The Effects of Bleaching Products on the Color Stability of Ion-releasing Restoratives

The Effects of Bleaching Products on the Color Stability of Ion-releasing Restoratives | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article The Effects of Bleaching Products on the Color Stability of Ion-releasing Restoratives Jian Sheng Lee, Noor Azlin Yahya, Azwatee Abdul Aziz, Adrian U-Jin Yap This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6589441/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 05 Nov, 2025 Read the published version in BMC Oral Health → Version 1 posted 13 You are reading this latest preprint version Abstract Background Contemporary ion-releasing restoratives have been developed to prevent secondary caries while maintaining the mechanical strength and esthetic qualities of conventional composite resins. Dental bleaching procedures may affect the physical properties of restorations. This study aimed to evaluate the effect of bleaching agents on the color stability of these ion-releasing restoratives. Methods Forty-five disc-shaped specimens of Activa Bioactive, Beautifil II LS, Cention-N, Riva LC HVGIC, and Luna were fabricated using customised cylindrical teflon molds. Baseline CIE-Lab color measurements were recorded using a spectrophotometer. Specimens were assigned to three subgroups (n = 15) and exposed to take-home bleaching (Pola Night), in-office bleaching (Pola Rapid), or artificial saliva (control) per manufacturers’ protocols. Color measurements were repeated at 24 hours (T1), two weeks (T2), and one month (T3), with color change (ΔE*) calculated. Data were analyzed using two-way ANOVA, two-way repeated measures ANOVA and post-hoc tests (p < 0.05). Results ΔL* ranged from − 0.02 ± 1.23 to 4.94 ± 1.37; Δa* from − 0.31 ± 0.12 to 0.65 ± 0.13; Δb* from − 3.08 ± 1.24 to 0.31 ± 0.86; and ΔE* from 0.94 ± 0.48 to 5.99 ± 1.33. At T1, Riva LC HVGIC showed the highest ΔE*, while Luna had the least. Both bleaching products had similar effects on ΔE*. Activa Bioactive’s ΔE* increased significantly from T1 to T3, reaching the highest value at T3. Conclusions The impact of bleaching on ion-releasing restoratives’ color stability was material-dependent. Ion-releasing restoratives tooth bleaching agents spectrophotometry CIE-Lab color stability BACKGROUND Direct tooth-colored restorations are widely used to replace damaged tooth structures and enhance dental esthetics. Composite resin (CR) remains the preferred restorative material in modern dentistry due to its excellent mechanical and esthetic properties. However, systematic reviews have identified recurrent caries as a major cause of CR restoration failures [ 1 , 2 ]. Recurrent caries often occur in restorative margins, due to their susceptibility to plaque formation. These areas are more difficult to clean and the presence of an interfacial gap at the tooth-restoration margin leads to bacterial colonization [ 3 ]. Ion-releasing restorative materials (IRMs) were developed to address this issue. These materials release and recharge remineralizing ions that promote fluorapatite crystal formation, which is more acid-resistant [ 4 , 5 ]. Conventional IRMs, such as glass ionomer cement (GIC), are limited by poor mechanical and optical properties, restricting their use in stress-bearing and esthetic zones. Advances in IRM technology have incorporated resin monomers and fluoroaluminosilicate fillers, enhancing mechanical, optical, and remineralizing properties for use in esthetic areas [ 6 ]. New IRMs have been developed with innovative fillers such as Isofiller in alkasites (Ivoclar-Vivadent) and surface pre-reacted glass ionomer (S-PRG) in giomers [ 7 , 8 ]. Additionally, handling properties have improved in high-viscosity GIC and Activa Bioactive Restoratives [ 9 , 10 ]. As public awareness of dental esthetics grows, the global tooth-bleaching market is rapidly expanding [ 11 ]. Vital tooth bleaching is categorized into in-office, take-home, and over-the-counter products, primarily containing hydrogen peroxide or carbamide peroxide. These agents release free radicals that break down staining molecules in tooth structures [ 12 ]. However, this nonspecific reaction can have adverse effects, including crown fractures, dentine hypersensitivity, restoration discoloration, and debonding [ 13 , 14 ]. Several studies have demonstrated changes in restoration color following exposure to bleaching agents [ 15 , 16 , 17 ]. The severity of color change is categorized using the perceptibility and acceptability thresholds. One study reported that ΔE* values exceeding 1.2 are visually perceptible, and those above 2.7 are deemed unacceptable [ 18 ]. The constant ionic exchange and dissolution of functional filler particles in IRMs result in internal porosities, making them more vulnerable to the effects of bleaching agents [ 19 ]. Given the limited research on the impact of bleaching products on contemporary IRMs, this study aimed to evaluate the effects of in-office and take-home bleaching agents on the color stability of IRMs and to assess their color stability over time. The null hypotheses were (i) in-office and take-home bleaching products do not affect the color stability of IRMs; (ii) there are no differences in color stability between IRMs; (iii) the color of IRMs do not change over time following their exposure to bleaching agents. METHODS Evaluated Materials and Determination of Sample Size The technical profiles of materials under evaluation are presented in Table 1 . These included four IRMs of shade A2, specifically a bioactive composite (Activa [AB], Pulpdent Corporation, Watertown, MA, USA), a giomer (Beautifil II LS [BI], Shofu, Kyoto Japan), a bulk-fill alkasite (Cention-N [CN], Ivoclar-Vivadent, AG, Schaan, Liechtenstein), and an encapsulated high viscosity GIC (Riva LC HVGIC [RV], SDI Limited, Bayswater, Victoria, Australia), and a conventional CR control (Luna [LN], SDI Limited, Bayswater, Victoria, Australia). An in-office bleaching product (Pola Rapid [PR], SDI Limited, Bayswater, Victoria, Australia) and a take-home bleaching product, (Pola Night [PN], SDI Limited, Bayswater, Victoria, Australia) were used in this study A minimum total sample size of 90 specimens (n = 6 per group) was determined using G*Power Software version 3.1.9.4, based on an ANOVA model with an effect size of 0.6, alpha level of 0.05, and power of 95% across 15 groups [ 20 , 21 ]. Table 1 Technical profiles of the materials and bleaching products Material (Abbreviation) Manufacturer Type Compositions Filler weight, % Luna (LN) [Control] SDI Limited, Bayswater, Victoria, Australia Light-cured conventional composite Resin: UDMA, Bis-GMA,TEGDMA Filler: Strontium aluminosilicate, amorphous silica 76 Activa Bioactive Restorative (AB) Pulpdent, Watertown, MA, USA Dual-cured bioactive composite Resin: A blend of UDMA and other methacrylates with modified polyacrylic acid Filler: Amorphous silica, sodium fluoride 55.4 Beautifil II LS (BI) Shofu, Kyoto, Japan Light-cured giomer Resin: Low-shrinkage urethane diacrylate, Bis-MPEPP, Bis-GMA, TEGDMA Filler: Multi-functional glass and S-PRG filler based on fluoroboroalumino silicate glass, pre-polymerized filler, nanofiller 83.0 Cention-N (CN) Ivoclar-Vivadent, AG, Schaan, Liechtenstein Self-cured/ dual-cured alkasite Resin: UDMA, DCP, Aromatic aliphatic-UDMA, PEG-400 DMA Filler: Br-Al-Si glass filler, ytterbium trifluoride, Isofiller (copolymer), calcium barium aluminium fluorosilicate glass, calcium fluorosilicate glass 78.4 Riva LC HVGIC (RV) SDI Limited, Bayswater, Victoria, Australia Light-cured encapsulated resin-reinforced high viscosity glass ionomer cement Compartment 1: Polyacrylic acid, Tartaric acid, HEMA, Dimethacrylate- cross-linker, Acid monomer Compartment 2: Fluoro-alumino-silicate glass 95.0 Pola Rapid (PR) SDI Limited, Bayswater, Victoria, Australia N/A Liquid: 38% Hydrogen peroxide, 62% water Powder: 73.26% thickeners, 26.2% catalysts, 0.04% Dye, 0.5% Desensitising agents N/A Pola Night (PN) SDI Limited, Bayswater, Victoria, Australia N/A 2 22 wt% Carbamide peroxide (6.6% hydrogen peroxide), < 40 wt% additives, 30 wt% glycerol, 20 wt% Water, 0.1 wt% flavouring N/A Abbreviation: Bis-GMA = Bisphenol-A glycidyl methacrylate Bis-MPEPP = 2,2-Bis (4-methacryloxypolyethoxyphenyl) propane DCP = Tricyclodecan-dimethanol dimethacrylate UDMA = Urethane dimethacrylate TEGDMA = Triethylene glycol dimethacrylate HEMA = 2-hydroxyethyl methacrylate HVGIC = high viscosity glass ionomer cement S-PRG = Surface pre-reacted glass ionomer Aromatic aliphatic-UDMA = Tetramethyl-xylylendiurethane dimethacrylate PEG-400 DMA = Polyethylene glycol 400 dimethacrylate Specimen Preparation Forty-five disc-shaped specimens were prepared for each material following the manufacturers' instructions using a customized cylindrical teflon mold (8 × 2 mm). A cellulose acetate matrix strip and a glass slide were placed on the top and bottom surfaces of the mold to remove excess material under finger pressure and ensure a smooth finish. The specimens were then light-cured through the glass slide for 20 seconds using a calibrated LED curing unit (Radii Cal LED Curing Light, SDI, Bayswater, Victoria, Australia), with an output irradiance of 1200 mW/cm² and a wavelength