Color stability of nano resin-modified glass Ionomer restorative cement after acidic and basic medications challenge

Abstract

Background: Color stability of glass ionomers (GIs) could be affected by many factors such as pH and consumption of liquid medications like antibiotics. Most common antibiotics used during childhood are amoxicillin suspension (AM.S) and azithromycin suspension (AZ.S) which have acidic and basic pH respectively. Aim: to evaluate and compare the effect of AM.S and AZ.S on color stability of nano resin-modified GI. Methods: Thirty disc of nano resin-modified glass ionomer (2mm height x 4mm diameter) were divided into three groups (n=10 for each) and independently exposed to AM.S, AZ.S, and artificial saliva (A.S.). Color stability was evaluated in triplicate by VITA Easyshade® before and after three immersion protocols, repeated over a three-week duration with two-days intervals. In each protocol, samples were exposed for two minutes, three times daily for AM.S, once daily for AZ.S, and A.S. full day. GI discs rinsed off after each immersion and kept in artificial saliva until next immersion period. Results: One way ANOVA test and Post-hoc analysis of the changes in color space compartments of nano-resin modified GI samples demonstrated just a significant change (p˂0.05) in yellow-blue axis (Δb*) value after immersion in AM.S in comparison with A.S. Total Color change values (ΔE) of nano resin-modified glass ionomer samples also illustrated a significant effect (p˂0.05) between AM.S and A.S. only. The highest (ΔE) value was recorded for samples immersed in AM.S (ΔE =12.5) followed by AZ.S (ΔE=6.5) while the lowest was recorded for A.S. (ΔE=1.1). Conclusion: AM.S (the acidic medication) exhibited a higher staining effect to nano-resin modified GI samples when compared with AZ.S (the basic medication). Several factors such as low pH, more exposure time and coloring material of the immersion media added critical roles in coloring instability.