Analysis and Assessment of Pulp Vitality of 102 Intrinsically Stained Teeth in Dogs.

Our prospective study analyzed clinical, radiographic, and histological characteristics of 102 intrinsically stained teeth. Sixty-nine dogs ranging from one to fifteen years of age were included in this study. Little more than half of the intrinsically stained teeth had no evidence of coronal injury (53.9%, 55/102). We found that most intrinsically stained teeth were histologically nonvital (87.6%, 85/97) and approximately 2/3 of these (57.7%, 56/97) had no histological endodontic or periodontal inflammation at the time of evaluation. Radiographic evidence of endodontic disease was present in 57% (58/102) of the intrinsically stained teeth. Radiographic evidence of periodontal disease was present in 48% (49/102) of intrinsically stained teeth and 28% (29/102) had radiographic evidence of tooth resorption. 18.6% (19/102) of intrinsically stained teeth were radiographically normal. Evidence of pulp necrosis was common in these intrinsically stained teeth, while only occasional teeth (12.4%, 12/97) had histologically confirmed pulpitis. All teeth with radiographic evidence of periapical lucency had pulp necrosis. Based on our histological findings, the majority of intrinsically stained teeth 87.6% are truly nonvital.

Case-specific characteristics of pink teeth in dental autopsies - A systematic review.

The cadaveric alterations that derive from the decomposition of the human body are often investigated and examined in medical autopsies together with any other evidence of thanatological interest. This study aimed to systematically review case-specific characteristics of dental autopsies that reported the pink tooth phenomenon (PTP). The review was performed in October/2018 and followed PRISMA and Cochrane guidelines. Seven databases were searched as primary study sources (PubMed, Scopus, LILACS, SciELO, Web of Science, Science Direct and Embase) and three (OATD, Open Grey and Open Thesis) were searched for "grey literature". Only descriptive studies were collected, namely case reports and case series. The risk of bias among the studies was assessed with The Joanna Briggs Institute Critical Appraisal tool. From each case, the sex and age of the victims were registered, together with the place of body recovery, time of death, cadaveric status, cause of death, and number and position of pink teeth. Additionally, a supplemental quantitative analysis was conducted within a sampled subgroup. Poisson regression with robust variance was used to analyze relative risks of presenting pink teeth according to age and tooth position. Eleven studies out of 1004 were eligible. In total 71 cases of cadavers with pink teeth were reported. Two (2.81%) victims had unknown sex, while 17 (23.95%) were females and 52 (73.24%) were males. The victims were aged between 4 and 85 years (mean age 31.13 ±â€¯13.32). Dental autopsies registered 331 pink teeth (163 anterior, 87 premolars and 81 molars). The age did not influence on presenting an additional pink tooth, regardless of tooth position (p > 0.05). Forensic dentists must be aware of pink teeth in dental autopsies. This is an unspecific phenomenon and must not be misinterpreted in medico-legal investigations.

Effects of different discoloration challenges and whitening treatments on dental hard tissues and composite resin restorations.

OBJECTIVES: To compare the relative effects of cigarette smoke (CS), electronic cigarette (EC), red wine, coffee, and soy sauce on the color of enamel, dentin, and composite resin restorations, as well as the effects of whitening treatments. METHODS: Seventy premolars with composite restorations were exposed to CS, EC aerosol (a novel EC device with MESH™ technology [P4M3 version 1.0, Philip Morris International]), red wine, coffee, and soy sauce for 56 min/day for 15 days. Two whitening sessions with 6% and 35% hydrogen peroxide (H2O2) were performed on the exposed samples. Teeth exposed to CS and EC aerosol were also brushed with whitening toothpaste for 3 weeks. Color match of resin restorations was assessed, and color changes were compared after exposure and after whitening treatments. RESULTS: Discolorations in enamel, dentin, and composite resin were observed in the order of red wine > CS > soy sauce > coffee > EC. Color mismatch between enamel and resin restorations occurred only in red wine and CS groups. Brushing with whitening toothpaste removed discoloration caused by EC aerosol; H2O2 treatments were necessary to eliminate discolorations caused by coffee and soy sauce. Discolorations of dentin and resin restorations could not be completely removed by whitening treatments, and color mismatch remained in teeth exposed to red wine and CS. CONCLUSION: Red wine and CS cause significant tooth discoloration and color mismatch in enamel and resin restorations that are not reversible by whitening treatments. Tooth discoloration associated with EC aerosol was minimal and could be removed by brushing with whitening toothpaste. CLINICAL SIGNIFICANCE: Red wine drinkers and cigarette smokers have increased risks for tooth discoloration and color mismatch between enamel and composite resin restorations. Whitening treatments may not be effective in correcting the color mismatch. Tooth discoloration associated with EC aerosol is minimal.

