Amber coloured plasma-Case for illustration.

INTRODUCTION: Abnormal colour of plasma is infrequently identified during processing of blood and blood components. Common reasons include haemolysis, medications or diet related. Sometimes, the aetiology is unknown. It is a dilemma for every transfusion specialist encountering this situation. Effort should be made to find the aetiology of discolouration of plasma, so that the blood donor can be suitably advised, and a decision can be made regarding the use of blood products. MATERIALS AND METHODS: We encountered two cases of orange coloured (amber coloured) plasma in our regular blood donors. All the common reasons for abnormal plasma discolouration were evaluated, including the donor's medication and diet. Spectrophotometry along with Liquid Chromatography-Mass Spectrometry (LC-MS) in both the positive and negative ion modes with literature search helped in arriving at a conclusion. RESULTS: Haemolysis was ruled out by estimation of plasma haemoglobin. Spectrophotometric analysis of the coloured plasma samples showed a peak, which was absent in normal coloured plasma. This was further investigated using Liquid Chromatography-Mass Spectrometry (LC-MS) in both the positive and negative ion modes. There was no significant difference between the coloured and normal samples in the positive ion mode. But in the negative ion mode, there was a peak observed at 110.5 and 191 m/z value in the profile of the coloured samples in comparison with the normal sample. Literature review shows the peak was corresponding to the presence of quinic acid residues-a substance found in coffee, and potentially excreted into the plasma of an individual with high coffee consumption. CONCLUSION: Reporting unusual causes associated with plasma discolouration is important. Present guidelines forbid issue of abnormal coloured blood and blood components for transfusion. Further such reports are necessary to confirm the safety of recipients receiving such units. This is the first case report to our knowledge of quinic acid discolouring blood products.

Evaluation of Long-term colour resistance of composite materials used in aligner treatments: A comparative study.

AIM: The aim of this study is to evaluate the discolouration resistance of attachments made of composites having different physical properties, filler ratios and viscosity through the simulated environment and conditions. MATERIALS AND METHODS: Seventy-two extracted human teeth were aligned to simulate upper and lower dental arches. The attachments were prepared according to the guides determined by ClearCorrect. Three different composite groups were used for attachments preparation: Aligner Connect, G-Aenial Universal Injectable, and Tetric Prime and Tetric Evoflow combination. Dental models and aligners were kept in artificial saliva throughout the experiment of 96 weeks. The aligners were also subjected to 2308 thermal cycles and insertion and removing procedures 840 times for each period of 12 weeks. Afterwards, the models were kept in coffee and red wine solutions. Colour measurements were made with Vita Easy Shade 4.0 at 12th, 24th, 48th and 96th simulated weeks. RESULTS: No significant difference in discolouration was observed during thermal cycle application of 12th and 24th week experimental periods. In the later periods, discolouration was observed in the composite materials, and G-Aenial Universal Injectable was less coloured than the other samples. The composite samples were more coloured in proportion to their residence time. The G-Aenial Universal Injectable was more affected by wine solution, and Tetric Prime and Tetric Evoflow combination were more affected by coffee solution. CONCLUSIONS: Viscosity, resin matrix content and nature of inorganic filler particles of the composite materials significantly affect the colour changing properties of them due to the long-term ageing and exposure to colouring agents.

Understanding children's attention to traumatic dental injuries using eye-tracking.

BACKGROUND/AIM: Traumatic dental injuries (TDIs) in the primary dentition may result in tooth discolouration and fractures. The aim of this child-centred study was to explore the differences between preschool children's eye movement patterns and visual attention to typical outcomes following TDIs to primary teeth. MATERIALS AND METHODS: An eye-tracker recorded 155 healthy preschool children's eye movements when they viewed clinical images of healthy teeth, tooth fractures and discolourations. The visual search pattern was analysed using the eye movement analysis with the Hidden Markov Models (EMHMM) approach and preference for the various regions of interest (ROIs). RESULTS: Two different eye movement patterns (distributed and selective) were identified (p < .05). Children with the distributed pattern shifted their fixations between the presented images, while those with the selective pattern remained focused on the same image they first saw. CONCLUSIONS: Preschool children noticed teeth. However, most of them did not have an attentional bias, implying that they did not interpret these TDI outcomes negatively. Only a few children avoided looking at images with TDIs indicating a potential negative impact. The EMHMM approach is appropriate for assessing inter-individual differences in children's visual attention to TDI outcomes.