of 468–470 nm. The light-curing unit was recharged and calibrated after every 15 specimens to maintain consistent output. Specimen thickness was measured using a digital caliper (Mitutoyo Corporation, Kawasaki, Japan). The specimens were stored in artificial saliva (SAGF) (Gal et al., 2001) and incubated at 37°C for 24 hours to allow post-irradiation polymerization (Memmert Incubator IN750, Schwabach, Germany). Following this, the specimens were finished and polished using medium, fine, and superfine Sof-Lex discs (3M ESPE, St Paul, Minnesota, USA) at 15000 rpm, with 10 strokes applied in a single direction for each disc. The specimens were polished by single operator to ensure consistency in the applied pressure. Specimen dimensions were verified using the digital caliper to ensure standardized thinckness (2.0 \(\:\pm\:\) 0.2 mm). Polished specimens were then stored in artificial saliva at 37°C in the incubator for two weeks before the bleaching procedure. The artificial saliva was refreshed weekly to prevent deposit buildup. Bleaching Procedure The specimens of each material were randomly distributed into three groups (n = 15) as follows: Group A (control): Immersion in artificial saliva for seven days. Group B (take-home bleaching): Exposed to PN for 45 minutes daily for seven days. Group C (in-office bleaching): Exposed to PR for three cycles of 8 minutes on day seven. The specimens were rinsed with distilled water and dried before the bleaching procedures. Specimens were stored in artificial saliva at 37°C when not undergoing any bleaching procedures. Color Measurement The colour of each specimen was measured using the Commission Internationale de l'Éclairage (CIE L a b*) colour system with a spectrophotometer (CM-5, Konica Minolta, Tokyo, Japan). The standard observer angle was set at 10°, and each specimen was positioned within the 3 mm diameter illumination area. Reflectance values were recorded after 1 second of exposure to the D65 standard illuminant, against a standardised black background. Three readings per specimen were taken at baseline (T0), 24 hours (T1), two weeks (T2), and one month (T3) after bleaching. The color change, ΔE, was calculated by comparing the T1, T2 and T3 values with the T0 value using the following formula: Where L is the lightness from black to white a is the color along the red and green dimension b is the color along the yellow and blue dimension i is the measurement value at 24 hours (T1), two weeks (T2), and one month (T3) 0 is the measurement value at baseline (T0) Statistical Analysis Statistical analysis was conducted using SPSS version 25 for Windows (SPSS Inc., Chicago, Illinois, USA). The Kolmogorov-Smirnov test was applied to confirm data normality. Two-way analysis of variance (ANOVA) was performed to evaluate the interaction between IRMs and bleaching products on ΔE. Tukey’s post-hoc test was used to analyze differences between IRMs and bleaching products. Two-way repeated-measures ANOVA was employed to assess the interaction between IRMs and time on ΔE. RESULTS The ΔE values are summarized in Table 2 , ranging from 0.94 ± 0.48 to 5.99 ± 1.33. IRMs and bleaching products both significantly influenced the ΔE* (p < 0.05). Two-way ANOVA revealed a significant interaction between IRMs and bleaching products on ΔE* (p < 0.05). Additionally, two-way repeated-measures ANOVA showed a significant interaction between IRMs and time on ΔE* (p < 0.05). Table 3 compares the mean L*, a*, and b* values for the restorative materials at T0, T1, T2, and T3. Most materials showed an increase in L* and a* values, along with a decrease in b* values over time. The change in L* (ΔL*) ranged from − 0.02 ± 1.23 to 4.94 ± 1.37, a* (Δa*) ranged from − 0.31 ± 0.12 to 0.65 ± 0.13, and b* (Δb*) varied from − 3.08 ± 1.24 to 0.31 ± 0.86. Table 4 summarizes the ΔE* values for the restorative materials following exposure to two bleaching products and artificial saliva across three time intervals. For all materials, no significant differences were found between PR and PN, indicating that both bleaching agents had comparable effects. In the cases of BI and CN, the ΔE* values did not differ significantly among AS, PN, and PR. However, for AB and LN, immersion in AS produced higher ΔE* values compared to PR and PN, whereas for RV samples, the opposite was observed—bleaching with PR and PN yielded higher ΔE* than AS. When stored in AS, RV and BI consistently showed the lowest ΔE* values, while AB consistently exhibited the highest across all time intervals. After bleaching with PN and PR, RV recorded the highest ΔE* at T1 and T2, but by T3, AB surpassed RV. Additionally, LN and BI maintained the lowest ΔE* values following bleaching at every time point. Notably, AB was the only material to demonstrate a significant change in ΔE* over time, with a marked increase from T1 to T2 and a further significant rise from T2 to T3 in the PR group. Table 2 Mean ΔE* (SD) of restorative materials exposed to bleaching products (n = 15). Materials Bleaching Products Time Intervals T1 T2 T3 LN AS 2.33 (1.30) 2.41 (1.58) 2.70 (1.22) PN 0.94 (0.48) 1.05 (0.49) 1.22 (0.98) PR 1.43 (0.86) 1.21 (0.43) 1.34 (0.40) AB AS 2.50 (0.85) 4.95 (1.80) 5.99 (1.33) PN 2.39 (0.71) 3.43 (1.14) 3.80 (1.41) PR 1.78 (0.78) 2.56 (0.95) 4.02 (1.31) BI AS 1.51 (0.71) 1.64 (0.96) 1.47 (0.52) PN 1.47 (0.43) 1.28 (0.60) 1.50 (0.63) PR 1.35 (0.71) 1.45 (0.94) 1.67 (0.90) CN AS 2.15 (1.24) 2.51 (1.32) 2.53 (1.20) PN 2.13 (1.15) 1.85 (0.92) 2.20 (1.22) PR 2.71 (1.29) 2.52 (1.09) 2.13 (1.09) RV AS 1.38 (0.68) 1.88 (1.08) 2.05 (0.77) PN 3.34 (0.72) 3.59 (0.88) 3.67 (0.67) PR 3.55 (0.78) 3.39 (0.95) 3.86 (0.65) Abbreviation : LN = Luna, AB = Activa, BI = Beautifil, CN = Cention-N, RV = Riva; AS = Artificial saliva, PR = Pola Rapid, PN = Pola Night; T1 = 24 hours after bleaching, T2 = two weeks after bleaching, T3 = one month after bleaching; “ Italicized ” values = ΔE* exceed the acceptability threshold of 1.2; “Bolded” values = ΔE* exceed the perceptibility threshold of 2.7. Table 3 Mean (SD) L*, a* and b* of restorative materials. Materials T0 Bleaching Products T1 T2 T3 L* a* b* L* a* b* L* a* b* L* a* b* LN 63.99 (0.96) -2.49 (0.18) 6.81 (0.50) AS 65.89 (1.47) -1.92 (0.38) 6.55 (0.96) 66.02 (1.73) -1.94 (0.46) 6.40 (0.81) 66.34 (1.22) -1.96 (0.32) 6.03 (0.91) PN 64.15 (0.88) -2.32 (0.17) 6.55 (0.49) 64.01 (1.07) -2.33 (0.21) 6.60 (0.42) 64.33 (1.32) -2.26 (0.22) 6.51 (0.71) PR 64.57 (1.20) -2.14 (0.19) 6.93 (0.98) 64.16 (0.94) -2.06 (0.18) 7.10 (0.72) 64.55 (0.81) -2.06 (0.14) 7.12 (0.86) AB 55.00 (1.35) -1.49 (0.10) 10.36 (1.42) AS 56.78 (0.99) -1.38 (0.10) 9.20 (1.26) 58.98 (1.80) -1.06 (0.09) 7.82 (1.46) 59.94 (1.37) -0.84 (0.13) 7.28 (1.23) PN 55.69 (1.41) -1.34 (0.10) 8.80 (1.23) 57.28 (0.83) -1.07 (0.07) 7.97 (1.19) 57.69 (1.11) -0.89 (0.06) 7.89 (1.24) PR 54.98 (1.22) -1.24 (1.26) 9.20 (1.00) 56.26 (1.29) -1.09 (0.11) 8.49 (1.18) 57.64 (1.05) -0.90 (0.09) 7.51 (1.18) BI 60.29 (0.97) 0.13 (0.18) 4.42 (0.56) AS 60.81 (1.37) 0.17 (0.20) 4.66 (0.82) 61.10 (1.58) 0.13 (0.17) 4.35 (0.75) 60.96 (1.20) 0.21 (0.18) 4.50 (0.78) PN 60.69 (1.14) 0.13 (0.07) 3.54 (0.45) 60.43 (1.22) 0.17 (0.09) 3.83 (0.48) 60.54 (1.49) 0.24 (0.12) 3.99 (0.55) PR 60.32 (1.40) 0.14 (0.10) 4.21 (0.85) 61.21 (1.23) 0.17 (0.11) 3.77 (0.48) 61.39 (1.32) 0.30 (0.15) 3.76 (0.47) CN 61.81 (1.83) -0.95 (0.16) 10.28 (0.79) AS 62.15 (2.39) -0.76 (0.24) 9.81 (0.59) 62.37 (2.56) -0.49 (0.24) 9.61 (0.93) 62.75 (1.82) -0.41 (0.18) 8.78 (1.13) PN 61.92 (2.00) -0.70 (0.15) 9.51 (1.21) 62.10 (1.51) -0.52 (0.23) 9.43 (1.11) 62.22 (1.87) -0.40 (0.16) 9.29 (1.27) PR 62.13 (2.83) -0.75 (0.22) 10.03 (1.12) 62.21 (2.41) -0.52 (0.22) 10.16 (1.34) 62.55 (1.93) -0.41 (0.18) 9.98 (1.13) RV 57.64 (2.11) -0.12 (0.22) 9.69 (0.86) AS 57.95 (0.92) -0.43 (0.12) 8.87 (0.96) 58.88 (1.32) -0.30 (0.17) 8.79 (0.80) 59.32 (0.81) -0.24 (0.16) 8.79 (0.71) PN 58.59 (1.52) 0.04 (0.11) 6.79 (0.44) 59.77 (1.21) 0.10 (0.10) 6.97 (0.48) 59.78 (1.23) 0.10 (0.11) 6.91 (0.38) PR 59.57 (1.18) 0.03 (0.15) 6.88 (0.47) 59.30 (1.26) 0.02 (0.12) 7.03 (0.56) 60.28 (0.75) 0.08 (0.11) 6.97 (0.61) Abbreviation: LN = Luna, AB = Activa, BI = Beautifil, CN = Cention-N, RV = Riva; AS = Artificial saliva, PR = Pola Rapid, PN = Pola Night; T0 = baseline color measurement, T1 = 24 hours after bleaching, T2 = two weeks after bleaching, T3 = one month after bleaching; L*=lightness from black to white, a*=color along the red and green dimension, b = color along the yellow and blue dimension. Table 4 Statistical analyses of ΔE* between (A) bleaching products, (B) restorative materials, and (C) time intervals (A) Comparison of ΔE* between different bleaching products. Restorative materials T1 T2 T3 LN AS > PR = PN AS > PR = PN AS > PN = PR AB = AS > PR = PN AS > PN = PR BI = = = CN = = = RV PR = PN > AS PR = PN > AS PR = PN > AS (B) Comparison of ΔE* between different restorative materials. Time intervals AS PN PR T1 AB > LN ≥ CN > BI ≥ RV RV > AB ≥ CN > BI ≥ LN RV ≥ CN > AB ≥ LN ≥ BI T2 AB > LN ≥ CN ≥ RV ≥ BI RV ≥ AB > CN ≥ BI ≥ LN RV ≥ AB ≥ CN > BI ≥ LN T3 AB > LN ≥ CN > RV ≥ BI AB ≥ RV > CN ≥ LN ≥ BI AB ≥ RV > CN ≥ BI ≥ LN (C) Comparison of ΔE* between time intervals. Restorative materials AS PN PR LN = = = AB T3 = T2 > T1 T3 = T2 > T1 T3 > T2 > T1 BI = = = CN = = = RV = = = Abbreviations: LN = Luna; AB = Activa; BI = Beautifil; CN = CentionN; RV = Riva; AS = Artificial Saliva; PN = Pola Night; PR = Pola Rapid; T1 = 24 hours after bleaching, T2 = two weeks after bleaching, T3 = one month after bleaching; In A, “=” indicates no significant difference and “>” indicates a significantly greater ΔE*. In B, “≥” denotes a greater value without statistical significance, while “>” indicates statistical significance. In C, “=” indicates no statistically significant difference between time intervals. DISCUSSION Effects of Bleaching Products on IRMs As bleaching products significantly affected the ΔE* values, the first null hypothesis was rejected. In general, the L* and a* values increased, while the b* value decreased after bleaching. Changes in the L* and b* dimensions were more pronounced than those in the a* dimension. When mapped to the Munsell color space, the specimens’ colors shifted towards a lighter and bluish hue, resulting in a lightening of the restorative materials [ 22 ]. Furthermore, the a* and b* values approached the zero or neutral axis (i.e., negative a* values increased, positive b* values decreased), causing desaturation and a duller appearance [ 23 ]. These findings align with studies by Karamangar et al. and Korać et al., which identified an increase in L* as the primary contributor to color changes [ 17 , 24 ]. RV and AB specimens bleached with PN and PR exhibited a larger change in the b* value compared to the L* value, consistent with Yu et al., who reported significant declines in the b* values of resin-modified GIC and compomer after bleaching [ 15 ]. The bleaching mechanism involves hydrogen peroxide oxidizing surface pigments and amides directly related to the restoration's shade [ 12 ]. In resin-based materials, discoloration is exacerbated by the resin matrix’s water sorption properties. Water absorption promotes the elution of residual monomers, adversely affecting color stability [ 25 ]. For IRMs, the glass matrix acts as a permeable hydrogel, facilitating ion and water diffusion and allowing dissociated peroxides to penetrate the material [ 26 ]. These reactive oxygen species and perhydroxyl ions attack the resin-filler interface, leading to plasticization and matrix dissolution. This process forms micropores that alter reflectance and optical properties [ 16 ]. Additionally, the erosion caused by bleaching agents is influenced by their acidity [ 27 ]. The pH of bleaching products ranges from 3.6 to 7.3, with fluoroaluminosilicate fillers dissolving more rapidly under acidic conditions, resulting in higher particle elution [ 28 , 29 ]. Interestingly, AS induced more color change in LN and AB than bleaching. This may be attributed to differences in surface roughness between control and bleached samples. 25 Polished specimens might initially expose fillers at the surface, which are dissolved by hydrogen peroxide during bleaching, resulting in smoother surfaces. Consequently, bleached samples exhibit lower surface roughness compared to those immersed in artificial saliva, enhancing optical appearance [ 30 ]. Another plausible explanation is the ability of bleaching products to reverse discoloration caused by artificial saliva. The oxidizing agents in bleaching procedures can cleave staining chromophores formed during prolonged AS immersion [ 31 , 32 ]. Both PR and PN exhibited comparable effects on all IRMs, consistent with prior research [ 24 , 33 , 34 ]. The similarity in outcomes may stem from differences in bleaching protocols and formulations. PR, with a high hydrogen peroxide concentration (38%) and a short application duration (24 minutes), contrasts with PN, which uses a lower hydrogen peroxide concentration (6.6%) but requires a longer application time (315 minutes). Comparison Between Restorative Materials Different IRMs exhibited varying color stability, indicating that the second null hypothesis was rejected. Variations in color stability among materials can be attributed to differences in filler content, size, and the type of organic monomer used. Consistent with previous studies, the resin-based composite LN demonstrated superior color stability against bleaching agents compared to IRMs [ 15 , 16 , 35 ]. Methacrylate-based composites form tightly cross-linked, high-molecular-weight polymers that limit the penetration of oxidizing agents into the material [ 16 ]. Among the IRMs, RV and AB were significantly affected by bleaching, potentially due to the degradation of metal polyacrylate salts within their matrices [ 35 ]. AB exhibited the highest ΔE* values at T3. With the lowest filler content (55.4%), AB contains a higher proportion of resin matrix, which is prone to water sorption and subsequent discoloration. In contrast, BI demonstrated comparable ΔE* values to LN, owing to its high filler content (83% by weight) and hydrophobic monomers like UDMA [ 36 ]. CN’s color stability is supported by its hydrophobic resin matrix comprising UDMA, DCP, aromatic-aliphatic UDMA, and PEG-400 DMA, combined with high filler content. Additionally, CN employs thiocarbamide as a photoinitiator instead of oxidation-prone tertiary amines, reducing long-term discoloration [ 37 ]. Comparison Between Time Intervals The third null hypothesis was rejected, as there were significant changes in ΔE* values over time. The ΔE* values of most IRMs increased insignificantly over time, likely due to the water and color stabilization of restorative materials which has occurred within the first 7–14 days of artificial saliva immersion [ 38 , 39 ]. However, AB exhibited a significant ΔE* increase over time, possibly due to its larger resin component, which enhances water sorption [ 40 ]. Clinical Perceptibility and Acceptability of Color Change Thresholds for perceptibility and acceptability of color changes are essential for evaluating the clinical significance of restoration discoloration. Reported threshold values in the literature range from 0.4 to 2.6 for perceptibility and 1.7 to 5.5 for acceptability [ 41 ]. Most groups in this study exceeded the perceptibility threshold (ΔE*=1.2) at T1, except for LN bleached with PN, which only slightly exceeded this threshold at T3 (ΔE*=1.22). RV bleached with both PN and PR, and CN bleached with PR, exceeded the acceptability threshold (ΔE*=2.7) at T1. Notably, AB exhibited significant and progressive color deterioration over time, resulting in clinically unacceptable color alterations in the AS, PN, and PR groups by T3. Ugurlu et al. (2022) investigated the color change of bleached natural tooth structure in vivo and reported a ΔE* of 14.22 immediately after bleaching, which decreased to 7.51 over two years [ 42 ]. This substantial change highlights the discrepancy in color stability between natural teeth and restorations, reinforcing the need to replace restorations following bleaching procedures. Limitations of the Study This study does not fully replicate the oral environment, as it lacks factors such as biofilm adhesion and thermal variations. While AS includes ions that mimic natural saliva, it lacks glycoproteins that influence viscosity and impact diffusion and reaction rates between biomaterials and immersion media [ 21 ]. Future studies could enhance aging protocols by incorporating thermocycling to simulate thermal changes. A limitation of the CIE-Lab color space used in this study is its measurement of only three parameters—lightness (L*), red-to-green (a*), and yellow-to-blue (b*). As discussed, human color perception varies with lighting and surrounding objects, and humans are more sensitive to reddish (a*) than yellowish (b*) changes [ 43 , 44 ]. The CIEDE2000 (ΔE00) formula, which accounts for variations in lightness, chroma, hue, and illumination conditions, offers a more accurate assessment of clinically relevant color changes [ 45 ]. Future research should adopt ΔE00 for more clinically relevant evaluations, noting that its perceptibility and acceptability thresholds differ from ΔEab values. The correlation between color stability and surface roughness, microhardness, water sorption, and solubility was not assessed in this study. Future investigations should explore these material properties alongside optical attributes such as gloss, translucency, fluorescence, and opalescence to provide a more comprehensive understanding of restorative materials' performance [ 46 ]. CONCLUSION Within the limitations of this study, all null hypotheses were rejected and the following conclusions are drawn: The bleaching products significantly influenced the color stability of IRMs. However, there were no differences in the ΔE* between PR and PN. The IRMs showed differing color stability. RV exhibited significantly greater ΔE* after bleaching indicating poor color stability, while BI and CN showed no significant change. The IRMs’ color significantly changed over time. Specifically, AB’s ΔE* significantly increased from T1 to T3. AB had the greatest color changes for all bleaching groups after one month. Abbreviations Abbreviation Definition a* Colour along the red and green dimension AB Activa Bioactive Restorative ANOVA Analysis of Variance Aromatic Aliphatic-UDMA Tetramethyl-xylylendiurethane dimethacrylate AS Artificial saliva b* Colour