An investigation into most effective method of treating stained teeth: an in vitro study

Abstract

Objective: To assess the most efficacious method of treating stained teeth: bleaching alone, veneering alone or a combination of bleaching and veneering and whether the choice alters depending on the degree of staining. Methods: Extracted teeth were sectioned to give 117 samples. These samples were split into unstained, lightly and darkly stained groups based on CIE Lab value L*. The lightly and darkly stained groups were stained using tea. Teeth from each group were then assigned to one of four sub-groups (control (C), bleaching alone (B), veneering alone (V), or a combination of bleaching and veneering (BV), each containing 13 samples. Veneering was performed using 0.8mm thick ceramic veneer of shade B1. CIE Lab values were recorded using a spectrophotometer and the colour difference (ΔE) was calculated for each intervention. The final colour was compared to the value for obtained from a B1 (Vita) Shade tab. Statistical significance was assessed using analysis of variance. Results: In all three test groups, intervention resulted in a statistically significant colour change compared to the C group (p≤0.001). In the unstained group, the only intervention that reached statistically significant parity to B1 was BV (p=0.015). In the lightly stained group, BV produced the most colour change and the value closest to B1 (p≤0.003). In Abstract dark group, BV produced the greatest colour change and the value closest to B1 however, this was not statistically significantly better than V (p=0.146). Conclusions: All the interventions produced a statistically significant and clinically visible colour change compared to the control. External light activated bleaching produced a clinically visible colour change. In all groups the combination of bleaching and veneering gave the closest value to B1.