Ability of Whitening Toothpastes in Removing Stains from Composite Resinsproperty compared to standard dentifrices. The dentifricesused by Yankell et al. 28 and Sharma et al. 29 may containingredients with chemical action. The importance ofchemical action has also been demonstrated by Koertge etal., who performed a longitudinal clinical study on bakingsoda based dentifrices and found that they are significantlymore effective in removing extrinsic stain than standardsilica-based dentifrices (abrasive type) although it is lessabrasive compared to the silica-based dentifrices.Koertge et al. 8 had stated that the whitening effector stain removal effect of a dentifrice may not solelyrelated to its abrasiveness. In the present study, ColgateTotal, Colgate Advanced Whitening and Darlie All ShinyWhite demonstrated no significant difference in the abilityto remove stains from three types of composite resinsi.e. Filtek Z350 (nanofilled), Filtek Z250 (microhybrid)and Beautifil (Giomer). Both Colgate Total and ColgateAdvanced Whitening were manufactured by the samemanufacturer. It is important to take note of the increase insurface roughness of composite resins when brushed withwhitening dentifrices with high abrasivity. The increase insurface roughness after long term toothbrushing may leadto easier absorption and adsorption of external stains 30 .Eventually, this may negate the purpose of the whiteningdentifrice and formed a vicious cycle of stains formation.CONCLUSIONWithin the limitations of the present study, it canbe concluded that coffee solution has the ability to staincomposite resins on prolonged and heavy consumptionleading to discolouration that can be perceived clinically.The clinicians should warn patients with large compositerestorations to reduce intake of coffee or rinse immediatelyafter consumption to avoid unsightly discolouration of therestorations. Filtek Z350 was more stain resistant thanFiltek Z250 and Beautifil. The whitening toothpastes(Colgate Advanced Whitening and Darlie All Shiny White)do not offer added advantage to remove stains comparedto ordinary toothpaste (Colgate Total). Lastly, we advocatefurther study to evaluate the effect of whitening toothpasteon surface roughness of composites resins and also theeffect of vicious cycle of brushing and consumption ofcoffee on long term colour stability of composite resins.REFERENCES1. Manhart J, Chen HY, Hickel R. The suitability of packableresin-based composites for posterior restorations. J Am DentAssoc 2001; 132(5): 639-645.2. Van Dijken JWV. Direct resin composite inlays/onlays: an 11year follow up. J Dent 2000; 28: 299-306.3. Dietschi D, Campanile G, Holz J, Meyer JM. Comparison ofthe color stability of ten new-generation composites: an invitro study. Dent Mater 1994; 10: 353-62.4. Lu H, Roeder LB, Lei L, Powers JM. Effect of surfaceroughness on stain resistance of dental resin composites. JEsthet Restor Dent 2005; 17: 102-109.5. Tjan AHL, Chan CA. The polishability of posteriorcomposites. J Prothet Dent 1989; 61: 138-146.6. Türkün LS, Türkün M. Effect of bleaching and repolishingprocedures on coffee and tea stain removal from three anteriorcomposite veneering materials. J Esthet Restor Dent 2004;16: 290-301.7. Neme AL, Frazier KB, Roeder LB, Debner TL. Effect ofprophylactic polishing protocols on the surface roughness ofesthetic restorative materials. Oper Dent 2002; 27(1): 50-58.8. Koertge TE, Brooks CN, Sarbin AG, et al. A longitudinalcomparison of tooth whitening resulting from dentifrice uses.J Clin Dent 1998; 9: 63-71.9. Kleber CJ, Moore MH, Nelson