Color Stability of Darkly Discolored Arrested Caries Lesions Following Bleaching Treatment

A total of 105 teeth with DDACL (21 patients) and 96 healthy teeth (6 patients) were treated with in-office bleaching using 40% hydrogen peroxide (Opalescence Boost) following the routine clinical protocol of the Department of Restorative Dentistry, Selçuk University. All procedures and evaluations were performed by a single clinician. Color was measured with a Vita Easyshade spectrophotometer (L*, a*, b*), and color differences were calculated with the CIEDE2000 formula. Laser fluorescence was measured with DIAGNODent Pen, and caries status was recorded with ICDAS II. Evaluations were performed at baseline (T1), immediately after bleaching (T2), 1 week (T3), and 3 months (T4).

Primary outcomes

• Color change (CIEDE2000 ΔE00) from baseline to 3 months after bleaching [3 months]: Tooth color was measured with a Vita Easyshade spectrophotometer (CIELAB L*, a*, b*), and color differences were calculated with the CIEDE2000 formula (ΔE00) between baseline and each follow-up time point (immediately after bleaching, 1 week, and 3 months), separately for DDACL and healthy teeth.

Secondary outcomes

• Change in laser fluorescence (DIAGNODent Pen) values from baseline to 3 months [3 months]: Laser fluorescence values measured with the DIAGNODent Pen on the facial surface of the teeth; higher values indicate greater fluorescence associated with demineralization or discoloration.Measurements were taken at baseline, immediately after bleaching, 1 week, and 3 months.
• Change in ICDAS II codes of DDACL teeth from baseline to 3 months [3 months]: Caries status of DDACL teeth scored according to the International Caries Detection and Assessment System (ICDAS II). Codes were recorded at baseline, immediately after bleaching, 1 week, and 3 months.
• Change in participant and clinician color satisfaction score (1-10) from baseline to 3 months [3 months]: Participant and clinician satisfaction with tooth color, rated on a numerical scale from 1 to 10. Scores were recorded at baseline and at 3 months after bleaching.

Sex: All, ages: 18 Years to 55 Years, accepts healthy volunteers

Inclusion Criteria:

* Aged between 18 and 55 years
* No missing maxillary or mandibular anterior and premolar teeth
* No restorations, cavitations, or active caries on the facial surface of these teeth
* Able to attend regular follow-up appointments

Exclusion Criteria:

* Medically compromised patients
* History of previous bleaching treatment
* Poor oral hygiene
* Cavitated or active caries lesions or restorations on the facial surface of the target teeth

• Merve Albakır Yiğit, DDS, Specialist, Principal investigator, Selçuk University Faculty of Dentistry
• Nevin Çobanoğlu, Prof, Study director, Selçuk University Faculty of Dentistry