ArticleOdontology2026
Colour change and fracture resistance of endodontically treated teeth after staining and walking bleach: role of filling strategy.
Article in Odontology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
The present study aimed to evaluate the effect of different root canal sealers and obturation strategies on colour stability and fracture resistance of maxillary incisors following a staining and walking bleaching protocol. One hundred and twenty human maxillary incisors were prepared and allocated to six groups (n = 15) according to sealer type (AH Plus or MTA Cem S), presence of gutta-percha, and application of staining/bleaching procedures. Two additional groups included teeth that underwent staining/ bleaching without endodontic treatment and intact teeth. Colour was measured spectrophotometrically in the CIE Lab* colour space at serial time points, and CIEDE2000 (ΔE00) values were calculated for interval-specific and cumulative colour change. Fracture resistance was measured in Newtons using a universal testing machine, and fracture patterns were classified as repairable or non-repairable. Colour-coordinate data were analysed using linear mixed-effects models. ΔE00 values and fracture resistance were compared using one-way ANOVA followed by Tukey HSD test. In the six experimental root-filled groups, a 2 × 3 factorial ANOVA was additionally performed to examine the interaction between bleaching status and filling strategy. Repairability was analysed using the Pearson chi-square test. Significant within-group changes in L* and a* values were observed across all experimental conditions, whereas significant changes in b* values were detected in the staining/bleaching groups-including those with gutta-percha combined with AH Plus, gutta-percha combined with MTA Cem S, MTA Cem S alone, and the staining/bleaching control-as well as in the intact control group, but not in the corresponding non-stained/non-bleached groups. Significant between-group differences were found for ΔE00 2-1, ΔE00 4-2, and ΔE00 4-1, whereas ΔE00 3-2, ΔE00 4-3, and ΔE00 3-1 did not differ significantly among groups. The greatest residual overall colour change was observed in gutta-percha combined with AH Plus. Gutta-percha combined with MTA Cem S yielded the highest mean fracture resistance (p < 0.05). In the factorial analysis of experimental groups, fracture resistance and ΔE00 4-1 both showed significant bleaching × filling-strategy interactions. Repairability did not differ significantly among groups. Gutta-percha combined with MTA Cem S yielded the highest mean fracture resistance, whereas the AH Plus-containing stained/bleached condition showed the greatest residual colour change. The aesthetic and mechanical outcomes observed after the staining/bleach sequence should be interpreted in conjunction with the overall filling-restorative condition rather than as isolated effects of bleaching alone.
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