Near-infrared imaging of demineralization on the occlusal surfaces of teeth without the interference of stains.

Most new caries lesions are found in the pits and fissures of the occlusal surface. Radiographs have extremely low sensitivity for early occlusal decay, and by the time the lesion is severe enough to appear on a radiograph, it typically has penetrated well into the dentin and surgical intervention is required. The occlusal surfaces are often heavily stained, and visual and tactile detection have poor sensitivity and specificity. Previous near-infrared imaging studies at wavelengths beyond 1300 nm have demonstrated that stains are not visible and demineralization on the occlusal surfaces can be viewed without interference from stains. The objective of our study is to determine how the contrast between sound and lesion areas on occlusal surfaces varies with wavelength from the visible to 2350 nm and determine to what degree stains interfere with that contrast. The lesion contrast for reflectance is measured in 55 extracted teeth with suspected occlusal lesions from 400 to 2350 nm employing silicon and indium gallium arsenide imaging arrays. In addition, the lesion contrast is measured on 25 extracted teeth with suspected occlusal lesions from 400 to 1600 nm in reflectance and from 830 to 1400 nm in transillumination before and after stains are removed using a ultrasonic scaler. The highest lesion contrast in reflectance is measured at wavelengths >1700 nm. Stains interfere significantly at wavelengths <1150 nm (400 to 1150) for both reflectance and transillumination measurements. Our study suggests that the optimum wavelengths for imaging decay in the occlusal surfaces are >1700 nm for reflectance (1700 to 2350 nm) and near 1300 nm (1250 to 1350 nm) for transillumination.

The reproducibility of assessment of white spot lesions adjacent to orthodontic brackets, with a quantitative light induced fluorescence digital camera at different rotations of teeth - an in vitro study.

BACKGROUND: A quantitative light-induced fluorescence digital (QLF-D) camera is able to assess demineralizations adjacent to orthodontic brackets. Rotations of teeth during and the presence of the orthodontic appliances may influence the longitudinal follow-up of such lesions over time. METHODS: Brackets were bonded on extracted teeth: 54 incisors and 31 canines. Demineralizations were formed in vitro directly cervical of the bracket. Images were captured using a QLF-D camera mounted on an optical bench, equipped with a goniometer on a turntable. The teeth were placed in the goniometer simulating buccolingual rotation (0°, 10°, 20°), the turn-table was used for mesiodistal rotations (0°, 10°, 20°). Standardized QLF-D images were made before (with and without a wire) and after debonding at combinations of aforementioned angles of rotation. The image after debonding at 0° buccolingual and 0° mesiodistal rotation served as a control. RESULTS: The presence of a bracket resulted in a significantly higher fluorescence loss, yet a smaller lesion area (p < 0.05) in comparison to the control. A significant higher fluorescence loss was seen for rotations towards lingual relative to the 0° buccolingual and 0° mesiodistal rotation, while the effect was less explicit towards buccal. CONCLUSIONS: Fluorescence loss and lesion size are influenced by the angle of rotation under which the demineralization is photographed. The full extent of demineralizations is only apparent after debonding when photographed at rotations of 0° mesiodistal and up to 20° buccal. Precaution must be taken into account assessing demineralizations of patients undergoing treatment with fixed appliances when using a QLF-D camera.

Forensic thanatology and the pink tooth phenomenon: From the lack of relation with the cause of death to a potential evidence of cadaveric decomposition in dental autopsies - Case series.

Forensic thanatology comprises the investigation of every phenomenon related to death performed through cadaveric exams. The pink tooth phenomenon (PTP) emerges as a thanatological finding registered during medical or dental autopsy. The PTP consists of a reddish or pink coloration caused in the teeth by the penetration of pulpal hemoglobin in the dentinal tubules. Initially, the PTP was associated with specific violent deaths, such as drowning, hanging and poisoning. However, scientific reports have pointed towards the occurrence of PTP as an expression of cadaveric decomposition regardless of the cause of death. The present study aims to report eight dental autopsies of victims of violent death that presented the PTP. The autopsies were conducted by forensic pathologists and dentists between 2013 and 2018. Seven victims were males and one was female. The age ranged above 6years old. Cranio-encephalic trauma, firearm shooting and asphyxia figured as the causes of death. All the victims were in advanced decomposition. The PTP was detected in deciduous and permanent, anterior and posterior and maxillary and mandibular teeth. Forensic experts, especially dentists, must be aware of the PTP for more detailed registration of postmortem findings and more accurate cadaveric exams.