along the yellow and blue dimension BI Beautifil II LS Bis-GMA Bisphenol-a glycidyl methacrylate Bis-MPEPP 2,2-bis (4-methacryloxypolyethoxyphenyl) propane CIE Commission Internationale Del’eclairege CN Cention-N CR Composite resin DC Tricyclodecan-dimethanol dimethacrylate F-PRG Full pre-reacted glass ionomer GIC Glass ionomer cement HEMA 2-hydroxyethyl methacrylate HVGIC High viscosity glass ionomer cement IRM Ion-releasing restorative material ISO International Standarisation Organisation L* Lightness from black to white LC Light cure LED Light-emitting diode LN Luna PEG-400 DMA Polyethylene glycol 400 dimethacrylate PN Pola Night PR Pola Rapid RMGIC Resin-modified glass ionomer cement RV Riva light cure HVGIC S-PRG Surface pre-reacted glass ionomer Subscript 0 The measurement value at baseline (T0) Subscript i The measurement value at 24 hours (T1), two weeks (T2), and one month (T3) T0 Before bleaching at baseline T1 24 hours after bleaching T2 Two weeks after bleaching T3 One month after bleaching TEGDMA Triethylene glycol dimethacrylate UDMA Urethane dimethacrylate Δa* Change in the colour along the red and green dimension Δb* Change in the colour along the yellow and blue dimension ΔE* Colour change ΔE 00 CIEDE2000 colour-difference formula ΔL* Change in the lightness Declarations Disclosure and Acknowledgements This research was funded by the Dental Postgraduate Research Grant (DPRG 01/24) from the Faculty of Dentistry, Universiti Malaya. The authors wish to express their appreciation to SDI Limited (Bayswater, Australia) and Shofu Inc. (Kyoto, Japan) by providing materials, and to Dr. Alias Abdul Aziz for providing statistical support. Ethics Approval and Consent to Participate Not applicable Consent for Publication Not applicable Availability of data and materials The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. Competing interests The authors declare that they have no competing interests. Funding This research was funded by the Dental Postgraduate Research Grant (DPRG 01/24) from the Faculty of Dentistry, Universiti Malaya. Additionally, materials were sponsored by SDI Limited (Bayswater, Australia) and Shofu Inc. (Kyoto, Japan). Authors' contributions LJS was responsible for carrying out the research, analysing the data, and writing the manuscript. NAY, AAA, and AUJ designing and supervised the project, provided guidance throughout, and reviewed the manuscript. All authors read and approved the final manuscript. Acknowledgements The authors acknowledge all the staff of the Biomaterials Research Laboratory, Faculty of Dentistry, Universiti Malaya, for their support, and thank Dr Alias bin Abdul Aziz for providing statistical assistance. References Demarco FF, Collares K, Coelho-de-Souza FH, Correa MB, Cenci MS, Moraes RR, Opdam NJ. Anterior composite restorations: A systematic review on long-term survival and reasons for failure. Dent Mater. 2015. 10.1016/j.dental.2015.07.005 . Opdam NJ, Van De Sande FH, Bronkhorst E, Cenci MS, Bottenberg P, Pallesen U, Gaengler P, Lindberg A, Huysmans MC, Van Dijken JW. Longevity of posterior composite restorations: a systematic review and meta-analysis. J Dent Res. 2014. 10.1177/0022034514544217 . Ferracane JL. Models of caries formation around dental composite restorations. 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Long-term assessment of contemporary ion-releasing restorative dental materials. Materials. 2022. 10.3390/ma15124042 . Faul F, Erdfelder E, Lang AG, Buchner A. G* Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007. 10.3758/bf03193146 . Gal JY, Fovet Y, Adib-Yadzi M. About a synthetic saliva for in vitro studies. Talanta. 2001. 10.1016/s0039-9140(00)00618-4 . Attin T, Manolakis A, Buchalla W, Hannig C. Influence of tea on intrinsic color of previously bleached enamel. J Oral Rehabil. 2003. 10.1046/j.1365-2842.2003.01097.x . McGuire RG. Reporting of objective color measurements. Hort Sci. 1992;27(12):1254–5. Kamangar SSH, Kiakojoori K, Mirzaii M, Fard MJK. Effects of 15% carbamide peroxide and 40% hydrogen peroxide on the microhardness and color change of composite resins. J Dent (Tehran). 2014;11(2):196–209. Moldovan M, Balazsi R, Soanca A, Roman A, Sarosi C, Prodan D, Vlassa M, Cojocaru I, Saceleanu V, Cristescu I. Evaluation of the degree of conversion, residual monomers and mechanical properties of some light-cured dental resin composites. Materials. 2019. 10.3390/ma12132109 . de Camargo FLL, Lancellotti AC, de Lima AF, Martins VR, de Souza Gonçalves L. Effects of a bleaching agent on properties of commercial glass-ionomer cements. Restor Dent Endod. 2018. 10.5395/rde.2018.43.e32 . Turker SB, Biskin T. Effect of three bleaching agents on the surface properties of three different esthetic restorative materials. J Prosthet Dent. 2003;89:466–73. Price RT, Sedarous M, Hiltz GS. The pH of tooth whitening products. J Can Dent Assoc. 2000;66:421–6. Mair L, Joiner A. The measurement of degradation and wear of three glass ionomers following peroxide bleaching. J Dent. 2004. 10.1016/j.jdent.2003.10.011 . Dogan A, Ozcelik S, Dogan OM, Hubbezoglu I, Cakmak M, Bolayir G. Effect of bleaching on roughness of dental composite resins. J Adhes. 2008. 10.1080/00218460802505234 . Hussain SK, Al-Abbasi SW, Refaat MM, Hussain AM. The effect of staining and bleaching on the color of two different types of composite restoration. J Clin Exp Dent. 2021. 10.4317/jced.58837 . Gul P, Harorlı OT, Ocal IB, Ergin Z, Barutcigil C. Color recovery effect of different bleaching systems on a discolored composite resin. Nig J Clin Pract. 2017. 10.4103/njcp.njcp_385_16 . Silva Costa SX, Becker AB, de Souza Rastelli AN, Monteiro Loffredo LD, de Andrade MF, Bagnato VS. Effect of four bleaching regimens on color changes and microhardness of dental nanofilled composite. Int J Dent. 2009. 10.1155/2009/313845 . Kurtulmus-Yilmaz S, Cengiz E, Ulusoy N, Ozak ST, Yuksel E. The effect of home-bleaching application on the color and translucency of five resin composites. J Dent. 2013. 10.1016/j.jdent.2012.12.007 . Rao YM, Srilakshmi V, Vinayagam KK, Narayanan LL. An evaluation of the color stability of tooth-colored restorative materials after bleaching using CIELAB color technique. Indian J Dent Res. 2009. 10.4103/0970-9290.49071 . Gonulol N, Ozer S, Sen Tunc E. Water sorption, solubility, and color stability of giomer restoratives. J Esthet Restor Dent. 2015. 10.1111/jerd.12119 . Bhattacharya S, Purayil TP, Ginjupalli K, Kini S, Pai S. Effect of thermocycling on the color stability of aesthetic restorative materials: An in-vitro spectrophotometric analysis. Pesq Bras Odontopediatr Clin Integr. 2020. 10.1590/pboci.2020.020 . Lima RBWE, Farias JFGD, Adrade AKM, Silva FDSDCME, Duarte RM. Water sorption and solubility of glass ionomer cements indicated for atraumatic restorative treatment considering the time and the pH of the storage solution. RGO-Rev Gaúcha Odontol. 2018. 10.1590/1981-863720180001000043100 . Luce MS, Campbell CE. Stain potential of four microfilled composites. J Prosthet Dent. 1988;60(2):151–4. Omar HAA. Water sorption and solubility of resin filled composites. 2015. https://core.ac.uk/download/pdf/58915984.pdf . Accessed 22 Oct 2024. Paravina RD, Pérez MM, Ghinea R. Acceptability and perceptibility thresholds in dentistry: A comprehensive review of clinical and research applications. J Esthet Restor Dent. 2019. 10.1111/jerd.12465 . Ugurlu M, Al-Haj Husain N, Özcan M. Color change after 25% hydrogen peroxide bleaching with photoactivation: a methodological assessment using spectrophotometer versus digital photographs. Materials. 2022. 10.3390/ma15145045 . Burkinshaw SM. Color in relation to dentistry: Fundamentals of color science. Br Dent J. 2004. 10.1038/sj.bdj.4810880 . Gómez-Polo C, Montero J, Gómez‐Polo M, Martin Casado A. Comparison of the CIELab and CIEDE 2000 color difference formulas on gingival color space. J Prosthodont. 2020. 10.1111/jopr.12717 . del Mar Perez M, Ghinea R, Ionescu AM, Pomares H, Pulgar R, Paravina RD. Dental ceramics: a CIEDE2000 acceptability thresholds for lightness, chroma and hue differences. J Dent. 2011. 10.1016/j.jdent.2011.09.007 . Joiner A. Tooth color: a review of the literature. J Dent. 2004. 10.1016/j.jdent.2003.10.013 . Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6589441","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":464678523,"identity":"9746e033-cae0-4425-8300-49a9756a055d","order_by":0,"name":"Jian Sheng Lee","email":"","orcid":"","institution":"Universiti Malaya","correspondingAuthor":false,"prefix":"","firstName":"Jian","middleName":"Sheng","lastName":"Lee","suffix":""},{"id":464678524,"identity":"01a40dd0-8a32-4fe7-90e3-fe6d91c74ff3","order_by":1,"name":"Noor Azlin Yahya","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAsUlEQVRIiWNgGAWjYHACxgMJDDZglgTReoBa0kjVwsBwmAQt5uzHHxx4uON84toG5oO3eRi2JTYQ0mLZk5BwIPHM7cRtB9iSrXkYbhPWYnAg4cCBxDaQFh4zaeK0nH/YANRyDqiF/xuRWm4kMwC1HADZwkaslmcgLcnG2w6zGVvOMbhtTITD0h8+/NlmJ7vtePPDG28qbssS1IIAzGATGBxJ0AIF9iTrGAWjYBSMgmEPAO4eRhYmi06sAAAAAElFTkSuQmCC","orcid":"","institution":"Universiti Malaya","correspondingAuthor":true,"prefix":"","firstName":"Noor","middleName":"Azlin","lastName":"Yahya","suffix":""},{"id":464678525,"identity":"d4fb09b1-e8c0-446a-9185-8bde1c314230","order_by":2,"name":"Azwatee Abdul Aziz","email":"","orcid":"","institution":"Universiti Malaya","correspondingAuthor":false,"prefix":"","firstName":"Azwatee","middleName":"Abdul","lastName":"Aziz","suffix":""},{"id":464678526,"identity":"0d0bd1ce-2a76-4ee3-858c-d63da278f3b6","order_by":3,"name":"Adrian U-Jin Yap","email":"","orcid":"","institution":"Ng Teng Fong General Hospital","correspondingAuthor":false,"prefix":"","firstName":"Adrian","middleName":"U-Jin","lastName":"Yap","suffix":""}],"badges":[],"createdAt":"2025-05-04 16:38:15","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6589441/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6589441/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12903-025-06681-0","type":"published","date":"2025-11-05T15:57:19+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":95564004,"identity":"b6081f23-838c-4402-b4f6-2fab1b86239a","added_by":"auto","created_at":"2025-11-10 16:06:21","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1196078,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6589441/v1/765241cb-f3b4-47ff-9582-61cc0019314c.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eThe Effects of Bleaching Products on the Color Stability of Ion-releasing Restoratives\u003c/p\u003e","fulltext":[{"header":"BACKGROUND","content":"\u003cp\u003eDirect tooth-colored restorations are widely used to replace damaged tooth structures and enhance dental esthetics. Composite resin (CR) remains the preferred restorative material in modern dentistry due to its excellent mechanical and esthetic properties. However, systematic reviews have identified recurrent caries as a major cause of CR restoration failures [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Recurrent caries often occur in restorative margins, due to their susceptibility to plaque formation. These areas are more difficult to clean and the presence of an interfacial gap at the tooth-restoration margin leads to bacterial colonization [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIon-releasing restorative materials (IRMs) were developed to address this issue. These materials release and recharge remineralizing ions that promote fluorapatite crystal formation, which is more acid-resistant [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Conventional IRMs, such as glass ionomer cement (GIC), are limited by poor mechanical and optical properties, restricting their use in stress-bearing and esthetic zones. Advances in IRM technology have incorporated resin monomers and fluoroaluminosilicate fillers, enhancing mechanical, optical, and remineralizing properties for use in esthetic areas [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. New IRMs have been developed with innovative fillers such as Isofiller in alkasites (Ivoclar-Vivadent) and surface pre-reacted glass ionomer (S-PRG) in giomers [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Additionally, handling properties have improved in high-viscosity GIC and Activa Bioactive Restoratives [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAs public awareness of dental esthetics grows, the global tooth-bleaching market is rapidly expanding [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Vital tooth bleaching is categorized into in-office, take-home, and over-the-counter products, primarily containing hydrogen peroxide or carbamide peroxide. These agents release free radicals that break down staining molecules in tooth structures [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. However, this nonspecific reaction can have adverse effects, including crown fractures, dentine hypersensitivity, restoration discoloration, and debonding [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Several studies have demonstrated changes in restoration color following exposure to bleaching agents [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. The severity of color change is categorized using the perceptibility and acceptability thresholds. One study reported that ΔE* values exceeding 1.2 are visually perceptible, and those above 2.7 are deemed unacceptable [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. The constant ionic exchange and dissolution of functional filler particles in IRMs result in internal porosities, making them more vulnerable to the effects of bleaching agents [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eGiven the limited research on the impact of bleaching products on contemporary IRMs, this study aimed to evaluate the effects of in-office and take-home bleaching agents on the color stability of IRMs and to assess their color stability over time. The null hypotheses were (i) in-office and take-home bleaching products do not affect the color stability of IRMs; (ii) there are no differences in color stability between IRMs; (iii) the color of IRMs do not change over time following their exposure to bleaching agents.\u003c/p\u003e"},{"header":"METHODS","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eEvaluated Materials and Determination of Sample Size\u003c/h2\u003e \u003cp\u003eThe technical profiles of materials under evaluation are presented in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. These included four IRMs of shade A2, specifically a bioactive composite (Activa [AB], Pulpdent Corporation, Watertown, MA, USA), a giomer (Beautifil II LS [BI], Shofu, Kyoto Japan), a bulk-fill alkasite (Cention-N [CN], Ivoclar-Vivadent, AG, Schaan, Liechtenstein), and an encapsulated high viscosity GIC (Riva LC HVGIC [RV], SDI Limited, Bayswater, Victoria, Australia), and a conventional CR control (Luna [LN], SDI Limited, Bayswater, Victoria, Australia). An in-office bleaching product (Pola Rapid [PR], SDI Limited, Bayswater, Victoria, Australia) and a take-home bleaching product, (Pola Night [PN], SDI Limited, Bayswater, Victoria, Australia) were used in this study A minimum total sample size of 90 specimens (n\u0026thinsp;=\u0026thinsp;6 per group) was determined using G*Power Software version 3.1.9.4, based on an ANOVA model with an effect size of 0.6, alpha level of 0.05, and power of 95% across 15 groups [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e].\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eTechnical profiles of the materials and bleaching products\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMaterial (Abbreviation)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eManufacturer\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eType\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eCompositions\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eFiller\u003c/p\u003e \u003cp\u003eweight, %\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLuna (LN)\u003c/p\u003e \u003cp\u003e[Control]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSDI Limited, Bayswater, Victoria,\u003c/p\u003e \u003cp\u003eAustralia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eLight-cured conventional composite\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eResin: UDMA, Bis-GMA,TEGDMA\u003c/p\u003e \u003cp\u003eFiller: Strontium aluminosilicate, amorphous silica\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e76\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eActiva Bioactive Restorative\u003c/p\u003e \u003cp\u003e(AB)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePulpdent, Watertown, MA, USA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDual-cured\u003c/p\u003e \u003cp\u003ebioactive composite\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eResin: A blend of UDMA and other methacrylates with modified polyacrylic acid\u003c/p\u003e \u003cp\u003eFiller: Amorphous silica, sodium fluoride\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e55.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBeautifil II LS (BI)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eShofu, Kyoto, Japan\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eLight-cured giomer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eResin: Low-shrinkage urethane diacrylate, Bis-MPEPP, Bis-GMA,\u003c/p\u003e \u003cp\u003eTEGDMA\u003c/p\u003e \u003cp\u003eFiller: Multi-functional glass and S-PRG filler based on fluoroboroalumino silicate glass,\u003c/p\u003e \u003cp\u003epre-polymerized filler, nanofiller\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e83.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCention-N\u003c/p\u003e \u003cp\u003e(CN)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIvoclar-Vivadent, AG, Schaan, Liechtenstein\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSelf-cured/ dual-cured alkasite\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eResin: UDMA, DCP, Aromatic aliphatic-UDMA, PEG-400 DMA\u003c/p\u003e \u003cp\u003eFiller: Br-Al-Si glass filler, ytterbium trifluoride, Isofiller (copolymer), calcium barium aluminium fluorosilicate glass, calcium fluorosilicate glass\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e78.