BJ. Laboratory assessmentof tooth whitening by sodium bicarbonate dentifrices. J ClinDent 1998; 9(3): 72-75.10. Pugh BR. Toothbrush wear, brushing forces and cleaningperformance. J Soc Cosmet Chem 1978; 29: 423-431.11. Ruyter IE, Svendsen, SA. Remaininig metacrylate groups incomposite restorative materials. Acta Odontol. Scand 1987;36: 75-82.12. Gross MD, Moser JB. A colorimetric study of coffee and teastaining of four composite resins. J Oral Rehabil 1977; 4:311-322.13. Asmussen E, Hansen EK. Surface discoloration of restorativeresins in relation to surface softening and oral hygiene. ScandJ Dent Res 1986; 94(2): 174-7.14. Mjör IA. The reasons for replacement and the age of failedrestorations in general dental practice. Acta Odontol Scand1997; 55(1): 58-63.15. Khokhar ZA, Razzoog ME, Yaman P. Colour stability ofcomposite resins. Quintessence Int 1991; 22: 733-737.16. Yannikakis SA, Zissis AJ, Polyzois GL, Caroni C. Colourstability of provisional resin restorative materials. J ProsthetDent 1998; 80: 533-539.17. Um CM, Ruyter IE. Staining of resin-based veneeringmaterials with coffee and tea. Quintessence Int 1991; 22:377-386.18. Teixeira ECN, Thompson JL, Piascik JR et al. IN vitrotoothbrush-dentifrice abrasion of two restorative composites.J Esthet Restor Dent 2005; 17: 172-182.19. Pfarrer AM, White DJ. Anticaries profile qualification of animproved whiteninig dentifrice. J Clin Dent 2001; 12: 30-3320. Shintani H, Satou J, Satou N et al. Effects of various finishingmethods on staining and accumulation of streptococcusmutans HS-6 on composite resins. Dent Mater 1985; 1: 225-227.21. Hörsted-Bindslev P, Mjör IA. Esthetic restorations. In: Modernconcepts in operative dentistry. Copenhagen: Munksgaard.1988; Pp. 190-246.22. Sumita BM, Dong W, Brian NH. An application ofnanotechnology in advanced dental materials. JADA 2003;134: 1382-1390.23. Gladys S, Van Meerbeek B, Braem M, Lambrechts P, VanherleG. Comparative physico-mechanical characterization of newhybrid restorative materials with conventional glass-ionomerand resin composite materials. J Dent Res 1997; 76: 883.24. Cattani-Lorente MA, Dupuis V, Payan J, Moya F, Meyer JM.Effect of water on the physical properties of resin-modifiedglass-ionomer cements. Dent Mater 1999; 15: 71.25. Itota T, Carrick TE, Yoshiyama M, McCabe JF. Fluoride releaseand recharge in giomer, compomer and resin composite. DentMater 2004; 20: 789-795.26. Geurtsen W, Leyhausen G, Garcia-Godoy F. Effect of storagemedia on the fluoride release and surface microhardness of102
Chong / Lim / Seowfour polyacid-modified composite resins (“compomer”).Dent Mater 1999; 15(3): 196-201.27. Amaral CM, Rodrigues JA, Erhardt MCG et al. Effect ofwhitening dentifrices on the superficial roughness of estheticrestorative materials. J Esthet Restor Dent 2006; 18(2): 109-119.28. Yankell SL, Shi X, Emling RC, Nelson BJ, Triol CW.Laboratory evaluations of three dentifrices with polishing orbrushing. J Clin Dent 1998; 9: 61-63.29. Sharma N, Galustians HJ, Qaqish J et al. Comparative toothwhitening and extrinsic tooth stain prevention efficacy of anew dentifrice and a commercially available tooth whiteningdentifrice: six-week clinical trial. J Clin Dent 2004; 15(2):52-57.30. Hachiya Y, Iwaku M, Hosoda H, Fusayama T. Relation offinish to discolouration of composite resins. J Prosthet Dent1984; 52: 811-814.Address for correspondence:Assoc. Prof. Dr. Liang Lin SeowSchool of DentistryInternational Medical University126, Jalan 19/155B, Bukit Jalil, 57000Kuala Lumpur, MalaysiaTel: 00603- 2731 7286e-mail: llseow@gmail.com103