Yawar Ali Abidi1 BDS, FCPS
Sameer Quraeshi2 BDS, MSc
Syed Ahmed Omer3 BDS, MSc,
Murtaza Raza Kazmi4 BDS, FCPS
Saqib Rashid5 BDS, MSc, FCPS
OBJECTIVES: To evaluate the effects of staining of two types lipsticks (one with common fixer other with ultra fixer) on the color stability of resin-based composite restorative material at different time intervals.
METHODOLOGY: Ninety disc-shaped specimens (10×2 mm) were prepared from Nanofilled composite. Filtek Supreme XT (3M ESPE, St. Paul, MN, USA). Discs were polished and divided in to 9 groups according to time elapsed after curing (0 hour, 1 hour, and 24 hours) and contact with different lipstick (lipstick with common fixer, lipstick with ultra fixers). Color measurements (L*, a*, b*) of each specimen were taken with a spectrophotometer (Data color; SF 600; Plus-CT; USA) according to the CIELAB color scale. For control group discs did not have any contact with lipsticks. For lipsticks group discs were stained at different time intervals (0 hour, 1 hour and 24 hours). Color analysis was done before and after staining. Discs were stored in artificial saliva at 370c.
STATISTICAL ANALYSIS: The color change value DE* were calculated. Data were analyzed using a 2-way analysis of variance with repeated measurement at a significance level of 0.05 and Tukey’s Honestly Significant Difference (HSD) for multiple comparisons.
RESULTS: All specimens displayed color changes after curing, and there was a statistically significant difference between both lipsticks and time periods (P<0.05); however, the change was not visually perceptible (DE*<3.3) for control group and group with common fixer. Color change for group with ultra fixer was visually perceptible (DE*>3.3).
CONCLUSIONS:Groups with ultra fixer caused greater staining than other groups. Therefore, lipstick wearers should be warned to avoid the use of lipsticks with ultra fixer after receiving composite restoration in anterior teeth for at least 24 hours.
KEY WORDS: Composite resin; ultra fixer; common fixer.
HOW TO CITE: Abidi YA, Quraeshi S, Omer SA, Kazmi MR, Rashid S. Effect of Different Lipsticks on Nanofilled Composite Resin at Different Contact Time After Photoactivation. J Pak Dent Assoc 2014; 23(3):95-99
To fulfill the esthetic demands of patient toothcolored restorative materials have been widely used in dentistry1. Different type of dental composite resins are available in the dental market and they are classified according to shape, size and distribution of fillers2. Nowadays Nanocomposite is widely used in clinical practice. Nanocomposite contains filler size ranging from 0.01-0.04mm3. It has many advantages such as increase mechanical properties, high wear resistance and low polymerization shrinkage4. Despite these advantages some problems still remain and one of them is color stability which is the ability of material to be able to retain its original color5. Dental composite resin content has been reported as being critical to color stability and leads to discoloration5. Discoloration of esthetic restorative material is caused by several intrinsic and extrinsic factors. Intrinsic stain is due to alteration of the resin matrix itself 6, However, extrinsic factors include staining by exogenous sources such as tea, coffee, beverages and mouth rinses. These agents cause discoloration by absorption and adsorption of colorants7.
Color evaluation can be done by visual method or by instrumental methods. In visual method an observer assesses the color change of the sample against white background, while in instrumental method devices such as Spectrophotometer, Calorimeters and computerized image analysis are used8.
The spectrophotometer measures wave lengths of transmitted light of specimen9. This instrument uses the (CIE) L*a*b* color system. This system consists of the following Parameters: L*, which refers to luminosity (white to black); a*, which refers to the red-green color axis and b*, which refers to yellow-blue axis9. Even though there are a number of studies on evaluating the staining power of commonly used products in daily life such as tea, coffee, soft drinks, chlorhexidine containing mouth rinses1, but no reports were found with regards to staining power of different lipsticks which is commonly used by female patients and is available with different fixers in market. There are a few clinical and in vitro studies which reported that these lipsticks have capability to causes alterations in color of composite resins14. Thus, there is great need to find the staining capability of lipsticks with common and ultra fixers and also considering the contact time with esthetic dental materials.