The Ostomy Skin Tool 2.0: a new instrument for assessing peristomal skin changes.

BACKGROUND: Peristomal skin complications (PSCs) are frequently reported postoperative complications. PSCs can present visibly or as symptoms such as pain, itching or burning sensations. AIM: To develop a new tool that can capture a range of sensation symptoms together with visible complications and an objective assessment of discolouration in the peristomal area. METHOD: Consensus from qualitative interviews with health professionals and people with an ostomy, and input from expert panels, formed the basis of a patient-reported outcome (PRO) questionnaire. A decision tree model was used to define a combined score including PRO and objectively assessed discolouration area. FINDINGS: Six elements were included in the PRO questionnaire and four health states representing different severity levels of the peristomal skin were defined. CONCLUSION: The Ostomy Skin Tool 2.0 is a sensitive tool that can be used to follow changes in the peristomal skin on a regular basis and thereby help prevent severe PSCs.

Biological parameters, discolouration and radiopacity of calcium silicate-based materials in a simulated model of partial pulpotomy.

AIM: To analyse the discolouration, radiopacity, pH and calcium ion release of Biodentine (BD), Bio-C repair (BCR) and Bio-C temp (BCT), as well as their biological effects on human dental pulp cells (hDPCs). METHODOLOGY: Sixty-four extracted bovine incisors were prepared to simulate crown fractures with pulp exposure and open root apex. The roots were filled using a mixture of agar and blood (control), and BD, BCR or BCT were placed over this mixture. Colour assessment analyses of the samples were performed before and immediately after material insertion and repeated at 30 and 90 days, using a spectrophotometer. The colour change of each specimen was evaluated at the crown and calculated based on the CIELab colour space. Digital radiographs were acquired for radiopacity analysis. hDPCs were placed in contact with different dilutions of culture media previously exposed to such materials and tested for cell viability using the MTT assay. The pH and calcium ion release of all materials were measured after 24 h; the data were assessed using one-way analysis of variance (ANOVA). Cell viability was analysed by two-way ANOVA. Differences in colour parameters and wound-healing data were assessed by two-way repeated measures ANOVA (α = 0.05). Tukey's and Dunnett's tests were used to compare the experimental groups with the control group. RESULTS: BCR had grater radiopacity and smaller colour alteration (ΔEab/ΔE00) than the other materials tested (p < .005; p < .001). No significant differences in pH were found amongst the tested materials (p > .05). BCT was associated with the largest release of calcium ions (p < .0001). BD had cell viability similar to that of the control at the lowest dilutions, and BCR was similar to that of the control, regardless of the dilution tested (p > .05). BCT had a lower percentage of viability than that of the control at all tested dilutions (p < .0001). Cell migration rates in BD and BCR were similar to those in the control group after 24 h and 48 h (p > .05), whilst BCT had larger voids than the control in both periods (p < .0001). CONCLUSIONS: BCR, BCT and BD were associated with tooth discolouration. BCR had the lowest staining values, the highest radiopacity and viability greater than 80% hDPCs.

First report of Phaeoacremonium oleae and P. viticola associated with olive trunk diseases in Italy.

