In vitro staining effects of stannous fluoride and sodium fluoride on ceramic material

Statement of problem.: Long-term fluoride application on the teeth of patients receiving radiation therapy for head and neck tumors results in excessive staining and roughening of ceramic restorations. Purpose.: The purpose of this in vitro study was to compare the staining effects of 2 fluoride treatments on ceramic disks by simulating 1 year of clinical exposure at 10 minutes per day. In addition, 2 different surface preparations were tested. Material and methods.: Eighty ceramic disks (IPS Empress), 20 × 2 mm, were fabricated. Half of the disks were glazed, and the remaining disks were polished. All disks were brushed for 3 minutes with a soft-bristle power toothbrush and mild dentifrice (baseline) and were immersed in 1 of the 2 fluoride products (0.4% SnF₂, Gel-Kam Gel, or 1.1% NaF, Prevident 5000) for 10 days (n=20). Means and standard deviations of color change (ΔE), surface roughness (Ra, um), and surface gloss (GU) of the ceramic material were measured with a reflection spectrophotometer, a profilometer, and a gloss meter, respectively, at baseline and after fluoride treatment. Two- and 3-way ANOVA (α=.05), with surface preparation (polished vs. glazed) and fluoride treatment (0.4% SnF₂ or 1.1% NaF) as independent variables and condition (baseline vs. after fluoride treatment) as a repeated measure, was used to analyze the data. Fisher's PLSD intervals (α=.05) were calculated for comparisons among the means. Results.: The polished specimens had significantly higher ΔE values, significantly higher surface gloss values, and significantly lower surface roughness values than the glazed specimens before fluoride treatment (P<.001). After both fluoride treatments, ceramic disks exhibited significantly higher surface roughness values when polished and significantly lower surface gloss values when glazed or polished (P<.001). The glazed specimens presented significantly higher surface roughness (P<.001) and lower surface gloss values (P<.001) when treated with 0.4% SnF₂ as compared to NaF. For the polished specimens, there was no significant difference in surface roughness and surface gloss values between the 2 fluoride treatments. Conclusions.: Use of 0.4% SnF₂ and 1.1% NaF gels, in vitro, caused significant color change in the polished IPS Empress ceramic disks. Polishing of the ceramic surface before immersion in either fluoride agent caused the ceramic tested to be more resistant to etching by the 2 solutions tested. The NaF caused less deterioration of the porcelain surface and was less stain inducing than SnF₂. (J Prosthet Dent 2010;103:163-169).