Tooth colour and whiteness: A review.

OBJECTIVES: To review current knowledge concerning the application of colour science on tooth colour and whiteness description, measurement, distribution and its psychological impact. DATA SOURCES: "Scopus" databases were searched electronically with the principal keywords tooth, teeth, colour, white, whiteness. Language was restricted to English and original studies and reviews were included. Conference papers and abstracts were excluded. CONCLUSIONS: The appearance and colour of teeth are a common concern for patients across many populations and are associated with an increased desire for treatments that improve dental aesthetics, including tooth whitening. The application of colour science in dentistry has allowed the precise description of tooth colour and whiteness. Coupled with the advances in instrumental tooth colour measurement, such as spectrophotometers, colorimeters, spectroradiometers and digital imaging systems, these parameters are quantifiable in a reproducible and robust manner. These principles have been applied to the tooth colour distribution in many study populations, indicating, in general, differences in tooth colour for subject age and gender, but not for ethnicity. Psychophysical studies on tooth colour and whiteness via third party assessment of images indicate that whitened teeth lead to judgements that are more positive on personality traits such as social competence and appeal, intellectual ability and relationship satisfaction.

Dental intrinsic green pigmentation from primary to mixed dentition: clinical and histological findings.

AIM: The aim of this report is to present a case of a child with green pigmentation of the primary dentition caused by bilirubin elevation due to choleostasis during neonatal life, and the 5-year follow-up. CASE REPORT: The case presented initially with bands of green pigmentation of all primary teeth in a pattern that followed the time of their calcification, with those formed earlier being more severely affected. Fading of the green pigmentation was detected during the follow-up, while erupted lower permanent incisors were normal. Histological findings of an exfoliated primary incisor showed a green line at the enamel-dentine junction with the external surface of the dentine showing a band of variable width and irregularly arranged tubules. CONCLUSION: Bilirubin green pigmentation of primary teeth follows a chronological pattern and its intensity fades with time. Overlying enamel in affected areas may appear thinner.

Micro-CT analysis of naturally arrested brown spot enamel lesions.

OBJECTIVES: The aim of this study was to characterize the mineral density parameters through natural enamel brown spot lesions (BSLs) and to visualize and map their mineral distribution pattern in comparison to enamel whitespot lesions (WSLs). METHODS: Study specimens included seventeen proximal WSLs (ICDAS 1, 2), seventeen proximal BSLs and seventeen sound proximal specimens (ICDAS 0) collected from The Oral Surgery Department at Sydney Dental Hospital, Sydney, Australia. Imaging was undertaken using a high resolution, desktop micro-computed tomography system. A calibration equation was used to transform the grey level values of the images into true mineral density values. The qualitative analysis and the quantification of the lesion parameters including the mineral density and the thickness of the enamel lesion surface layer were performed using mineral density profiles plotted in FIJI and the visualized mineral maps in MATLAB respectively. RESULTS: The maps of brownspot lesions revealed irregular demineralization patterns with faint boundaries and outlines. The regular triangular shape of proximal lesions was recognizable only in some parts of individual BSLs or was completely unrecognizable within the entire lesion. Scattered free-form areas of high density enamel were observed within or close to the surface of BSLs. A layer of high density enamel with a mineral density close to that of sound enamel was observed in all of the BSLs. The mean mineral density of the body of BSLs, including the scattered areas of high mineral density, was significantly higher than the corresponding values in white-spot lesions. The mean thickness of the surface layer in BSLs (79±15µm) was also significantly higher than white-spot lesions (51±11µm) (p<0.05). CONCLUSION: This study demonstrated that the mineralization parameters such as density and the thickness of the surface layer as well as distribution patterns through natural enamel brown spot lesions (BSLs) are different from enamel white-spot lesions (WSLs). The higher mineral density of the body of the lesion and the increased thickness of the surface layer in brown spot enamel lesions may suggest possible subsurface remineralization in the majority of naturally arrested BSLs.

Diagnostic guide enabling distinction between taphonomic stains and enamel hypomineralisation in an archaeological context.

