Effect of adding zinc oxide and zirconium oxide on decreasing tooth discoloration from mineral trioxide aggregate in a regenerative endodontic model

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Piyawat Vibulcharoenkitja
Danuchit Banomyong
Benjaratana Sirisinsuk
Parina Angnanon
Pornjaras Jiarratanasawat
Kalsiree Lertsodsai
Thitipong Wongkanchana


Objectives: To investigate the effect of adding zirconium oxide (ZrO) or zinc oxide (ZnO) (5% by weight) on decreasing tooth discoloration from mineral trioxide aggregate in a regenerative endodontic tooth model over 28-day period.

Materials and methods: Thirty human mandibular premolars were prepared to achieve regenerative endodontic models and divided into three groups- (a) original MTA (MTA), (b) MTA+5% ZrO (MTA/ZrO), and (c) MTA+5% ZnO (MTA/ZnO). The powder of MTA was added with ZrO or ZnO in a blending machine until homogeneous. The powder was mixed with the liquid and then placed as a coronal barrier in 3-mm thick at the level of cemento-enamel junction. Each specimen was embedded in a block and placed on a customized platform to control tooth-color measuring area at cervical third on the buccal side. In a light-controlled box, tooth color in CIE L*a*b* values was measured using the spectrophotometer at day 1 (baseline) and day 28. The difference in tooth color was calculated into ΔE value. The specimens at day 28 were selected, horizontally sectioned and photographed to observe discoloration of MTA material and/or dentin.

Results: At day 28, ΔE of MTA (6.83±1.70) was significantly higher than MTA/ZrO (3.70±1.36) and MTA/ZnO (4.20±1.31) (p<0.01). In the sectioned specimens, severe discoloration was observed in MTA material and adjacent root dentin. MTA/ZrO and MTA/ZnO showed less discoloration of material and dentin.

Conclusion: Mixing 5% ZrO or ZnO into MTA containing bismuth oxide significantly decreased tooth discoloration in the regenerative endodontic model.


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Vibulcharoenkitja P, Banomyong D, Sirisinsuk B, Angnanon P, Jiarratanasawat P, Lertsodsai K, Wongkanchana T. Effect of adding zinc oxide and zirconium oxide on decreasing tooth discoloration from mineral trioxide aggregate in a regenerative endodontic model. M Dent J [Internet]. 2021 Apr. 26 [cited 2023 Dec. 7];41(1):91-6. Available from: https://he02.tci-thaijo.org/index.php/mdentjournal/article/view/248080
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