The Journal of Contemporary Dental Practice

Register      Login



Volume / Issue

Online First

Related articles

VOLUME 21 , ISSUE 9 ( September, 2020 ) > List of Articles


Effect of Toothbrushing on Surface Color of Ceramic-polymer Materials: An In Vitro Study

Farzan L Pouranfar, Ryan Sheridan, Cade Salmon, Kraig S Vandewalle

Keywords : Ceramic polymers, Extrinsic stains, Lithium disilicate, Surface color, Toothbrushing

Citation Information : Pouranfar FL, Sheridan R, Salmon C, Vandewalle KS. Effect of Toothbrushing on Surface Color of Ceramic-polymer Materials: An In Vitro Study. J Contemp Dent Pract 2020; 21 (9):1054-1058.

DOI: 10.5005/jp-journals-10024-2933

License: CC BY-NC 4.0

Published Online: 22-01-2021

Copyright Statement:  Copyright © 2020; The Author(s).


Aim and objective: The purpose of this study was to examine the effects of toothbrushing on the change in color of extrinsic characterization of ceramic-polymer materials. Materials and methods: Two ceramic-polymer materials (CeraSmart, GC; Enamic, VITA) and one lithium-disilicate material (IPS e.max CAD; Ivoclar Vivadent) were tested. Specimens of each material were prepared, characterized, and glazed per manufacturer's instructions. The treated surface of the blocks were then brushed in a toothpaste slurry with artificial saliva using a toothbrush machine with a soft toothbrush. Commission Internationale de L'Eclairage (CIE) L*a*b* values were recorded with a spectrophotometer at baseline and at 3, 6, 9, and 12 simulated years of brushing (7,300 strokes/year). A mean change in color (ΔE*) and standard deviation was determined for each group and brushing interval. Data were analyzed with a two-way repeated measures ANOVA examining the effects of toothbrushing the ceramic materials on ΔE* over time (α = 0.05). Results: The difference in the ΔE* between CeraSmart and Enamic was significant at 3 years, while the differences between them were not significant at 6, 9, and 12 years of simulated brushing. The ΔE* of IPS e.max CAD was significantly lower than CeraSmart and Enamic at all time points (all p < 0.0001) except for the comparison with Enamic at 3 years. Conclusion: The extrinsic stains on the ceramic-polymer materials may be more susceptible to change from simulated toothbrushing compared to the lithium-disilicate material. Clinical significance: Toothbrushing may change the color of extrinsic characterization of ceramic-polymer materials. However, the change may remain clinically imperceptible to the naked eye (ΔE* > 1.0) for nearly 6 equivalent years of brushing.

