Spectrophotometric analysis of the effectiveness of different dentin tubule occlusion techniques in preventing discoloration caused by photosensitizers used in photodynamic therapy

Aim: The efficacy of Copal Varnish (CV), dentin bonding agent (DBA), Nd:YAG laser and Er:YAG laser, which occludes dentin tubules by different mechanisms, was investigated in order to prevent unwanted coloration caused by methylene blue (MB) and phthalocyanine used in photodynamic therapy (PDT). Materials and methods: 165 upper incisors included in the study. Root canals were prepared up to 30/0.6 size for all teeth using Protaper Next rotary files. Then the teeth were randomly divided into 2 main groups (n = 60); MB and phthalocyanine. Each main group was randomly divided into 5 subgroups (n = 15); Positive control, DBA, CV, Er:YAG and Nd:YAG. Root canals were filled with photosensitizers (PS) and activated after the dentin tubule occlusion method was applied to all teeth. Then, the residual PSs were removed by irrigation. Color measurements of the samples were carried out 5 different time periods. Results: Clinically detectable color change was observed in all groups except for the negative control (Delta E >= 3.3). It was determined that the positive control using MB caused more unwanted coloration in the CV on the 30th and 90th days compared to the phthalocyanine used in the 90th day (p < 0.05). While none of the dentin tubule occlusion methods were superior to each other in preventing undesirable coloration caused by phthalocyanine, Er:YAG caused less unwanetd coloration than CV only on the 90th day in preventing unwanted coloration caused by MB (p < 0.05). Conclusions: All dentin tubule occlusion methods used in the present study were effective in preventing some degree of unwanted discoloration. However, it was found that no technique could completely prevent unwanted coloration.