Over 300 trunk, branch and stem samples with vascular discolouration, necrotic wood and shoot death were collected from olive (Olea europaea) orchards in Lecce, Brindisi, Bari and Foggia provinces (Apulia region, Italy) from October to May from 2013 to 2019. Small chips of symptomatic wood samples were surface sterilised (5% NaOCl, 3 min; 70% ethanol, 30 s), rinsed (sterile distilled water, ×3), and placed onto potato dextrose agar (PDA) plates amended with 500 ppm streptomycin sulphate. After 14 days at 25 °C in the dark, hyphal tips of growing fungi, including different taxa, for instance Phaeoacremonium and Botryosphaeriaceae spp., were transferred to new PDA plates and incubated until sporulation. Monoclonal colonies resembling Phaeoacremonium-like genus (Mostert et al. 2006) were selected for further study, and genomic DNA of 59 representative isolates was extracted (Carlucci et al. 2013). Partial actin and ß-tubulin genes were amplified with primers ACT-513F/ACT-783R (Carbone & Kohn 1999), and T1(O'Donnell & Cigelnik 1997) and Bt2b (Glass & Donaldson 1995), respectively. The sequenced amplicons were compared by BLAST algorithms with reference strains of Phaeoacremonium spp. retrieved from GenBank. Forty-four isolates showed 99% to 100% similarity with reference strains P. italicum, P. minimum, P. parasiticum, P. scolyti and P. sicilianum (Carlucci et al. 2015), nine with P. oleae, and six with P. viticola. Actin and ß-tubulin sequences of P. oleae (Pm14) and P. viticola (Pm34) were submitted to GenBank (MW714561, MW714563; MZ318697, MZ318696). Microscopy of P. oleae isolates showed: conidiophores branched and unbranched, (18.7-)21.9-57.1(-67.8) × (2.9-)3.3-4.7(-5.2) (mean, 38.9×4.1) µm (n=30); conidia oblong-ellipsoidal to obovoid or subcylindrical 3.4 to 5.5 µm long, and 1.5 to 2.4 (mean, 4.6 × 2.2) µm wide (n=30). Microscopy of P. viticola isolates showed: conidiophores subcylindrical, branched at base (6.7-)8.9-27.2(-29.3) × (2.0-)2.6-3.3(-3.7) (mean, 21.4 × 3.2) µm (n=30); conidia oblong-ellipsoidal to obovoid or subcylindrical 3.3 to 6.8 µm long, and 1.1 to 2.2 (mean, 4.2 × 1.6) µm wide (n=30). In spring 2020, artificial inoculations were carried out with P. oleae (Pm14, Pm46) and P. viticola (Pm34, Pm43) strains on 10 healthy, 2-year-old olive seedlings cultivar 'Coratina'. Agar plugs (diameter, 0.3-0.5 cm) from 10-day-old cultures grown on water agar at 23 (±2) °C were inserted under the bark of small wounds in the stems (length, 0.4-1.0 cm) made with a sterile scalpel. After inoculation, the wounds were wrapped with wet sterile cotton wool and sealed with Parafilm. Ten control olive seedlings were inoculated with sterile agar plugs. The experiment was replicated three times. All inoculated young olive plants were grown in pots in a greenhouse without temperature control. After 120 days, inoculated plants showed decline symptoms, and when cut longitudinally, brown streaks were observed in the wood. For P. oleae these streaks measured 3.0-5.5 cm long (standard deviation [SD], 0.9 cm, and for P. viticola they were 1.8-3.5 cm (SD, 0.62). Both fungal species were re-isolated from the symptomatic wood from 85% and 80%, respectively, of these inoculated olive seedlings, fulfilling Koch's postulates. No symptoms were observed from olive seedlings used as control. P. oleae was first described as a fungal pathogen of wild olive (Olea europaea subsp. cuspidate) in South Africa by Spies et al. (2018), and P. viticola as a fungal pathogen of grapevine in France by Dupont et al. (2000). To the best of our knowledge, this is the first report of P. oleae associated with olive trunk disease in Italy, and the first report of P. viticola associated with olive trunk disease worldwide. References: Carbone I. & Kohn L.M. 1999. Mycologia 91:553. Carlucci A. et al. 2015. Eur. J. Plant Pathol. 141:717. Carlucci A. et al. 2013. Phytopathol. Mediterr. 52:517. Dupont et al. 2000. Mycologia 92:499-504. Glass N. L. & Donaldson G. C. 1995. J. Cl. Microbiol. 41: 1332. Mostert L. et al. 2006. Stud. Mycol. 54:1. O'Donnell K. & Cigelnik E. 1997. Mol. Phylogenetics Evol 7:103. Spies et al. 2018. Persoonia 40:26.