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRiva LC HVGIC\u003c/p\u003e \u003cp\u003e(RV)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSDI Limited, Bayswater, Victoria, Australia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eLight-cured encapsulated resin-reinforced high viscosity glass ionomer cement\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eCompartment 1: Polyacrylic acid, Tartaric acid, HEMA, Dimethacrylate- cross-linker, Acid monomer\u003c/p\u003e \u003cp\u003eCompartment 2: Fluoro-alumino-silicate glass\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e95.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePola Rapid\u003c/p\u003e \u003cp\u003e(PR)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSDI Limited, Bayswater, Victoria, Australia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eN/A\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eLiquid: 38% Hydrogen peroxide,\u003c/p\u003e \u003cp\u003e62% water\u003c/p\u003e \u003cp\u003ePowder: 73.26% thickeners,\u003c/p\u003e \u003cp\u003e26.2% catalysts, 0.04% Dye, 0.5% Desensitising agents\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eN/A\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePola Night\u003c/p\u003e \u003cp\u003e(PN)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSDI Limited, Bayswater, Victoria, Australia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eN/A\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2 22 wt% Carbamide peroxide (6.6% hydrogen peroxide), \u0026lt; 40 wt% additives, 30 wt% glycerol, 20 wt% Water, 0.1 wt% flavouring\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eN/A\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eAbbreviation:\u003c/p\u003e \u003cp\u003eBis-GMA\u0026thinsp;=\u0026thinsp;Bisphenol-A glycidyl methacrylate\u003c/p\u003e \u003cp\u003eBis-MPEPP\u0026thinsp;=\u0026thinsp;2,2-Bis (4-methacryloxypolyethoxyphenyl) propane\u003c/p\u003e \u003cp\u003eDCP\u0026thinsp;=\u0026thinsp;Tricyclodecan-dimethanol dimethacrylate\u003c/p\u003e \u003cp\u003eUDMA\u0026thinsp;=\u0026thinsp;Urethane dimethacrylate\u003c/p\u003e \u003cp\u003eTEGDMA\u0026thinsp;=\u0026thinsp;Triethylene glycol dimethacrylate\u003c/p\u003e \u003cp\u003eHEMA\u0026thinsp;=\u0026thinsp;2-hydroxyethyl methacrylate\u003c/p\u003e \u003cp\u003eHVGIC\u0026thinsp;=\u0026thinsp;high viscosity glass ionomer cement\u003c/p\u003e \u003cp\u003eS-PRG\u0026thinsp;=\u0026thinsp;Surface pre-reacted glass ionomer\u003c/p\u003e \u003cp\u003eAromatic aliphatic-UDMA\u0026thinsp;=\u0026thinsp;Tetramethyl-xylylendiurethane dimethacrylate\u003c/p\u003e \u003cp\u003ePEG-400 DMA\u0026thinsp;=\u0026thinsp;Polyethylene glycol 400 dimethacrylate\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eSpecimen Preparation\u003c/h3\u003e\n\u003cp\u003eForty-five disc-shaped specimens were prepared for each material following the manufacturers' instructions using a customized cylindrical teflon mold (8 \u0026times; 2 mm). A cellulose acetate matrix strip and a glass slide were placed on the top and bottom surfaces of the mold to remove excess material under finger pressure and ensure a smooth finish. The specimens were then light-cured through the glass slide for 20 seconds using a calibrated LED curing unit (Radii Cal LED Curing Light, SDI, Bayswater, Victoria, Australia), with an output irradiance of 1200 mW/cm\u0026sup2; and a wavelength of 468\u0026ndash;470 nm. The light-curing unit was recharged and calibrated after every 15 specimens to maintain consistent output. Specimen thickness was measured using a digital caliper (Mitutoyo Corporation, Kawasaki, Japan).\u003c/p\u003e \u003cp\u003eThe specimens were stored in artificial saliva (SAGF) (Gal et al., 2001) and incubated at 37\u0026deg;C for 24 hours to allow post-irradiation polymerization (Memmert Incubator IN750, Schwabach, Germany). Following this, the specimens were finished and polished using medium, fine, and superfine Sof-Lex discs (3M ESPE, St Paul, Minnesota, USA) at 15000 rpm, with 10 strokes applied in a single direction for each disc. The specimens were polished by single operator to ensure consistency in the applied pressure. Specimen dimensions were verified using the digital caliper to ensure standardized thinckness (2.0 \u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:\\pm\\:\\)\u003c/span\u003e\u003c/span\u003e 0.2 mm). Polished specimens were then stored in artificial saliva at 37\u0026deg;C in the incubator for two weeks before the bleaching procedure. The artificial saliva was refreshed weekly to prevent deposit buildup.\u003c/p\u003e\n\u003ch3\u003eBleaching Procedure\u003c/h3\u003e\n\u003cp\u003eThe specimens of each material were randomly distributed into three groups (n\u0026thinsp;=\u0026thinsp;15) as follows:\u003c/p\u003e \u003cp\u003eGroup A (control): Immersion in artificial saliva for seven days.\u003c/p\u003e \u003cp\u003eGroup B (take-home bleaching): Exposed to PN for 45 minutes daily for seven days.\u003c/p\u003e \u003cp\u003eGroup C (in-office bleaching): Exposed to PR for three cycles of 8 minutes on day seven.\u003c/p\u003e \u003cp\u003eThe specimens were rinsed with distilled water and dried before the bleaching procedures. Specimens were stored in artificial saliva at 37\u0026deg;C when not undergoing any bleaching procedures.\u003c/p\u003e\n\u003ch3\u003eColor Measurement\u003c/h3\u003e\n\u003cp\u003eThe colour of each specimen was measured using the Commission Internationale de l'\u0026Eacute;clairage (CIE L\u003cem\u003ea\u003c/em\u003eb*) colour system with a spectrophotometer (CM-5, Konica Minolta, Tokyo, Japan). The standard observer angle was set at 10\u0026deg;, and each specimen was positioned within the 3 mm diameter illumination area. Reflectance values were recorded after 1 second of exposure to the D65 standard illuminant, against a standardised black background. Three readings per specimen were taken at baseline (T0), 24 hours (T1), two weeks (T2), and one month (T3) after bleaching. The color change, ΔE, was calculated by comparing the T1, T2 and T3 values with the T0 value using the following formula:\u003c/p\u003e \u003cp\u003e\u003cimg src=\"https://myfiles.space/user_files/69519_bce2c0439cd956a6/69519_custom_files/img1748885917.png\"\u003e\u003c/p\u003e\u003cp\u003e \u003cb\u003eWhere\u003c/b\u003e \u003c/p\u003e \u003cp\u003eL is the lightness from black to white\u003c/p\u003e \u003cp\u003ea is the color along the red and green dimension\u003c/p\u003e \u003cp\u003eb is the color along the yellow and blue dimension\u003c/p\u003e \u003cp\u003ei is the measurement value at 24 hours (T1), two weeks (T2), and one month (T3)\u003c/p\u003e \u003cp\u003e0 is the measurement value at baseline (T0)\u003c/p\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eStatistical Analysis\u003c/h2\u003e \u003cp\u003eStatistical analysis was conducted using SPSS version 25 for Windows (SPSS Inc., Chicago, Illinois, USA). The Kolmogorov-Smirnov test was applied to confirm data normality. Two-way analysis of variance (ANOVA) was performed to evaluate the interaction between IRMs and bleaching products on ΔE. Tukey\u0026rsquo;s post-hoc test was used to analyze differences between IRMs and bleaching products. Two-way repeated-measures ANOVA was employed to assess the interaction between IRMs and time on ΔE.\u003c/p\u003e \u003c/div\u003e"},{"header":"RESULTS","content":"\u003cp\u003eThe ΔE values are summarized in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e, ranging from 0.94\u0026thinsp;\u0026plusmn;\u0026thinsp;0.48 to 5.99\u0026thinsp;\u0026plusmn;\u0026thinsp;1.33. IRMs and bleaching products both significantly influenced the ΔE* (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Two-way ANOVA revealed a significant interaction between IRMs and bleaching products on ΔE* (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Additionally, two-way repeated-measures ANOVA showed a significant interaction between IRMs and time on ΔE* (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e compares the mean L*, a*, and b* values for the restorative materials at T0, T1, T2, and T3. Most materials showed an increase in L* and a* values, along with a decrease in b* values over time. The change in L* (ΔL*) ranged from \u0026minus;\u0026thinsp;0.02\u0026thinsp;\u0026plusmn;\u0026thinsp;1.23 to 4.94\u0026thinsp;\u0026plusmn;\u0026thinsp;1.37, a* (Δa*) ranged from \u0026minus;\u0026thinsp;0.31\u0026thinsp;\u0026plusmn;\u0026thinsp;0.12 to 0.65\u0026thinsp;\u0026plusmn;\u0026thinsp;0.13, and b* (Δb*) varied from \u0026minus;\u0026thinsp;3.08\u0026thinsp;\u0026plusmn;\u0026thinsp;1.24 to 0.31\u0026thinsp;\u0026plusmn;\u0026thinsp;0.86.\u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e summarizes the ΔE* values for the restorative materials following exposure to two bleaching products and artificial saliva across three time intervals. For all materials, no significant differences were found between PR and PN, indicating that both bleaching agents had comparable effects. In the cases of BI and CN, the ΔE* values did not differ significantly among AS, PN, and PR. However, for AB and LN, immersion in AS produced higher ΔE* values compared to PR and PN, whereas for RV samples, the opposite was observed\u0026mdash;bleaching with PR and PN yielded higher ΔE* than AS. When stored in AS, RV and BI consistently showed the lowest ΔE* values, while AB consistently exhibited the highest across all time intervals. After bleaching with PN and PR, RV recorded the highest ΔE* at T1 and T2, but by T3, AB surpassed RV. Additionally, LN and BI maintained the lowest ΔE* values following bleaching at every time point. Notably, AB was the only material to demonstrate a significant change in ΔE* over time, with a marked increase from T1 to T2 and a further significant rise from T2 to T3 in the PR group.