OBJECTIVE: Molar Incisor Hypomineralisation (MIH) is a structural anomaly that affects the quality of tooth enamel and has important consequences for oral health. The developmentally hypomineralised enamel has normal thickness and can range in colour from white to yellow or brown with or without surface breakdown. The possibility of finding MIH in 'ancient populations' could downplay several current aetiological hypotheses (e.g., dioxin derivatives, bisphenols, antibiotics) without excluding the possible multifactorial aspect of the anomaly. In an archaeological context, chemical elements contained in the burial ground can stain teeth yellow or brown and therefore might create a taphonomic bias. The purpose of the present study is to test a proposed diagnostic guide enabling determination of the pathological or taphonomic cause of enamel discolouration and defects that resemble MIH present on 'ancient teeth'. DESIGN: Two sample groups including MIH discoloration (n=12 teeth) from living patients, taphonomic discoloration (n=9 teeth) and unknown discoloration (n=2 teeth) from medieval specimens were tested. Three non-destructive methods-Raman spectroscopy, X-ray micro-computed tomography and X-ray fluorescence were utilised. RESULTS: Hypomineralised enamel has decreased mineral density (p<0.0001) and increased phosphate/ß-carbonate ratio (p<0.01) compared to normal enamel whereas relative concentrations of manganese, copper, iron and lead are similar. In taphonomic discoloration, relative concentrations of these elements are significantly different (p<0.05) to normal enamel whereas mineral density and Raman spectra profile are comparable. CONCLUSIONS: Enamel hypomineralisation can be distinguished from taphonomic staining in archaeological teeth.

Is resin infiltration an effective esthetic treatment for enamel development defects and white spot lesions? A systematic review.

OBJECTIVES: To determine if resin infiltration is an effective treatment for improving the esthetic appearance of tooth discoloration resulting from development defects of enamel (EDD) and white spot lesions (WSL) by means of a systematic review. DATA SOURCES: A comprehensive search was performed in PubMed, Scopus, Web of Science, LILACS, BBO Library, Cochrane Library, and SIGLE, as well as in the abstracts of IADR conference, and in the clinical trials registry. STUDY SELECTION: Clinical studies in patients with whitish tooth discoloration, in which the resin infiltration technique was applied, were included. Color masking was the primary outcome. The methodological quality and risk of biases of included papers was assessed using MINORS criteria for non-randomized (NRS) comparative studies and Cochrane Collaboration for randomized clinical trials (RCT). RESULTS: From a total of 2930 articles, 17 were assessed for eligibility and 11 remained in the qualitative synthesis. Four NRS and seven RCT studies were selected, the latter consisting of four full-text studies and three conference abstracts. Two studies were excluded from the quality assessment, due to overlapping results. The number of participants (treated teeth) ranged from 18 to 21 (38-74) in the NRS, and 20-83 (20-231) in the RCT studies. Post-orthodontic WSL were the most frequent treated lesions. Initial condition was used as control in the NR studies. In the RCT, resin infiltration was compared to non treatment, remineralization, or bleaching. Overall, partial or complete color masking of affected teeth was reported immediately after resin infiltration. Only two studies followed original outcomes up to one year and reported maintenance of original color masking. Two NR studies were assessed as "moderate" and one as "high" quality. Two RCT were classified as "low" risk of bias in the chosen key domains. The remaining four studies were considered "unclear" or "high" risk of bias. CONCLUSION: Although the partial or total masking effect of enamel whitish discoloration has been shown with resin infiltration, there is no strong evidence to support this technique based on the present clinical studies. CLINICAL SIGNIFICANCE: Enamel whitish discolorations in esthetically compromised areas are clinically undesirable. Minimally invasive approaches used as attempts to minimize the discoloration include the resin infiltration technique. The evidence for clinical recommendation of this technique is not strong, thus, further RCT studies with long-term follow-ups should be conducted.

Structural color changes in permanent enamel of patients with cleft lip and palate: a case-control study.