Efficacy of whitening toothpaste containing blue covarine: A double-blind controlled randomized clinical trial.

OBJECTIVE: This randomized clinical trial evaluated the efficacy and safety of a blue-covarine whitening toothpaste on tooth bleaching. SUBJECTS AND METHODS: Seventy-five subjects with shade mean C1 or darker were randomized into three groups (n = 25): CT-conventional toothpaste, WT-whitening toothpaste, and CP10-10% carbamide peroxide. Subjects from CT and WT brushed their teeth twice/day for 2 weeks. CP10 used bleaching gel for 4 hours/night for 2 weeks. Tooth shade and CIELab parameters were measured at baseline, after the first application, 2- and 4-week. ΔE*ab and ΔE00 were calculated. Subjects' perception about tooth color appearance, tooth sensitivity (TS), and gingival irritation (GI) were also assessed. RESULTS: At all evaluation periods, it was not observed differences between WT and CT considering tooth shade (P > 0.7) or CIELab parameters (P > 0.3). At 2- and 4-week, ΔE*ab and ΔE00 were higher for CP10 than WT or CT (P = 0.001). WT and CT reported major dissatisfaction with tooth color appearance than CP10 (P = 0.001). At 1- and 2-week, WT experienced GI and TS similar to CT, both lower than CP10 (P < 0.01). CONCLUSION: There were no significant differences in the whitening efficacy between whitening and conventional toothpastes. Neither of the dentifrices was as effective as at-home bleaching. CLINICAL SIGNIFICANCE: The silica-based toothpaste containing blue covarine evaluated in this study did not give significant tooth whitening benefits over 2 weeks of use.

Multinational survey on living with an ostomy: prevalence and impact of peristomal skin complications.

BACKGROUND: Peristomal skin complications (PSCs) impair life for people with an ostomy. Visual signs of PSCs include discolouration, but sensation symptoms like pain, itching, and burning are equally important and underreported. AIM: To provide improved understanding of PSC prevalence and associated challenges in the communities of ostomy patients and ostomy care nurses. METHODS: The Ostomy Life Study 2019 encompassed a patient survey (completed by 5187 people with an ostomy) and a nurse survey (completed by 328 ostomy care nurses). FINDINGS: In total, 88% of patients experienced PSCs and 75% experienced PSC symptoms in the absence of discolouration. Eighty per cent of nurses considered ostomy-related issues to be the main reason for PSCs, and a correlation between PSC severity and number of nurse consultations was demonstrated. CONCLUSION: This study revealed a remarkably high PSC incidence in the absence of discolouration and highlighted direct consequences of having compromised skin and the health-economic consequences.

In vivo evaluation of tooth colour alterations during orthodontic retention: A split-mouth cohort study.

OBJECTIVES: To assess in vivo colour alterations of teeth following removal of fixed orthodontic appliances during retention. SETTING AND SAMPLE POPULATION: The Department of Orthodontics at the Aristotle University of Thessaloniki. Forty-eight patients after orthodontic treatment. MATERIAL AND METHODS: Debonding and cleaning procedures after orthodontic treatment were performed using two different carbide burs attached to a low or high-speed handpiece, respectively, in a non-blinded cohort study with split-mouth design. Spectrophotometric colour data of teeth were recorded: (a) after debonding, (b) three months later, prior to and following finishing with Soflex discs, and (c) after 1 year. The CIE Lab colour parameters were measured for each tooth, and the corresponding ΔΕ differences were calculated. The effect on colour was assessed with 3-way mixed ANOVA and Bonferroni's comparisons test (a < 0.05). RESULTS: Orthodontic debonding and cleaning procedures were found to have statistically significant effects on the CIE colour parameters of treated teeth, since the L* values decreased 0.6 units (P < 0.001), a* values were stable (0.0 units) and b* values increased 1.4 units (P < 0.001), during the first retention year. Finishing temporarily decreased the enamel colour differences. Total ΔΕ differences for all types of teeth measured ranged from 1.4 to 2.1 units. The greatest changes were exhibited during the first 3 months in teeth on which high-speed rotary instruments were used (1.6 units). CONCLUSION: The clinical relevance of this study points out that the colour of natural teeth following removal of fixed orthodontic appliances changes in long-term.