This study estimates superficial color alteration of composite resin stained with two different types of lipsticks (one with common fixer and the other with ultra fixer) at different time intervals, immediately, 1 hour and 24 hours after curing.
The hypotheses tested were:
- The composite resin shows color alteration when stained with lipstick;
- The composite resin shows color alteration when stained 24 hour after polymerization.
- Lipstick with ultra fixer show more color alterationof composite then lipstick with regular fixer.
PREPRATION OF SPECIMEN
In this study, 90 specimens of nanocomposite FiltekTM Z350 XT shade A3 (3M ESPE, St.Paul, MN, USA) were made using poly tetra fluoroethylene mold (10mm in diameter and 2mm of thickness). All materials were prepared according to manufacturers’ instructions (Table I). Composite resin was placed in one increment in mold
Table I: The detail of materials used in this study
and overfilled, to avoid air bubbles and inclusion mold covered with mylar strips and compressed with glass slides on the upper and lower surface. Samples were light cured at the distance of 1 mm for 40 seconds on each side with LED curing lamp Mectron (Intensity 1000mw/cm2 starlight pro-led curing lamp, Italy). After curing glass slide and mylar strips were removed. The discs were polished with coarse, medium, fine and ultra fine Discs (Sof-Lex Pop-On; 3M ESPE, St. Paul, MN, USA). After preparation discs were divided in 9 groups (n=10) according to time interval between curing and contact with both lipsticks.
Two same color lipsticks represented pigmenting agents. One lipstick had common fixer and other had ultra fixer.
Color measurement were performed with a spectrophotometer (Data color; SF 600; Plus-CT; USA, Efroze Textile mills F.B.Area, Karachi) using CIE L*a*b*(Comission International l´Eclairage) system. The analyzed color parameters were the values for L*, a* and b*. Where L* is the luminosity, a* represent the color variation between green-red and b* represent the color variation between blue-yellow. DE is the total color variation. The total color variation was calculated according to following equation.
DE*ab = [(DL*)2 + (Da*)2+ (Db*)2]1/2
The spectrophotometer was calibrated before each color analysis session of discs in accordance with manufacturer’s instruction.
For color analysis each discs was placed inside the central orifice of the white, opaque Teflon matrix. A mortise device was placed on the white Teflon, which was positioned over the disc to standardize the contact of the tip from the spectrophotometer to disc surface at 90o angle.
Study group divided according to time interval between curing and staining with lipstick and type of fixer in the lipstick detail of groups given in table II
For the groups (G1, G4 and G7) at 0 hours after curing discs surfaces were cleaned and dry with absorbent paper. Base line colors of the discs were recorded (average of 3 readings).
G1 was not stained. G4 was stained with common fixer lipstick only single coat in one direction is applied. G7 was stained with ultra fixer lipstick in a same manner like G4. These discs were then kept in dry conditions for 1 hour, after which the excess lipstick was removed with absorbent paper. Then the final color readings of the discs were taken (average of 3 readings).
For the groups (G2, G5 and G8) same procedure is repeated after 1 hour of curing. Discs were stored in artificial saliva at 37oC. For the groups (G1, G4 and G7) same procedure is repeated after 24 hour.
Statistical analysis was computed with Statistical Package for Social Sciences (SPSS) software, version 16.00 (SPSS Inc, USA). Descriptive analysis was executed in the form of mean and standard deviation for change in color. ?E values were tested for significant difference at (0.05 level of significance) using two-way ANOVA with repeated measurement and Tukey’s Honestly Significant Difference (HSD) for multiple comparisons.