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMean ΔE* (SD) of restorative materials exposed to bleaching products (n\u0026thinsp;=\u0026thinsp;15).\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eMaterials\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eBleaching Products\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e \u003cp\u003eTime Intervals\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eT1\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eT2\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eT3\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eLN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003e2.33 (1.30)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e2.41 (1.58)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e2.70 (1.22)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.94 (0.48)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.05 (0.49)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e1.22 (0.98)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003e1.43 (0.86)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e1.21 (0.43)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e1.34 (0.40)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eAB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003e2.50 (0.85)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e4.95 (1.80)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e5.99 (1.33)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003e2.39 (0.71)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e3.43 (1.14)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e3.80 (1.41)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003e1.78 (0.78)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e2.56 (0.95)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e4.02 (1.31)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eBI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003e1.51 (0.71)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e1.64 (0.96)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e1.47 (0.52)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003e1.47 (0.43)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e1.28 (0.60)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e1.50 (0.63)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003e1.35 (0.71)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e1.45 (0.94)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e1.67 (0.90)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eCN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003e2.15 (1.24)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e2.51 (1.32)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e2.53 (1.20)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003e2.13 (1.15)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e1.85 (0.92)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e2.20 (1.22)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e2.71 (1.29)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e2.52 (1.09)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e2.13 (1.09)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eRV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003e1.38 (0.68)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003e1.88 (1.08)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003e2.05 (0.77)\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e3.34 (0.72)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e3.59 (0.88)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e3.67 (0.67)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e3.55 (0.78)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e3.39 (0.95)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e3.86 (0.65)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eAbbreviation :\u003c/p\u003e \u003cp\u003eLN\u0026thinsp;=\u0026thinsp;Luna, AB\u0026thinsp;=\u0026thinsp;Activa, BI\u0026thinsp;=\u0026thinsp;Beautifil, CN\u0026thinsp;=\u0026thinsp;Cention-N, RV\u0026thinsp;=\u0026thinsp;Riva;\u003c/p\u003e \u003cp\u003eAS\u0026thinsp;=\u0026thinsp;Artificial saliva, PR\u0026thinsp;=\u0026thinsp;Pola Rapid, PN\u0026thinsp;=\u0026thinsp;Pola Night;\u003c/p\u003e \u003cp\u003eT1\u0026thinsp;=\u0026thinsp;24 hours after bleaching, T2\u0026thinsp;=\u0026thinsp;two weeks after bleaching, T3\u0026thinsp;=\u0026thinsp;one month after bleaching;\u003c/p\u003e \u003cp\u003e\u0026ldquo;\u003cem\u003eItalicized\u003c/em\u003e\u0026rdquo; values\u0026thinsp;=\u0026thinsp;ΔE* exceed the acceptability threshold of 1.2;\u003c/p\u003e \u003cp\u003e\u0026ldquo;Bolded\u0026rdquo; values\u0026thinsp;=\u0026thinsp;ΔE* exceed the perceptibility threshold of 2.7.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMean (SD) L*, a* and b* of restorative materials.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"14\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c13\" colnum=\"13\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c14\" colnum=\"14\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eMaterials\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eT0\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eBleaching\u003c/p\u003e \u003cp\u003eProducts\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c8\" namest=\"c6\"\u003e \u003cp\u003eT1\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c11\" namest=\"c9\"\u003e \u003cp\u003eT2\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c14\" namest=\"c12\"\u003e \u003cp\u003eT3\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eL*\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003ea*\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eb*\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eL*\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003ea*\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003eb*\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003eL*\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003ea*\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c11\"\u003e \u003cp\u003e\u003cb\u003eb*\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c12\"\u003e \u003cp\u003e\u003cb\u003eL*\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c13\"\u003e \u003cp\u003e\u003cb\u003ea*\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c14\"\u003e \u003cp\u003e\u003cb\u003eb*\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eLN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e63.99\u003c/p\u003e \u003cp\u003e(0.96)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e-2.49\u003c/p\u003e \u003cp\u003e(0.18)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e6.81\u003c/p\u003e \u003cp\u003e(0.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eAS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e65.89\u003c/p\u003e \u003cp\u003e(1.47)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-1.92\u003c/p\u003e \u003cp\u003e(0.38)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e6.55\u003c/p\u003e \u003cp\u003e(0.96)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e66.02\u003c/p\u003e \u003cp\u003e(1.73)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e-1.94\u003c/p\u003e \u003cp\u003e(0.46)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e6.40\u003c/p\u003e \u003cp\u003e(0.81)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e66.34\u003c/p\u003e \u003cp\u003e(1.22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" 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\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e0.24\u003c/p\u003e \u003cp\u003e(0.12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e3.99\u003c/p\u003e \u003cp\u003e(0.55)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e60.32 \u003c/p\u003e \u003cp\u003e(1.40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.14\u003c/p\u003e \u003cp\u003e(0.10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e4.21\u003c/p\u003e \u003cp\u003e(0.85)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e61.21\u003c/p\u003e \u003cp\u003e(1.23)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.17\u003c/p\u003e \u003cp\u003e(0.11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e3.77\u003c/p\u003e \u003cp\u003e(0.48)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e61.39\u003c/p\u003e \u003cp\u003e(1.32)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e0.30\u003c/p\u003e \u003cp\u003e(0.15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e3.76\u003c/p\u003e \u003cp\u003e(0.47)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eCN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e61.81 (1.