces, the measured color depends on
both the actual colors of the surface and the lighting
conditions under which the surface is measured. Color
is also affected by the thickness and smoothness of
the specimen surface.[14] In this study, therefore, tooth
resembling specimen was used.
Crispin and Caputo[15] studied the color stability
of provisional materials. “They found that methyl
methacrylate materials exhibited the least darkening,
followed by ethyl methacrylate and vinyl-ethyl
methacrylate materials.” Maalhagh-Fard et al.[9]
evaluated the effects of two finishing techniques and
pumice polishing on the surface roughness of eight
different provisional materials. Pumice application
alone did not smooth the surface of all materials.
In the Guler et al. study,[5] the color stability of four
provisional restorative materials was evaluated after 48
h of immersion in a staining solution, according to the
different finishing procedures. According to the results
798
of this study, the methyl methacrylate-based provisional
restorative material was found to be more color stable
than the autopolymerized and light-polymerized
composite provisional materials tested. The use of
diamond polishing paste after polishing with pumice
decreased the staining of the methyl methacrylate and
bis-acryl composites tested to a significant extent.
The greatest color change values were obtained in the
groups that were polished with polishing discs and were
found to be significantly different when compared to
values obtained with other polishing techniques. The
results of present study are in agreement to this study.
The discoloration by coffee might be due to both
surface adsorption and absorption of colorants. Fine
coffee particles may have deposited into the pits of
the methyl methacrylate. Polymerization shrinkage
of the resin could have led to the formation of these
pits. The significant color change exhibited by
methyl methacrylate resin may be due to higher water
sorption.[16] Proprietary variations in chemistry such
as size distribution of the polymethylmethacrylate
particles, polarity of the monomers, and efficiency of
the initiator system for provisional resins may lead to
varying degrees of polymerization, water sorption,
and, consequently, color stability.[11]
Optical properties of the material also play a
significant role in color change. This chemical change
may be attributed to the oxidation of the polymer
matrix or oxidation of unreacted double bonds in the
residual monomers and the subsequent formation of
degradation products from water diffusion.[16]
DV also lead to reduced color staining in comparison
to pumice or polishing discs. Application of a coat
of varnish is much more convenient than the other
polishing techniques. However, more research needs
to be done with respect to this.
Limitations of the Study
This study is conducted with a low sample size.
Furthermore, more different provisional materials
could be compared along with the varying polishing
techniques. It is an in vitro study where only one solution
is used to see the colorant effect while in the oral cavity,
teeth are exposed to numerous other substances.
CONCLUSION
The color stability of provisional crown made with
autopolymerizing resin was evaluated after 30  min
of immersion in the coffee solution, according to the
different polishing procedures. Within the limitations
of this study, the following conclusions were drawn:
1. The use of PP significantly decreased the staining
of the polymethylmethacrylate.
2. A coat of DV helps in reducing staining and may
be used instead of other polishing techniques.
Drug Invention Today | Vol 10 • Issue 5 • 2018
 Saloni Kachhara, et al.
3. The use of polishing discs or pumice did not help
in reducing staining.
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Source of support: Nil; Conflict of interest: None Declared
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