Color Stability Under Challenge: Effects of Thermo-Aging and Mouthrinse Exposure on Anterior Teeth and Esthetic Composites

Authors

DOI:

https://doi.org/10.58600/eurjther2930

Keywords:

chlorhexidine, CIEDE2000, color stability, composite resin, enamel, esthetic restorations, mouthrinse solutions, thermal aging

Abstract

Objective: The aim of this study is to comparatively evaluate how the color stability of different esthetic composite resins and natural anterior teeth is affected after exposure to thermal aging and various mouthrinse solutions.

Materials and Methods: A total of 96 extracted permanent anterior teeth were prepared with Class V cavities on the buccal surfaces and restored using three different esthetic composite resins: G-aenial Anterior (GC Corp., Tokyo, Japan), SOLARE X (GC Corp., Tokyo, Japan), and Estelite Sigma Quick (Tokuyama Dental Corp., Tokyo, Japan). The palatal surfaces of the same teeth were used as a natural enamel reference. Following restoration, all specimens underwent thermal aging for 10,000 cycles between 5 °C and 55 °C. Subsequently, the samples were immersed for 24 hours in four different mouthrinse solutions: 0.12% chlorhexidine solution (Kloroben, Drogsan, Türkiye), an antiseptic and anticavity formulation (Listerine Total Care, Johnson & Johnson, USA), a zinc-containing mouthrinse (Listerine Total Care Stay White, Johnson & Johnson, UK), and distilled water (control group). Color measurements were performed using a VITA Easyshade Advance 4.0 spectrophotometer, and color differences were calculated according to the CIEDE2000 (ΔE₀₀) formula.

Results: Color changes were observed in all composite materials after thermal aging and exposure to mouth-rinse solutions. Specimens exposed to chlorhexidine-containing solutions exhibited significantly greater discoloration compared with the control group (p < 0.050). Statistically significant differences in color stability were also found among the materials (p < 0.050).

Conclusion: Within the limitations of this in vitro study, chlorhexidine-containing mouthrinse caused the highest color change, while material type significantly influenced color stability.

References

[1] Abuljadayel R, Mushayt A, Al Mutairi T, Sajini S (2023) Evaluation of bioactive restorative materials' color stability: Effect of immersion media and thermocycling. Cureus. 15(8):43038. https://doi.org/10.7759/cureus.43038

[2] Piccoli YB, Lima VP, Basso GR, Salgado VE, Lima GS, Moraes RR (2019) Optical stability of high-translucency resin-based composites. Oper Dent. 44(5):536-544. https://doi.org/10.2341/18-025-L

[3] Lee YK (2016) Translucency changes of direct esthetic restorative materials after curing, aging and treatment. Restor Dent Endod. 41(4):239-245. https://doi.org/10.5395/rde.2016.41.4.239

[4] Fugolin APP, Pfeifer CS (2017) New resins for dental composites. J Dent Res. 96(10):1085-1091. https://doi.org/10.1177/0022034517720658

[5] Fonseca ASQS, Labruna Moreira AD, de Albuquerque PPAC, de Menezes LR, Pfeifer CS, Schneider LFJ (2017) Effect of monomer type on the degree of conversion, water sorption and solubility, and color stability of model dental composites. Dent Mater. 33(4):394-401. https://doi.org/10.1016/j.dental.2017.01.010

[6] Huang W, Ren L, Cheng Y, Xu M, Luo W, Zhan D, et al. (2022) Evaluation of the color stability, water sorption, and solubility of current resin composites. Materials (Basel). 15(19):6710. https://doi.org/10.3390/ma15196710

[7] Sarafianou A, Iosifidou S, Papadopoulos T, Eliades G (2007) Color stability and degree of cure of direct composite restoratives after accelerated aging. Oper Dent. 32(4):406-411. https://doi.org/10.2341/06-127