Management of discolouration following revitalization endodontic procedures: A case series.

AIM: To discuss the causes and management of tooth crown discolouration following regenerative/revitalization endodontic therapy (RET) and to present the decision-making process affecting three RET-related cases of crown discolouration. SUMMARY: This case series outlines several approaches used in the management of post-RET discolouration. The cases highlight the influence of the material used in creating a coronal seal on the choice and success of the management techniques provided. The first two cases highlight successful management of post-RET discolouration through the use of internal-external bleaching. The use of internal bleaching in the third case was not recommended; therefore, external bleaching followed by a direct composite veneer was carried out.

Mineral trioxide aggregate and other bioactive endodontic cements: an updated overview - part II: other clinical applications and complications.

Mineral trioxide aggregate (MTA) is a dental material used extensively for vital pulp therapies (VPT), protecting scaffolds during regenerative endodontic procedures, apical barriers in teeth with necrotic pulps and open apices, perforation repairs as well as root canal filling and root-end filling during surgical endodontics. A number of bioactive endodontic cements (BECs) have recently been introduced to the market. Most of these materials have calcium and silicate in their compositions; however, bioactivity is a common property of these cements. These materials include the following: BioAggregate, Biodentine, BioRoot RCS, calcium-enriched mixture cement, Endo-CPM, Endocem, EndoSequence, EndoBinder, EndoSeal MTA, iRoot, MicroMega MTA, MTA Bio, MTA Fillapex, MTA Plus, Neo MTA Plus, Ortho MTA, Quick-Set, Retro MTA, Tech Biosealer, and TheraCal LC. It has been claimed that these materials have properties similar to those of MTA but without the drawbacks. In Part I of this review, the available information on the chemical composition of the materials listed above was reviewed and their applications for VPT was discussed. In this article, the clinical applications of MTA and other BECs will be reviewed for apexification, regenerative endodontics, perforation repair, root canal filling, root-end filling, restorative procedures, periodontal defects and treatment of vertical and horizontal root fractures. In addition, the literature regarding the possible drawbacks of these materials following their clinical applications is reviewed. These drawbacks include their discolouration potential, systemic effects and retreatability following use as a root filling material. Based on selected keywords, all publications were searched regarding the use of MTA as well as BECs for the relevant clinical applications. Numerous publications were found regarding the use of BECs for various endodontic applications. The majority of these investigations compared BECs with MTA. Despite promising results for some materials, the number of publications using BECs for various clinical applications was limited. Furthermore, most studies had several methodological shortcomings and low levels of evidence.

Protection Against Discolouration by Two Over-the Counter Desensitising Products.

PURPOSE: To determine in vitro the protection potential against discolouration of two OTC (over-the-counter) desensitising products on enamel and dentin in comparison to a standard toothpaste and water by means of a spectrophotometer. MATERIALS AND METHODS: A total of 96 samples of bovine enamel-dentin complex and 48 of bovine dentin were alternatively immersed in red wine, tea, coffee or water after having been treated by a sodium monofluorophosphate- and calcium phosphate-based product (Curodont Protect), an amine fluoride-based toothpaste (Elmex Red), a stannous chloride-based toothpaste (Elmex Protection Erosion) or distilled water (negative control). Initial (T0) and final colour (T1, after 4 weeks of immersion in staining solutions) of each specimen were assessed by a spectrophotometer. Statistical analysis was done by means of repeated measures ANOVA followed by Fisher's LSD post-hoc test. Differences between T0 and T1 were considered stastistically significant at p ≤ 0.05. RESULTS: When enamel samples were measured over a black background, ΔE00 values (T0-T1) varied from 2.2 (SD 0.7) for amine fluoride-based product/water to 53.9 (SD 7.6) for amine fluoride-based-product/red wine. When dentin samples were measured over a black background, ΔE00 values (T0-T1) varied from 5.4 (SD 0.9) stannous chloride based product/water to 61.6 (SD 3.7) amine fluoride-based product/red wine. CONCLUSION: Specifically, the application of the sodium monofluorophosphate was able to statistically significantly (p ≤ 0.05) reduce discolouration induced by the staining solutions tested only on the enamel-dentin complex, while distilled water and the stannous fluoride-based product were able to statistically significantly (p ≤ 0.05) reduce discolouration induced by the staining solutions tested in pure dentin samples.

