Journal of Isfahan Medical School

Journal of Isfahan Medical School

The effect of different concentrations of chlorhexidine mouthwash on color change of lithium disilicate-based all-ceramic crowns and indirect composite restorations

Document Type : Original Article (s)

Authors
Tahereh Imani Foladi 1
Ali Fahim 2
1 Assistant Professor, Department of Dental Prosthodontics, School of Dentistry, Ardabil University of Medical Sciences, Ardabil, Iran
2 General Dentist, School of Dentistry, Ardabil University of Medical Sciences, Ardabil, Iran
10.48305/jims.v44.i868.1144
Abstract
Background: Chlorhexidine mouthwash is very effective in the prevention and treatment of periodontal diseases and caries and is widely used. However, it causes discoloration of restorations, and these changes in them can disrupt the aesthetics of restorations; therefore, this study was conducted with the aim of investigating the effect of different concentrations of chlorhexidine mouthwash on discoloration of all-ceramic crowns with lithium disilicate base and indirect composite restorations.
Methods: In this in vitro study, 36 indirect composite samples and 36 lithium disilicate ceramic discs were prepared in two groups A and B. After preparation, samples from groups A and B were randomly divided into three subgroups of 12: Subgroup 1 - Control group (distilled water), 2 - In the presence of 2/10ths of a percent chlorhexidine mouthwash, 3 - In the presence of 1/12ths of a percent chlorhexidine mouthwash; The color of the samples was measured and compared in 3 stages. Initially, the samples were placed in artificial saliva for 24 hours. Then, they were dried with blotting paper, placed against a white background, and their color was initially measured using the CIELab system and a spectrophotometer and measuring the 3 parameters L, a, b; in the second stage, the samples were placed in solutions and their color was measured in three time intervals of 30 minutes, 6 hours, and 12 hours.
Findings: All ΔE values were in a range that is not clinically understandable, that is, less than 3.3. There was no significant difference in the color change caused by the two concentrations in either group. There was also no significant difference in the color change between the two groups overall. Comparison of the color change of the samples at different time intervals showed that increasing the time did not lead to a significant color change in the samples that was clinically understandable.
Conclusion: The results of the study showed that chlorhexidine mouthwash at different concentrations did not lead to a color change in the samples that was clinically understandable.