Means and SD are shown in table II
There was no statistically significant difference between the control group and group stained with common fixer lipstick (p>0.05), but there was statistically significant difference between the group stained with common fixer
Table II Mean and standard deviation
lipstick and group stained with ultra fixer lipstick (p<0.05). Statistically significant difference was also seen between
control group and group stained with ultra fixer lipstick. The composite resin showed more color change with both lipsticks as compare to control group.
With respect to time period there were statistically significant differences seen between all the groups at three different time periods (p<0.05). Statistically significant differences were seen at 0 hour, 1 hour and 24 hour.
There are a number of methods used for color determination of teeth and tooth color restorative material in dentistry. It is broadly categorized in two categories, instrumental and visual means9. Variability of results in colour determination among different observer is due to many factors including the observed object and position of observed object relative to observer, color distinctiveness of illuminate metamerism, perception of observer10. For this reason instrument measurement has been suggested, because it reduces subjective elucidation of visual color comparison, therefore, spectrophotometers and colorimeters are more extensively used today11. Due to these facts, the current study used the instrumental technique with a spectrophotometer recording the color values with the CIE (Comission International l´Eclairage) L* a*b* system. This system has the capability to find out the color change value DE.
In 1989 Johnston and Kao recommend that value of DE < 3.3 was not visually perceptible so change in color in this range is esthetically acceptable. However, DE >3.3 gives clinically visual perception of color change and is deemed esthetically unacceptible12.
The present study observed that, composite resin discs treated with ultra fixer lipsticks showed high staining index as compared to control groups and groups that were treated with common fixer, it proved our first hypothesis. These values are clinically unacceptable (DE>3.3) results are in agreement with result reported by Douglas et al13. Moreover, composite resin discs in control group show little color change at different time intervals, it might be caused by dehydration of composite resin or it is the continuation of cure. This change in color was considered as normal and esthetically acceptable, our results are in accordance with Avilmar et al which concluded that values of DE were much lower in control group and visually acceptable14. However, staining caused by both lipsticks was probably due to hydrophilic nature of matrix and increase vulnerability of water sorption in polymer15. As a result of this, composite resins absorbs coloring pigments in lipstick which results in discoloration. According to Ferracane et al9 composite resin show high absorption initially only but our results are not in agreement with it because discoloration of composite was high even at 24 hour after curing similar to color change in initial hours so the second hypothesis of present study was also accepted. Composite resins showed higher color change with ultra fixer lipstick at three different times (0 hr,1 hr and 24hrs) as compared to lipstick with common fixer, this also confirms the third hypothesis of present study.
There is necessity of more studies on staining power of different kind of lipsticks. Similar studies have reported
the effect of commonly utilized drinks such as tea, coffee, red wine and different mouth washes17-20. We used only one brand of composite resin in our study, therefore the results cannot be generalized. Also, only single brand of lipstick was used. Future studies addressing these limitations are recommended. Other clinical variables such as the frequency of reapplication of lipstick and the action of the tongue in terms of cleaning the stained resin restoration surface should be further analyzed. The results of our study must be interpreted with caution due to above mentioned limitation. It is recommended to instruct female patients to avoid the use of lipsticks for at least first 24 hours of composite resin based restoration on anterior teeth.
Groups with ultra fixer caused greater staining than other groups, so lipstick wearers should be warned to avoid the use of lipsticks with ultra fixers after receiving composite restoration in anterior teeth for at least 24 hours.
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1. Associate Professor & Head Department of Operative Dentistry Dr. Ishrat ul Ibad Khan Istitute of Oral Health Sciences, Dow University of Health Sciences.
2.Assistant Professor, Department of Prosthodontics Fatima Jinnah Dental College and Hospital. Email: email@example.com
3.Assistant Professor & Head Department of Science of Dental Materials Bahria University Medical & Dental College.
4.Assistant Professor, Head Department of Prosthodontics Fatima Jinnah Dental College and Hospital.
5.Professor, Head Department of Operative Dentistry Fatima Jinnah Dental College and Hospital.
Corresponding author: “Dr Yawar Ali Abidi ” < firstname.lastname@example.org >