  1. Bativala F, Weiner S, Berendsen P, et al. The microscopic appearance and effect of toothbrushing on extrinsically stained metal-ceramic restorations. J Prosthet Dent 1987;57(1):47–52. DOI: 10.1016/0022-3913(87)90115-6.
  2. Lund TW, Schwabacher WB, Goodkind RJ. Spectrophotometric study of the relationship between body porcelain color and applied metallic oxide pigments. J Prosthet Dent 1985;53(6):790–796. DOI: 10.1016/0022-3913(85)90158-1.
  3. Aker DA, Aker JR, Sorensen SE. Toothbrush abrasion of color-corrective porcelain stains applied to porcelain-fused-to-metal restorations. J Prosthet Dent 1980;44(2):161–163. DOI: 10.1016/0022-3913(80)90130-4.
  4. Anil N, Bolay S. Effect of toothbrushing on the material loss, roughness, and color of intrinsically and extrinsically stained porcelain used in metal-ceramic restorations: an in vitro study. Int J Prosthodont 2002;15(5):483–487.
  5. Featherstone DB, Domejean-Orliaguet S, Jenson L, et al. Caries risk assessment in practice for age 6 through adult. J Calif Dent Assoc 2007;35(10):703–713.
  6. Van der Weijden GA, Timmerman MF, Danser MM, et al. Relationship between the plaque removal efficacy of a manual toothbrush and brushing force. J Clin Periodontol 1998;25(5):413–416. DOI: 10.1111/j.1600-051x.1998.tb02464.x.
  7. Arai T, Kinoshita S. A comparison of plaque removal by different toothbrushes and toothbrushing methods. Bull Tokyo Med Dent Univ 1977;24(2):177–188.
  8. Gracis S, Thompson VP, Ferencz JL, et al. A new classification system for all-ceramic and ceramic-like restorative materials. Int J Prosthodont 2015;28(3):227–235. DOI: 10.11607/ijp.4244.
  9. Nasr E, Makhlouf AC, Zebouni E, et al. All-ceramic computer-aided design and computer-aided manufacturing restorations: evolution of structures and criteria for clinical application. J Contemp Dent Pract 2019;20(4):516–523. DOI: 10.5005/jp-journals-10024-2549.
  10. 3M ESPE. Lava Ultimate CAD/CAM Restorative. Accessed April 14, 2020.
  11. VITA Enamic [technical and scientific documentation]. February 2018. Accessed April 14, 2020.
  12. Ivoclar Vivadent technical, version 7 2017. Accessed April 14, 2020.
  13. VITA Enamic Bonding Protocol. Accessed April 14, 2020.
  14. GC, Optiglaze color instructions for use: Accessed April 14, 2020.
  15. GC America. CeraSmart [instructions for use]. June 2016. Accessed April 14, 2020.
  16. Fasbinder DJ, Neiva GF, Dennison JB, et al. Clinical performance of CAD/CAM-generated composite inlays after 10 years. J Cosmet Dent 2013;28:134–145.
  17. Sailer I, Makarov NA, Thoma DS, et al. All-ceramic or metal ceramic tooth-supported fixed dental prostheses (FDPs)? A systemic review of the survival and complication rates. Part I: single crowns (SCs). Dent Mater 2015 31(6):603–623. DOI: 10.1016/
  18. Manly RS. The abrasion of cementum and dentin by modern dentifrices. J Dent Res 1941;20(6):583–595. DOI: 10.1177/00220345410200060901.
  19. Lata S, Varghese NO, Varughese JM. Remineralization potential of fluoride and amorphous calcium phosphate-casein phosphor peptide on enamel lesions: an in-vitro comparative evaluation. J Conserv Dent 2010;13(1):42–46. DOI: 10.4103/0972-0707.62634.
  20. Khashayar G, Bain PA, Salari S, et al. Perceptibility and acceptability thresholds for colour differences in dentistry. J Dent 2014;42(6):637–644. DOI: 10.1016/j.jdent.2013.11.017.
  21. Guth JF, Zuch T, Zwinge S, et al. Optical properties of manually and CAD/CAM-fabricated polymers. Dent Mater J 2013;32(6):865–871. DOI: 10.4012/dmj.2013-099.
  22. Aroucha MA, Basilio J, Llopis J, et al. Colour stainability of indirect CAD-CAM processed composites vs. conventionally laboratory processed composites after immersion in staining solutions. J Dent 2014;42(7):831–838. DOI: 10.1016/j.jdent.2014.04.002.
  23. Garza LA, Thompson G, Cho SH, et al. Effect of toothbrushing on shade and surface roughness on extrinsically stained pressable ceramics. J Prosthet Dent 2016;115(4):489–494. DOI: 10.1016/j.prosdent.2015.09.013.
  24. Partin-Agarwal K, Terwilliger RJ, Lien W, et al. Polish retention of ceramic-polymer CAD/CAM materials. Gen Dent 2018;66(6):65–70.
  25. Mörmann WH, Stawarczyk B, Ender A, et al. Wear characteristics of current aesthetic dental restorative CAD/CAM materials: two-body wear, gloss retention, roughness and martens hardness. J Mech Behav Biomed Mater 2013;20:113–125. DOI: 10.1016/j.jmbbm.2013. 01.003.
  26. Koizumi H, Saiki O, Nogawa H, et al. Surface roughness and gloss of current CAD/CAM resin composites before and after toothbrush abrasion. Dent Mater J 2015;34(6):881–887. DOI: 10.4012/dmj.2015-177.
  27. Litonjua LA, Andreana S, Bush PJ, et al. Wedged cervical lesions produced by toothbrushing. Am J Dent 2004;17(4):237–240.
  28. Tanoue N, Matsumura H, Atsuta M. Analysis of composite type and different sources of polymerization light on in vitro toothbrush/dentifrice abrasion resistance. J Dent 2000;28(5):355–359. DOI: 10.1016/s0300-5712(00)00014-2.
  29. Saxer UP, Barbakow J, Yankell SL. New studies on estimated and actual toothbrushing times and dentifrice use. J Clin Dent 1998;9(2):49–51.
  30. Kulkarni A, Rothrock J, Thompson J. Impact of gastric acid induced surface changes on mechanical behavior and optical characteristics of dental ceramics. J Prosthodont 2020;29(3):207–218. DOI: 10.1111/jopr.12716.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.