[8] Sulaiman TA, Rodgers B, Suliman AA, Johnston WM (2021) Color and translucency stability of contemporary resin-based restorative materials. J Esthet Restor Dent. 33(6):899-905. https://doi.org/10.1111/jerd.12640

[9] Morais Sampaio GA de, Rangel Peixoto L, Vasconcelos Neves G de, Nascimento Barbosa D do (2021) Effect of mouthwashes on color stability of composite resins: A systematic review. J Prosthet Dent. 126(3):386-392. https://doi.org/10.1016/j.prosdent.2020.08.001

[10] Ren YF, Feng L, Serban D, Malmstrom HS (2012) Effects of common beverage colorants on color stability of dental composite resins: The utility of a thermocycling stain challenge model in vitro. J Dent. 40(Suppl 1):e48-56. https://doi.org/10.1016/j.jdent.2012.04.017

[11] Ghavami-Lahiji M, Firouzmanesh M, Bagheri H, Jafarzadeh Kashi TS, Razazpour F, Behroozibakhsh M (2018) The effect of thermocycling on the degree of conversion and mechanical properties of a microhybrid dental resin composite. Restor Dent Endod. 43(2):e26. https://doi.org/10.5395/rde.2018.43.e26

[12] Kim SY, Bae HJ, Lee HH, Lee JH, Kim YJ, Choi YS, Lee JH, Shin SY (2023) The effects of thermocycling on the physical properties and biocompatibilities of various CAD/CAM restorative materials. Pharmaceutics. 15(8):2122. https://doi.org/10.3390/pharmaceutics15082122

[13] Wahab FK, Shaini FJ, Morgano SM (2003) The effect of thermocycling on microleakage of several commercially available composite Class V restorations in vitro. J Prosthet Dent. 90(2):168-174. https://doi.org/10.1016/S0022-3913(03)00300-7

[14] El-Rashidy AA, Abdelraouf RM, Habib NA (2022) Effect of two artificial aging protocols on color and gloss of single-shade versus multi-shade resin composites. BMC Oral Health. 22(1):2351-2357. https://doi.org/10.1186/s12903-022-02351-7

[15] Çelik C, Yüzügüllü B, Erkut S, Ertaş E (2008) Effects of mouth rinses on color stability of resin-based composite. Eur J Dent. 2(4):247-253. https://doi.org/10.1055/s-0039-1697388

[16] Abeer El-Sayed ElEmbaby (2014) The effects of mouth rinses on the color stability of resin-based restorative materials. J Esthet Restor Dent. 26(4):264–271. https://doi.org/10.1111/jerd.12061

[17] Gómez Polo C, Gómez Polo M, Montero J, Martínez Vazquez De Parga JA, Celemin Viñuela A (2015) Correlation of natural tooth colour with aging in the Spanish population. Int Dent J. 65(5):227-234. https://doi.org/10.1111/idj.12176

[18] Allccahuaman-Avalos R, Medina-Sánchez R, Castro-Ramirez L, Ladera-Castañeda M, Cervantes-Ganoza L, Martínez-Campos R, et al. (2023) In vitro color stability evaluation of three polished and unpolished nanohybrid resin composites immersed in a 0.12% chlorhexidine-based mouthwash at different times. Polymers (Basel). 15(6):1339. https://doi.org/10.3390/polym15061339

[19] DailyMed (2025) Listerine total care fresh mint anticavity - sodium fluoride mouthwash. DailyMed Online https://dailymed.nlm.nih.gov. Accessed 27 Oct 2025.

[20] [20] Listerine (2025) Stay White - Reduce Tartar. Listerine Online. Available at: https://www.listerine.com Accessed 27 Oct 2025.