Effect of Silver Diamine Fluoride and Potassium Iodide Treatment on Secondary Caries Prevention and Tooth Discolouration in Cervical Glass Ionomer Cement Restoration.

This study investigated the effect of silver diamine fluoride (SDF) and potassium iodide (KI) treatment on secondary caries prevention and tooth discolouration in glass ionomer cement (GIC) restoration. Cervical GIC restorations were done on 30 premolars with: Group 1, SDF + KI; Group 2, SDF (positive control); Group 3, no treatment (negative control). After cariogenic biofilm challenge, the demineralisation of dentine adjacent to the restoration was evaluated using micro-computed tomography (micro-CT) and Fourier transform infrared (FTIR) spectroscopy. The colour of dentine adjacent to the restoration was assessed using CIELAB system at different time points. Total colour change (∆E) was calculated and was visible if ∆E > 3.7. Micro-CT showed the outer lesion depths for Groups 1, 2 and 3 were 91 ± 7 µm, 80 ± 7 µm and 119 ± 8 µm, respectively (p < 0.001; Group 2 < Group 1 < Group 3). FTIR found that there was a significant difference in amide I-to-hydrogen phosphate ratio among the three groups (p < 0.001; Group 2 < Group 1 < Group 3). ∆E of Groups 1, 2 and 3 after biofilm challenge were 22.5 ± 4.9, 70.2 ± 8.3 and 2.9 ± 0.9, respectively (p < 0.001; Group 3 < Group 1 < Group 2). SDF + KI treatment reduced secondary caries formation on GIC restoration, but it was not as effective as SDF treatment alone. Moreover, a perceptible staining on the restoration margin was observed, but the intensity of discolouration was less than that with solely SDF treatment.

Deficit irrigation reduces postharvest rib pinking in wholehead Iceberg lettuce, but at the expense of head fresh weight.

BACKGROUND: Postharvest pinking is a serious issue affecting lettuce quality. Previous studies suggested the possibility of using deficit irrigation to control discolouration; however, this approach may also affect yield. This study investigated the effect of varying irrigation deficits on iceberg lettuce (Lactuca sativa L.) to determine the relationship between irrigation deficit, pinking and fresh weight. RESULTS: The deficit imposed and head fresh weight obtained depended on both the duration and timing of withholding irrigation. Withholding irrigation for a period of 2 or 3 weeks in the middle or end of the growth period significantly reduced rib pinking compared to well-watered controls. Withholding irrigation for 2 weeks at the start of the growth period or 1 week at the end did not significantly reduce pinking. Withholding irrigation also reduced head fresh weight such that minimising pinking would be predicted to incur a loss of 40% relative to well-watered controls. However, smaller benefits to pinking reduction were achieved with less effect on head fresh weight. CONCLUSION: Deficit irrigation could be used to provide smaller but higher quality heads which are less likely to be rejected. The balance of these factors will determine the degree of adoption of this approach to growers. © 2016 Society of Chemical Industry.

Microbial dynamics during shelf-life of industrial Ricotta cheese and identification of a Bacillus strain as a cause of a pink discolouration.

