Color Change of Resin-based Composites After In Vitro Bleaching Protocols: A Systematic Review and Meta-analysis.

OBJECTIVES: To systematically review the literature on color stability of resin-based composites (RBC) after in vitro bleaching protocols and to assess the influence of bleaching protocols by meta-regression analysis on RBC color stability, and the association with clinical and experimental characteristics. METHODS: The electronic search was conducted in MEDLINE/PubMed, Scopus, and Web of Science databases and included English language studies that evaluated and reported color differences (CIELAB values) of RBC after in vitro bleaching procedures using hydrogen peroxide and/or carbamide peroxide. RESULTS: Database search for color change of RBC after bleaching retrieved 1335 eligible papers after removing duplicates. After initial screening, 66 articles were assessed for full-text reading with final inclusion of 23 published papers. A meta-regression analysis showed that storage time (p≤0.01), color measuring device (p≤0.01), and background color (p≤0.01) had influenced on color changes of RBC. The bleaching protocol (bleaching agent and time of application) did not influence on color changes of RBC (p>0.01). CONCLUSIONS: There is evidence that RBC change color after bleaching, but the change is not clinically significant.

Influence of Bleaching and Aging Procedures on Color and Whiteness of Dental Composites.

Bleaching can cause perceptible color changes on resin-based composite (RBC) restorations that may not be stable with aging. The objective of this study was to evaluate color stability and whiteness variations of RBCs after bleaching and aging procedures. Discs (10 mm in diameter and 1 mm thick) of shades A2 and A3 were fabricated from two RBCs (Filtek Z250 and Filtek Z350 XT) and divided into three subgroups (for each composite and shade) (n=5) as follows: control (no bleaching), at-home bleaching, and in-office bleaching. All specimens underwent an accelerated artificial aging up to 450 KJ/m2 and 900 KJ/m2 in an aging chamber (Suntest XXL+). A spectroradiometer (SpectraScan PR-670) was used to obtain CIE L*a*b* coordinates. CIEDE2000 color difference (ΔE00) and whiteness index for dentistry (WID) were used to evaluate color stability. Color and whiteness differences data were analyzed considering the 50:50% visual color difference thresholds (perceptibility [PT] and acceptability [AT]) and 50:50% whiteness thresholds (whiteness perceptibility [WPT] and whiteness acceptability [WAT]). Analysis of variance and Tukey tests (α=0.05) were used to statistically analyze the data. After bleaching, all specimens showed ΔE00 and ΔWID values below their corresponding acceptability thresholds (AT and WAT, respectively). After aging, L* and WID values decreased while b* values increased (p≤0.05), resulting in ΔE00 and ΔWID values above AT and WAT, respectively. Color changes after bleaching RBCs were clinically acceptable, while aging provoked clinically perceptible color changes.