OBJECTIVES: White spots are more common in patients with cleft lip and palate (CLP) than in the normal population. Whether these are due to the cleft itself or concomitant circumstances (e.g., surgical procedures, orthodontic treatments, systemic fluoridation, increased caries risk) remains unclear. This case-control study evaluated both their prevalence in CLP patients versus control subjects and associated risk factors. PATIENTS AND METHODS: A total of 73 CLP patients (average age 8.7 years, range 6-18 years, 42 % male) and a control group of 73 age- and gender-matched non-CLP patients were included. Enamel color changes, subsuming mineralization defects (DDE index), mild dental fluorosis (Dean's index), and initial caries (ICDAS score 2), were recorded. Caries index (dmf-t/DMF-T) scores were also recorded to distinguish between high or low caries risk as defined by the Deutsche Arbeitsgemeinschaft für Jugendzahnpflege criteria. Histories of systemic fluoridation, trauma to primary teeth, surgery, and orthodontic treatment were obtained using a questionnaire. Statistical analysis included t test, χ (2) test, and multivariable logistic regression. RESULTS: Enamel color changes were observed three times more often in the CLP group than in the control group (39.7 vs. 12.3 %; p < 0.001). Significantly more patients in the CLP group had a history of orthodontic treatment (38.4 vs. 15.1 %; p < 0.05). An increased risk for enamel color changes was associated with CLP itself [OR (odds ratio) 3.6; 95 % confidence interval (CI) 1.3-9.9] and table salt plus tablets combined for systemic fluoridation (OR 2.7, 95 % CI 1.1-6.9). No increased risks were identified for increased caries risk, history of primary-tooth trauma, or history of orthodontic treatment. CONCLUSION: The higher prevalence of enamel color changes in the CLP group (more than threefold compared to the control group) was not related to previous orthodontic treatments; however, systemic fluoridation (table salt and tablets) constituted a risk factor for the enamel color changes seen in the CLP patients.

The Smile Esthetic Index (SEI): A method to measure the esthetics of the smile. An intra-rater and inter-rater agreement study.

PURPOSE: To propose a method to measure the esthetics of the smile and to report its validation by means of an intra-rater and inter-rater agreement analysis. MATERIALS AND METHODS: Ten variables were chosen as determinants for the esthetics of a smile: smile line and facial midline, tooth alignment, tooth deformity, tooth dischromy, gingival dischromy, gingival recession, gingival excess, gingival scars and diastema/missing papillae. One examiner consecutively selected seventy smile pictures, which were in the frontal view. Ten examiners, with different levels of clinical experience and specialties, applied the proposed assessment method twice on the selected pictures, independently and blindly. Intraclass correlation coefficient (ICC) and Fleiss' kappa) statistics were performed to analyse the intra-rater and inter-rater agreement. RESULTS: Considering the cumulative assessment of the Smile Esthetic Index (SEI), the ICC value for the inter-rater agreement of the 10 examiners was 0.62 (95% CI: 0.51 to 0.72), representing a substantial agreement. Intra-rater agreement ranged from 0.86 to 0.99. Inter-rater agreement (Fleiss' kappa statistics) calculated for each variable ranged from 0.17 to 0.75. CONCLUSION: The SEI was a reproducible method, to assess the esthetic component of the smile, useful for the diagnostic phase and for setting appropriate treatment plans.

X-ray Study of Human Dental Tissues Affected by Erythroblastosis Fetalis.

Numerous diseases are known to cause microstructural alteration of dental tissues structure. One type in particular is associated with neonatal jaundice and circulation of bilirubin in blood at high concentration due to increased hemolysis in conditions such as erythroblastosis fetalis, septicemia, biliary atresia, and other causes of hyperbilirubinemia. In those conditions, the products of the catabolism of hemoglobin end up deposited in various tissues, including teeth, where they can present clinically as visibly stained brown/green teeth. There is almost no information on the nature or extent of the structural changes taking place in these conditions. Here, advanced nondestructive wide-angle synchrotron X-ray scattering techniques combined with scanning microscopy methods were used to investigate for the first time the ultrastructure of the dental hard tissues in an archival case of intrinsically pigmented green teeth. Despite no obvious elemental variation across the pigmented tissue region, the high-resolution crystallographic properties probed by wide-angle synchrotron X-ray scattering revealed an ultrastructural variation (orientation, particle size, and lattice parameter of hydroxyapatite crystallites) associated with a pigmentation line in dentine and with a distinct neonatal line in enamel.

Color masking of developmental enamel defects: a case series.

Developmental defects involving color alteration of enamel frequently compromise the esthetic appearance of the tooth. The resin infiltration technique represents an alternative treatment for color masking of these lesions and uniformization of tooth color. This technique is considered relatively simple and microinvasive, since only a minimal portion of enamel is removed. This article illustrates the color-masking effect with resin infiltration of fluorosis and traumatic hypomineralization lesions with a case series. The final esthetic outcomes demonstrated the ability of the resin infiltrant to mask the color of white developmental defect lesions, resulting in satisfactory clinical esthetic improvements. However, in more severe cases, the color-masking effect was not complete.