Dairy products are perishable and have to be preserved from spoilage during the food chain to achieve the desired shelf-life. Ricotta is a typical Italian soft dairy food produced by heat coagulation of whey proteins and is considered to be a light and healthy product. The shelf-life of Ricotta could be extended, as required by the international food trade market; however, heat resistant microflora causes spoilage and poses issues regarding the safety of the product. Next-generation sequencing (NGS) applied to the Ricotta samples defined the composition of the microbial community in-depth during the shelf-life. The analysis demonstrated the predominance of spore-forming bacteria throughout the shelf-life, mostly belonging to Bacillus, Paenibacillus and Clostridium genera. A strain involved in spoilage and causing a pink discolouration of Ricotta was isolated and characterised as Bacillus mycoides/weihenstephanensis. This is the first report of a food discolouration caused by a toxigenic strain belonging to the Bacillus cereus group that resulted the predominant strain in the community of the defective ricotta. These results suggest that the processing of raw materials to eliminate spores and residual microflora could be essential for improving the quality and the safety of the product and to extend the shelf-life of industrial Ricotta.

Violet-red discolouration of canned Palmyra palm during processing.

The objectives of the research were to investigate the causes of the violet-red discolouration during processing of canned Palmyra palm and to identify preventive methods without the use of chemical additives. Palmyra palm flesh with (13-21 %) /without some peel left on was tested for the source of violet-red discolouration during blanching. It was found that blanching in distilled water had no effect on discolouration when blanching conditions were at 75, 85, and 95 °C for 7 min but the violet-red discolouration occurred only when tap water was used for blanching at 95 °C for 7 min. Moreover, the addition of bicarbonate (NaHCO3) in distilled water to imitate higher alkalinity of tap water during blanching could contribute to the violet-red discolouration. Thus the observed cut off alkalinity of the blanching water wherein not to expect any discolouration was found to be about 100 ppm. After sterilization, there was no violet-red discolouration from Palmyra palm flesh without any peel left on even though it had a preceding treatment of blanching in highly alkaline tap water.

Tooth discolouration and internal bleaching after the use of triple antibiotic paste.

AIM: To assess the discolouration of teeth with closed and open apices after placement of triple antibiotic paste (TAP, ciprofloxacin, metronidazole and minocycline) in the pulp chamber and whether discolouration could be reversed by internal bleaching procedures. METHODOLOGY: Twenty extracted human mandibular premolars were divided into 2 groups (n = 10): teeth with closed apices (CA) and teeth with open apices (OA). After conventional access, the TAP was sealed in the pulp chamber for 3 weeks. The paste was removed by a rinse with sodium hypochlorite (NaOCl) and a mixture of sodium perborate and distilled water was sealed in the pulp chamber for 1, 2 and 3 weeks. The shade was measured by a spectrophotometer at six time periods: baseline (T0), after 3 weeks of placement of TAP (T1), after removal of TAP with a NaOCl rinse (T2) and after 1 (T3), 2 (T4) and 3 (T5) weeks of internal bleaching with sodium perborate paste. Data were collected based on the CIELAB-CIE1976 (L*a*b*) system and analysed using t-tests and anova. RESULTS: A significant decrease in the mean values of L* (lightness) was observed after treatment with TAP (T1, P < 0.05). Considerable increases in these values after bleaching with sodium perborate (T3 < T4 < T5) were found in both groups. The only significant difference in the intergroup analysis was between T1 and T2, in which ΔE values in the OA group were higher (P = 0.04). CONCLUSIONS: TAP discoloured the tooth structure, but discolouration could be reversed with sodium perborate paste. In general, teeth with closed and open apices had the same rates of discolouration and bleaching.

Factors affecting the rate of oxidation and resultant discolouration of tetracyclines contained in endodontic medicaments and irrigants.