[21] Beedubail S, Jaganath B, Krishnegowda S, Rudranaik S (2023) Assessment of color changes in teeth and composite resins under the influence of chlorhexidine with and without anti-discoloration system: An in vitro study. J Conserv Dent. 26(1):52. https://doi.org/10.4103/jcd.jcd_393_22

[22] Karamouzos A, Papadopoulos MA, Kolokithas G, Athanasiou AE (2007) Precision of in vivo spectrophotometric colour evaluation of natural teeth. J Oral Rehabil. 34(8):613-621. https://doi.org/10.1111/j.1365-2842.2007.01744.x

[23] Paravina RD, Ghinea R, Herrera LJ, Bona AD, Igiel C, Linninger M, et al. (2015) Color difference thresholds in dentistry. J Esthet Restor Dent. 27(S1):S1-S9. https://doi.org/10.1111/jerd.12149

[24] Babina K, Polyakova M, Sokhova I, Doroshina V, Arakelyan M, Novozhilova N (2020) The effect of finishing and polishing sequences on the surface roughness of three different nanocomposites and composite/enamel and composite/cementum interfaces. Nanomaterials (Basel). 10(7):1339. https://doi.org/10.3390/nano10071339

[25] Boussès Y, Brulat-Bouchard N, Bouchard PO, Tillier Y (2021) A numerical, theoretical and experimental study of the effect of thermocycling on the matrix-filler interface of dental restorative materials. Dent Mater. 37(5):772-782. https://doi.org/10.1016/j.dental.2021.01.010

[26] Kose HD, Giray I, Boyacioglu H, Turkun LS (2024) Can energy drinks affect the surface quality of bioactive restorative materials? BMC Oral Health. 24(1):1011. https://doi.org/10.1186/s12903-024-04781-x

[27] Hamdy TM, Abdelnabi A, Othman MS, Bayoumi RE, Abdelraouf RM (2023) Effect of different mouthwashes on the surface microhardness and color stability of dental nanohybrid resin composite. Polymers (Basel). 15(4):815. https://doi.org/10.3390/polym15040815

[28] Haridy MF, Mohamed AR, Saber S, Schafer E, Swelam SE, Haridy YM, et al. (2025) Enhancing severely compromised premolar strength: role of cusp reduction design in CAD/CAM composite restorations. Odontology Epub ahead of print. https://doi.org/10.1007/s10266-025-01167-5

[29] Ertürk-Avunduk AT, Aksu S, Delikan E (2021) The effects of mouthwashes on the color stability of resin-based restorative materials. Odovtos – Int J Dent Sci. 23(1):91–102. https://doi.org/10.15517/ijds.2020.43004

[30] Sharma G, Wu W, Dalal EN (2005) The CIEDE2000 color-difference formula: Implementation notes, supplementary test data, and mathematical observations. Color Res Appl. 30(1):21-30. https://doi.org/10.1002/col.20070

[31] Tejada-Casado M, Pérez MM, Della Bona A, Lübbe H, Ghinea R, Herrera LJ (2024) Chroma-dependence of CIEDE2000 acceptability thresholds for dentistry. J Esthet Restor Dent. 36(3):469-476. https://doi.org/10.1111/jerd.13153

[32] Faul F, Erdfelder E, Lang A-G, Buchner A (2007) G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 39(2):175–191. https://doi.org/10.3758/BF03193146

[33] Cohen J (2013) Statistical power analysis for the behavioral sciences, 2nd ed. Routledge, London, UK

[34] Kh AS (2017) The effect of preventive agents (mouthwashes/gels) on the color stability of dental resin-based composite materials. Dent J 5(1):45-52. https://doi.org/10.3390/dj5020018

[35] Ferracane JL (2011) Resin composite - state of the art. Dent Mater. 27(1):29-38. https://doi.org/10.1016/j.dental.2010.10.020

[36] Sideridou I, Tserki V, Papanastasiou G (2003) Study of water sorption, solubility and modulus of elasticity of light-cured dimethacrylate-based dental resins. Biomaterials. 24(4):655-665. https://doi.org/10.1016/S0142-9612(02)00380-0

[37] Aktu A, Ulusoy N (2024) Effect of polishing systems on the surface roughness and color stability of aged and stained bulk-fill resin composites. Materials (Basel). 17(14):3576. https://doi.org/10.3390/ma17143576