Tridimensional surface roughness analysis after resin infiltration of (deproteinized) natural subsurface carious lesions.

OBJECTIVES: The objectives of this study were to evaluate ex vivo the effects of resin infiltration on the areal surface roughness of natural non-cavitated proximal subsurface lesions with or without previous deproteinization and to determine differences between E2 and D1 lesions or between premolars and molars. MATERIALS AND METHODS: Forty premolars and 40 molars with proximal carious lesions and macroscopically intact surfaces (International Caries Detection and Assessment System (ICDAS) II; code 2) were radiologically assessed and randomly allocated to four groups (with 20 E2 and 20 D1 lesions, respectively). In each group, 10 lesions were deproteinized (NaOCl; 1%) before etching (HCl; 15%) and resin infiltration (Icon). Areal surface roughness (Sa) at the most demineralized lesion part (DIAGNOdent) was evaluated topometrically before and after deproteinization, after etching, and after infiltration using focus variation 3D scanning microscopy. RESULTS: Pretreatment with NaOCl (n = 40) had no significant effects on Sa (p = 0.208), but resulted in significantly differing Sa values between premolars and molars after etching (p = 0.011). Regarding the effects between etching and baseline, significantly differing Sa values (p = 0.0498) were found for premolars and molars (n = 40/40); Sa after resin infiltration (compared to etching) differed significantly between premolars and molars (p = 0.009). No treatment regimen lead to differences among the radiological grades (E2 vs. D1; p > 0.106). CONCLUSIONS: Resin infiltration showed only minor effects on Sa values of etched subsurface lesions (p < 0.170) and did neither equal nor improve baseline surface roughness (p > 0.401) of the different tooth types. CLINICAL RELEVANCE: Deproteinization should be recommended before etching and infiltration, even if surface roughness of infiltrated advanced (pre-)molar lesions will not be improved.

A novel in-frame 18-bp microdeletion in MT-CYB causes a multisystem disorder with prominent exercise intolerance.

A novel heteroplasmic mitochondrial DNA (mtDNA) microdeletion affecting the cytochrome b gene (MT-CYB) was identified in an Italian female patient with a multisystem disease characterized by sensorineural deafness, cataracts, retinal pigmentary dystrophy, dysphagia, postural and gait instability, and myopathy with prominent exercise intolerance. The deletion is 18-base pair long and encompasses nucleotide positions 15,649-15,666, causing the loss of six amino acids (Ile-Leu-Ala-Met-Ile-Pro) in the protein, but leaving the remaining of the MT-CYB sequence in frame. The defective complex III function was cotransferred with mutant mtDNA in cybrids, thus unequivocally establishing its pathogenic role. Maternal relatives failed to show detectable levels of the deletion in blood and urinary epithelium, suggesting a de novo mutational event. This is the second report of an in-frame intragenic deletion in MT-CYB, which most likely occurred in early stages of embryonic development, associated with a severe multisystem disorder with prominent exercise intolerance.

Spectrophotometric analysis of crown discoloration induced by various antibiotic pastes used in revascularization.

INTRODUCTION: Antibiotic pastes are used for disinfection in regenerative endodontic procedures. This study evaluated the crown discoloration induced by various antibiotic pastes including the mixture of metronidazole and ciprofloxacin with minocycline, doxycycline, amoxicillin, or cefaclor. METHODS: Seventy extracted bovine incisors were sectioned to obtain a standardized root length of 10 mm above the facial cementoenamel junction. After pulp tissue removal, irrigation with sodium hypochlorite and the placement of temporary filling material and cotton pellet were performed from the apical aspect. The specimens were then randomly divided into 7 groups (n = 10 for each group), and each group received the following antibiotic paste fillings: no filling (control group), calcium hydroxide, double antibiotic paste (DAP), triple antibiotic paste (TAP) with minocycline, TAP with doxycycline, TAP with amoxicillin, and TAP with cefaclor. Spectrophotometric readings were obtained on the buccal surfaces of the crown on day 1 to week 3 after filling, and the ΔE value was calculated. Data were analyzed with 2-way analysis of variance and the Tukey post hoc tests (P = .05), and the human perceptibility threshold was set to 3.7. RESULTS: TAP with minocycline, doxycycline, and cefaclor induced more coronal discoloration compared with the control group (P < .05). The control, calcium hydroxide, and DAP groups showed no color changes exceeding the perceptibility threshold at all time points. CONCLUSIONS: The results indicated that all antibiotic pastes, except DAP, induced crown discoloration.