AIM: To determine the effect of pH, oxygen levels and ions on tetracycline oxidation and resultant discolouration. METHODOLOGY: Solutions of demeclocycline hydrochloride or doxycycline hyclate were prepared and exposed to different pH conditions, pure oxygen or carbon dioxide, ascorbic acid or various ions (from calcium chloride, calcium nitrate, strontium chloride, magnesium chloride, zinc chloride, and bismuth nitrate). Subsequently, they were exposed to intense visible blue light (470 ± 15 nm) for 24 h. Colour change was monitored using standardized digital photography. Parametric statistical analysis employing the Wilcoxon matched-pairs signed-rank test was performed to compare the mean change in different colour channels, assessing the discolouration effect of the modified conditions. RESULTS: An acidic pH reduced discolouration, whilst alkaline pH increased it. A higher oxygen tension resulted in more discolouration, as did the presence of calcium, strontium, and bismuth ions, all of which bind to tetracyclines. Conversely, zinc and magnesium ions had a mild photoprotective effect. Ascorbic acid, an anti-oxidant, reduced the level of discolouration. CONCLUSIONS: The tendency of these tetracyclines to undergo photo-oxidation is increased by common variables present in the clinical environment. There are potential benefits from using photoprotectors and anti-oxidants in these materials, to reduce the possibility of discolouration.

Dental discoloration caused by bismuth oxide in MTA in the presence of sodium hypochlorite.

OBJECTIVES: The aim of this research was to analyse the dental discolouration caused by mineral trioxide aggregate (MTA) induced by bismuth oxide and also assess the colour stability of other dental cements. MATERIALS AND METHODS: Bismuth oxide, calcium tungstate and zirconium oxide were placed in contact with sodium hypochlorite for 24 h after which they were dried and photographed. Phase analyses were performed by X-ray diffraction (XRD) of radiopacifiers before and after immersion in sodium hypochlorite. Furthermore, teeth previously immersed in water or sodium hypochlorite were filled with MTA Angelus, Portland cement (PC), PC with 20 % zirconium oxide, PC with 20 % calcium tungstate and Biodentine. Teeth were immersed for 28 days in Hank's balanced salt solution after which they were sectioned and characterized using scanning electron microscopy (SEM) with energy-dispersive mapping and stereomicroscopy. RESULTS: Bismuth oxide in contact with sodium hypochlorite exhibited a change in colour from light yellow to dark brown. XRD analysis demonstrated peaks for radiopacifier and sodium chloride in samples immersed in sodium hypochlorite. The SEM images of the dentine to material interface showed alteration in material microstructure for MTA Angelus and Biodentine with depletion in calcium content in the material. The energy-dispersive maps showed migration of radiopacifier and silicon in dentine. CONCLUSIONS: MTA Angelus in contact with a tooth previously immersed in sodium hypochlorite resulted in colour alteration at the cement/dentine interface. CLINICAL RELEVANCE: MTA Angelus should not be used after irrigation with sodium hypochlorite as this will result in tooth discoloration.

Bacterial community dynamics during the early stages of biofilm formation in a chlorinated experimental drinking water distribution system: implications for drinking water discolouration.

AIMS: To characterize bacterial communities during the early stages of biofilm formation and their role in water discolouration in a fully representative, chlorinated, experimental drinking water distribution systems (DWDS). METHODS AND RESULTS: Biofilm development was monitored in an experimental DWDS over 28 days; subsequently the system was disturbed by raising hydraulic conditions to simulate pipe burst, cleaning or other system conditions. Biofilm cell cover was monitored by fluorescent microscopy and a fingerprinting technique used to assess changes in bacterial community. Selected samples were analysed by cloning and sequencing of the 16S rRNA gene. Fingerprinting analysis revealed significant changes in the bacterial community structure over time (P < 0·05). Cell coverage increased over time accompanied by an increase in bacterial richness and diversity. CONCLUSIONS: Shifts in the bacterial community structure were observed along with an increase in cell coverage, bacterial richness and diversity. Species related to Pseudomonas spp. and Janthinobacterium spp. dominated the process of initial attachment. Based on fingerprinting results, the hydraulic regimes did not affect the bacteriological composition of biofilms, but they did influence their mechanical stability. SIGNIFICANCE AND IMPORTANCE OF THE STUDY: This study gives a better insight into the early stages of biofilm formation in DWDS and will contribute to the improvement of management strategies to control the formation of biofilms and the risk of discolouration.