Clinical Evaluation of Discoloration Induced by Root Canal Treatment in Vital and Devital Teeth: A Prospective Study

Clinical Evaluation of Discoloration Induced by Root Canal Treatment in Vital and Devital Teeth: A Prospective Study

This prospective observational study aims to evaluate and compare tooth discoloration following root canal treatment in vital and devital teeth. Patients with maxillary premolar teeth requiring root canal treatment are included in the study. Before treatment, the teeth are classified as vital or devital based on their pulpal status. All teeth receive root canal treatment and coronal restoration using a standardized clinical protocol. Tooth color is objectively measured with a spectrophotometer before treatment and at 3, 6, and 9 months after treatment. Changes in tooth color over time are evaluated and compared between vital and devital teeth.

This prospective, single-center observational study is designed to investigate whether the preoperative pulpal status of a tooth is associated with the degree of discoloration occurring after root canal treatment.

Maxillary first and second premolar teeth requiring primary root canal treatment are evaluated clinically and radiographically. Before treatment, pulpal status is assessed using electric pulp testing and cold testing, and the teeth are classified as vital or devital according to the findings. Root canal treatment and coronal restoration are performed by the same operator using a standardized clinical protocol to minimize treatment-related variability.

Tooth color is assessed objectively using a VITA Easyshade V spectrophotometer under standardized conditions. At each assessment, three consecutive measurements are obtained from the middle third of the buccal surface, and the mean values are recorded. Changes in tooth color are evaluated throughout the follow-up period to determine the extent and progression of discoloration and to compare the color changes between vital and devital teeth.

Inclusion Criteria:

• Individuals aged 18 to 65 years.
• Systemically healthy individuals.
• Patients with maxillary premolar teeth requiring root canal treatment.
• Individuals who agree to participate in the study and provide written informed consent.

Exclusion Criteria:

• Teeth considered non-restorable.
• Teeth with full-coverage crown restorations.
• Teeth that have previously undergone root canal treatment.
• Patients with a history of medication use that may cause tooth discoloration.
• Teeth with restorations or caries involving more than two surfaces.
• Teeth with restorations, caries, or loss of tooth structure involving the buccal surface.
• Teeth with incomplete root development.
• Teeth with developmental anomalies.
• Teeth with a history of dental trauma.
• Teeth with internal or external root resorption.
• Teeth with advanced periodontal destruction.
• Individuals consuming more than two cups per day of coffee, tea, wine, or fruit juices that may cause tooth discoloration.
• Teeth with amalgam restorations.
• Current smokers.
• Pregnant or breastfeeding women.
• Individuals younger than 18 years or older than 65 years.