[38] Pisano M, Iandolo A, Abdellatif D, Chiacchio A, Galdi M, Martina S (2024) Effects of different curing methods on the color stability of composite resins. Restor Dent Endod. 49(4):e33. https://doi.org/10.5395/rde.2024.49.e33

[39] Meniawi M, Şirinsükan N, Can E (2025) Color stability, surface roughness, and surface morphology of universal composites. Odontology. Epub ahead of print. https://doi.org/10.1007/s10266-025-01108-2

[40] Yu P, Yang SM, Xu YX, Wang XY (2023) Surface roughness and gloss alteration of polished resin composites with various filler types after simulated toothbrush abrasion. J Dent Sci. 18(3):1016-1022. https://doi.org/10.1016/j.jds.2022.12.004

[41] Elfakhri F, Alkahtani R, Li C, Khaliq J (2022) Influence of filler characteristics on the performance of dental composites: A comprehensive review. Ceram Int. 48(19):27280-27294. https://doi.org/10.1016/j.ceramint.2022.06.314

[42] Morresi AL, D'Amario M, Capogreco M, Gatto R, Marzo G, D'Arcangelo C, et al. (2014) Thermal cycling for restorative materials: does a standardized protocol exist in laboratory testing? A literature review. J Mech Behav Biomed Mater. 29:295-308. https://doi.org/10.1016/j.jmbbm.2013.09.013

[43] Çakır Kılınç NN, Yıldız P (2024) Do mouthwashes affect the optical properties of resin cement? BMC Oral Health. 24(1):275. https://doi.org/10.1186/s12903-024-04044-9

[44] Hazar A, Hazar E (2024) Effects of different antiviral mouthwashes on the surface roughness, hardness, and color stability of composite CAD/CAM materials. J Appl Biomater Funct Mater. 22:22808000241248886. https://doi.org/10.1177/22808000241248886

[45] Carey CM, Yagudayev A, Font K (2021) Effect of temperature on tooth staining by 0.12% chlorhexidine gluconate. Front Dent Med. 2:779852. https://doi.org/10.3389/fdmed.2021.779852

[46] Van Swaaij BWM, Van der Weijden GA, Graziani F, Slot DE (2020) Does chlorhexidine mouthwash, with an anti-discoloration system, reduce tooth surface discoloration without losing its efficacy? A systematic review and meta-analysis. Int J Dent Hyg. 18(2):133–143. https://doi.org/10.1111/idh.12402

[47] Cortellini P, Labriola A, Tonetti MS (2008) Chlorhexidine with an anti-discoloration system after periodontal surgery: A comparative clinical study. J Clin Periodontol. 35(7):614–620. https://doi.org/10.1111/j.1600-051X.2008.01238.x

[48] Asmussen E (1984) Softening of BISGMA-based polymers by ethanol and by organic acids of plaque. Scand J Dent Res. 92(3):257-261. https://doi.org/10.1111/j.1600-0722.1984.tb00889.x

[49] Deus FP, Ouanounou A (2022) Chlorhexidine in dentistry: pharmacology, uses, and adverse effects. Int Dent J. 72(3):269-277. https://doi.org/10.1016/j.identj.2022.01.005

[50] Lynch RJM (2011) Zinc in the mouth, its interactions with dental enamel and possible effects on caries; a review of the literature. Int Dent J. 61(Suppl 3):46–54. https://doi.org/10.1111/j.1875-595x.2011.00049.x

Figure 1. Comparison of the effects of different mouthrinses on tooth surface color stability based on ΔE₁ and ΔE₂ values

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Published

2026-01-22

How to Cite

Keçeci, G., Güner, Z., Şenyurt, S. Z., & Erciyas, K. (2026). Color Stability Under Challenge: Effects of Thermo-Aging and Mouthrinse Exposure on Anterior Teeth and Esthetic Composites. European Journal of Therapeutics, 32(1), 94–105. https://doi.org/10.58600/eurjther2930

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