Highlights

Tahereh Imani Foladi: Google Scholar , PubMed

Ali Fahim: Google Scholar , PubMed

Keywords
Composite
Lithium disilicate
Ceramic veneer
Chlorhexidine mouthwash
Subjects
1.     Portalier L. Composite smile designs: the key to dental artistry. Curr Opin Cosmet Dent 1997; 4: 81-5.
2.     Morley J. The role of cosmetic dentistry in restoring a youthful appearance. J Am Dent Assoc 1999; 130(8): 1166-72.
3.     Heintze SD, Cavalleri A, Zellweger G, Buchler A, Zappini G. Fracture frequency of all-ceramic crowns during dynamic loading  in a chewing simulator using different loading and luting protocols. Dent Mater 2008; 24(10): 1352-61.
4.     Dickerson WG, Hastings JH. Indirect composite restorations. Curr Opin Cosmet Dent 1995: 51-6.
5.     Griggs JA. Recent advances in materials for all-ceramic restorations. Dent Clin North Am 2007; 51(3): 713-27.
6.     Willard A, Gabriel Chu TM. The science and application of IPS e.Max dental ceramic. Kaohsiung J Med 2018; 34(4): 238-242.
7.     Warden H, Gupta SH, Vallee J, Shulza A. Advances in all cermaic restorations. Dimens Dent Hyg 2012; 10(5): 60-63.
8.     Limly BT, Chakravarthy D, Padmaraj SN, Vijayaraja S, Jayadevan A, Dimple N. Indirect Resin Composite Restorations—A Narrative Review. Jacobs J Dent Res 2019; 5: 41.
9.     Abdul Azeem R, Malli Sureshbabu N. Clinical performance of direct versus indirect composite restorations in posterior teeth: A systematic review. J Conserv Dent 2018; 21(1): 2-9.
10.  Khaledi AA, Safari A, Adibi A, Adibi S. The effect of chlorhexidine mouth rinse on the colour stability of porcelain with three different surface treatments: An in vitro study. J Dent Biomater 2014; 1(1): 3-8.
11.  Mutlu-Sagesen L, Ergun G, Özkan Y, Semiz M. Color stability of a dental composite after immersion in various media. Dent Mater J 2005; 24(3): 382-90.
12.  Ertan A, Şahin E. Colour stability of low fusing porcelains: an in vitro study. J Oral Rehabil 2005; 32(5): 358-61.
13.  Spyropoulou PE, Kamposiora P, Eliades G, Papavasiliou G, Razzoog ME, Bayne SC. Cyclic loading effect on color stability of unshaded versus shaded zirconia. J Esthet Restor Dent 2016; 28(2): 77-84.
14.  Guignone BC, Silva LK, Soares RV, Akaki E, Goiato MC, Pithon MM, et al. Color stability of ceramic brackets immersed in potentially staining solutions. Dental Press J Orthod 2015; 20(4): 32-8.
15.  Artopoulou II, Powers JM, Chambers MS. In vitro staining effects of stannous fluoride and sodium fluoride on ceramic material. J Prosthet Dent 2010; 103(3): 163-9.
16.  Zajkani E. Effects of 0.2% Chlorhexidine and Re-polishing on the Color Stability of Nanofilled Composite Resins. J Dent Mater Tech 2019; 8(2): 73-8.
17.  Najafi MH, Taheri M, Mokhtari MR, Forouzanfar A, Farazi F, Mirzaee M, et al. Comparative study of 0.2% and 0.12% digluconate chlorhexidine mouth rinses on the level of dental staining and gingival indices. J Dent Res 2012; 9(3): 305-8.
18.  Derafshi R, Khorshidi H, Kalantari M, Ghaffarlou I. Effect of mouthrinses on color stability of monolithic zirconia and feldspathic ceramic: an in vitro study. BMC Oral Health 2017; 17(1): 129.
19.  Amornchat C, Kraivaphan P, Dhanabhumi C, Tandhachoon K. Effect of Cha-em Thai mouthwash on salivary levels of mutans streptococci and total IgA. Southeast Asian J Trop Med Public Health 2006; 37(3): 528-31.
20.  Sheen S, Owens J, Addy M. The effect of toothpaste on the propensity of chlorhexidine and cetyl pyridinium chloride to produce staining in vitro: a possible predictor of inactivation. J Clin Periodontol 2001; 28(1): 46-51.
21.  James P, Worthington HV, Parnell C, Harding M, Lamont T, Cheung A, et al. Chlorhexidine mouthrinse as an adjunctive treatment for gingival health. Cochrane Database Syst Rev 2017; 3(3): CD008676.
22.  Coelho C, Estima AS, Palmeirao Carrilho TM, Botelho R, Rabaça MF, Paula P, et al. Chlorhexidine mouthwash as an anticaries agent: A systematic review. Quintessence Int 2017; 48(7): 585-91.
23.  Kurtulmus-Yilmaz S, Ulusoy M. Comparison of the translucency of shaded zirconia all-ceramic systems. J Adv Prosthodont 2014; 6(5): 415-22.
24.  Dos Santos DM, da Silva EVF, Watanabe D, Bitencourt SB, Guiotti AM, Goiato MC. Effect of different acidic solutions on the optical behavior of lithium disilicate ceramics. J Prosthet Dent 2017; 118(3): 430-6.
25.  Roja RS, Sriman N, Prabhakar V, Minu K, Subha A, Ambalavanan P. Comparative evaluation of color stability of three composite resins in mouthrinse: An in vitro study. J Conserv Dent 2019; 22 (2): 175-80.
26.  Ebrahimnezhad S. Comparison of the effect of chlorhexidine and listerine on the stability of the monolithic glazed zirconium dye and the IPS-e.max glazed ceramics (in vitro) [in Persian]. J Res Dent Sci 2019; 16(4): 260-7.
27.  Sharafuddin F, Rahnama L. The effect of two types of mouthwash on the surfacehardness of direct and indirect composites [in Persian]. J Dent Shiraz Univ Med Sci 2006; 4(17): 13-22.
28.  Omrani LR, Hasani Tabatabaei M, Faridi S, Ahmad E. The effect of fluoride containing materials (mouthrinse and toothpaste) on color stability of resin composites [in Persian]. Int J Dent Med 2017; 30(3): 130-5.
29.  Alenazi H, Alshelwa E, Alhameh N, Alruwill Sh, Albounni R, Alsaffan A. Effect of chlorhexidine mouthwash on color stability of ceramic materials (e-max،zirconia). Int J Dev Res 2017; 7(6): 98-100.
30.  Haralur SB, Alqahtani NRS, Mujayri FA. Effect of hydrothermal aging and beverages on color stability of lithium disilicate and zirconia based ceramics. Medicina (Kaunas) 2019; 55 (11): 749.
31.  Alencar-Silva FJ, Barreto JO, Negreiros WA, Silva PG, Pinto-Fiamengui LM, Regis RR. Effect of beverage solutions and toothbrushing on the surface roughness, microhardness, and color stainability of a vitreous CAD-CAM lithium disilicate ceramic. J Prosthet Dent 2019; 121(4): 711.e1-711.e6.
32.  Palla ES, Kontonasaki E, Kantiranis N, Papadopoulou L, Zorba T, Paraskevopoulos KM, et al. Color stability of lithium disilicate ceramics after aging and immersion in common beverages. J Prosthet Dent 2018; 119(4): 632-42.
33.  Lee Y, Yu B, Lim H, Lim JL. Difference in the color stability of direct and indirect resin composites. J Appl Oral Sci 2011; 19(2): 154-60.
34.   Nikzad S, Azari A, Poursina M. Effects of beverage colorants and accelerated aging on the color stability of indirect resin composites. J Dent Sci 2012; 7(3): 231-7.
35.  Singh SV, Nikhil V, Chowdhry S, Chandra A. An in-vitro evaluation of tea and turmeric solution on the color stability of nanocomposite and microhybrid composites. Dent J Adv Stud 2013; 1(1): 4-8.
36.  Furtado M, Amorim A. Changes caused by the use of chlohexidine mouthwash in composite bulk-fill (in vitro). Ann Med 2019; 51(Suppl 1): 143.
37.  Salman F, Kamel J. Effect of different chlorhexidine mouth-rinses concentrations and different light cure intensities on composite filling discoloration (in vitro study). Acta Scientific Medical Sciences 2021: 134-45.
38.  Moghare Abed A, Yaghini J, Fahah A. Comparison of the side effects of two common Iranian made chlorhexidine mouthwashes [in Persian]. J Isfahan Dent Sch 2011; 6(5): 458-63.
39.  Cengiz S, Yüzbaşioğlu E, Cengiz MI, Velioğlu N, Sevimli G. Color stability and surface roughness of a laboratory‐processed composite resin as a function of mouthrinse. J Esthet Restor Dent 2015; 27(5): 314-21.
 
Journal of Isfahan Medical School
Volume 44, Issue 868
4th Week, August
July and August 2026
Pages 1144-1153

  • Receive Date 01 August 2026
  • Accept Date 17 August 2026