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e-0.95 (0.16)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e10.28 (0.79)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eAS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e62.15\u003c/p\u003e \u003cp\u003e(2.39)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.76\u003c/p\u003e \u003cp\u003e(0.24)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e9.81\u003c/p\u003e \u003cp\u003e(0.59)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e62.37\u003c/p\u003e \u003cp\u003e(2.56)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e-0.49\u003c/p\u003e \u003cp\u003e(0.24)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e9.61\u003c/p\u003e \u003cp\u003e(0.93)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e62.75\u003c/p\u003e \u003cp\u003e(1.82)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e-0.41\u003c/p\u003e \u003cp\u003e(0.18)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e8.78\u003c/p\u003e \u003cp\u003e(1.13)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e61.92 \u003c/p\u003e \u003cp\u003e(2.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.70\u003c/p\u003e \u003cp\u003e(0.15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e9.51\u003c/p\u003e \u003cp\u003e(1.21)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e62.10\u003c/p\u003e \u003cp\u003e(1.51)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e-0.52\u003c/p\u003e \u003cp\u003e(0.23)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e9.43\u003c/p\u003e \u003cp\u003e(1.11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e62.22\u003c/p\u003e \u003cp\u003e(1.87)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e-0.40\u003c/p\u003e \u003cp\u003e(0.16)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e9.29\u003c/p\u003e \u003cp\u003e(1.27)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e62.13\u003c/p\u003e \u003cp\u003e(2.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.75\u003c/p\u003e \u003cp\u003e(0.22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e10.03\u003c/p\u003e \u003cp\u003e(1.12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e62.21\u003c/p\u003e \u003cp\u003e(2.41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e-0.52\u003c/p\u003e \u003cp\u003e(0.22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e10.16\u003c/p\u003e \u003cp\u003e(1.34)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e62.55\u003c/p\u003e \u003cp\u003e(1.93)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e-0.41\u003c/p\u003e \u003cp\u003e(0.18)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e9.98\u003c/p\u003e \u003cp\u003e(1.13)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eRV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e57.64 (2.11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e-0.12 (0.22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e9.69 (0.86)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eAS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e57.95\u003c/p\u003e \u003cp\u003e(0.92)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.43\u003c/p\u003e \u003cp\u003e(0.12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e8.87\u003c/p\u003e \u003cp\u003e(0.96)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e58.88\u003c/p\u003e \u003cp\u003e(1.32)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e-0.30\u003c/p\u003e \u003cp\u003e(0.17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e8.79\u003c/p\u003e \u003cp\u003e(0.80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e59.32 \u003c/p\u003e \u003cp\u003e(0.81)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e-0.24\u003c/p\u003e \u003cp\u003e(0.16)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e8.79\u003c/p\u003e \u003cp\u003e(0.71)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e58.59\u003c/p\u003e \u003cp\u003e(1.52)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.04\u003c/p\u003e \u003cp\u003e(0.11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e6.79\u003c/p\u003e \u003cp\u003e(0.44)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e59.77\u003c/p\u003e \u003cp\u003e(1.21)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.10\u003c/p\u003e \u003cp\u003e(0.10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e6.97\u003c/p\u003e \u003cp\u003e(0.48)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e59.78\u003c/p\u003e \u003cp\u003e(1.23)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e0.10\u003c/p\u003e \u003cp\u003e(0.11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e6.91\u003c/p\u003e \u003cp\u003e(0.38)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e59.57\u003c/p\u003e \u003cp\u003e(1.18)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.03\u003c/p\u003e \u003cp\u003e(0.15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e6.88\u003c/p\u003e \u003cp\u003e(0.47)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e59.30\u003c/p\u003e \u003cp\u003e(1.26)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.02\u003c/p\u003e \u003cp\u003e(0.12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e7.03\u003c/p\u003e \u003cp\u003e(0.56)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e60.28\u003c/p\u003e \u003cp\u003e(0.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e0.08\u003c/p\u003e \u003cp\u003e(0.11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e6.97\u003c/p\u003e \u003cp\u003e(0.61)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"14\" nameend=\"c14\" namest=\"c1\"\u003e \u003cp\u003eAbbreviation:\u003c/p\u003e \u003cp\u003eLN\u0026thinsp;=\u0026thinsp;Luna, AB\u0026thinsp;=\u0026thinsp;Activa, BI\u0026thinsp;=\u0026thinsp;Beautifil, CN\u0026thinsp;=\u0026thinsp;Cention-N, RV\u0026thinsp;=\u0026thinsp;Riva;\u003c/p\u003e \u003cp\u003eAS\u0026thinsp;=\u0026thinsp;Artificial saliva, PR\u0026thinsp;=\u0026thinsp;Pola Rapid, PN\u0026thinsp;=\u0026thinsp;Pola Night;\u003c/p\u003e \u003cp\u003eT0\u0026thinsp;=\u0026thinsp;baseline color measurement, T1\u0026thinsp;=\u0026thinsp;24 hours after bleaching, T2\u0026thinsp;=\u0026thinsp;two weeks after bleaching, T3\u0026thinsp;=\u0026thinsp;one month after bleaching;\u003c/p\u003e \u003cp\u003eL*=lightness from black to white, a*=color along the red and green dimension, b\u0026thinsp;=\u0026thinsp;color along the yellow and blue dimension.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eStatistical analyses of ΔE* between (A) bleaching products, (B) restorative materials, and (C) time intervals\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003e(A) Comparison of ΔE* between different bleaching products.\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRestorative materials\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eT1\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eT2\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eT3\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAS\u0026thinsp;\u0026gt;\u0026thinsp;PR\u0026thinsp;=\u0026thinsp;PN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAS\u0026thinsp;\u0026gt;\u0026thinsp;PR\u0026thinsp;=\u0026thinsp;PN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAS\u0026thinsp;\u0026gt;\u0026thinsp;PN\u0026thinsp;=\u0026thinsp;PR\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e=\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAS\u0026thinsp;\u0026gt;\u0026thinsp;PR\u0026thinsp;=\u0026thinsp;PN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAS\u0026thinsp;\u0026gt;\u0026thinsp;PN\u0026thinsp;=\u0026thinsp;PR\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e=\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e=\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e=\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e=\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e=\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e=\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePR\u0026thinsp;=\u0026thinsp;PN\u0026thinsp;\u0026gt;\u0026thinsp;AS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePR\u0026thinsp;=\u0026thinsp;PN\u0026thinsp;\u0026gt;\u0026thinsp;AS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePR\u0026thinsp;=\u0026thinsp;PN\u0026thinsp;\u0026gt;\u0026thinsp;AS\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003e(B) Comparison of ΔE* between different restorative materials.\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTime intervals\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eAS\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003ePN\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003ePR\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eT1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAB\u0026thinsp;\u0026gt;\u0026thinsp;LN\u0026thinsp;\u0026ge;\u0026thinsp;CN\u0026thinsp;\u0026gt;\u0026thinsp;BI\u0026thinsp;\u0026ge;\u0026thinsp;RV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRV\u0026thinsp;\u0026gt;\u0026thinsp;AB\u0026thinsp;\u0026ge;\u0026thinsp;CN\u0026thinsp;\u0026gt;\u0026thinsp;BI\u0026thinsp;\u0026ge;\u0026thinsp;LN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRV\u0026thinsp;\u0026ge;\u0026thinsp;CN\u0026thinsp;\u0026gt;\u0026thinsp;AB\u0026thinsp;\u0026ge;\u0026thinsp;LN\u0026thinsp;\u0026ge;\u0026thinsp;BI\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eT2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAB\u0026thinsp;\u0026gt;\u0026thinsp;LN\u0026thinsp;\u0026ge;\u0026thinsp;CN\u0026thinsp;\u0026ge;\u0026thinsp;RV\u0026thinsp;\u0026ge;\u0026thinsp;BI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRV\u0026thinsp;\u0026ge;\u0026thinsp;AB\u0026thinsp;\u0026gt;\u0026thinsp;CN\u0026thinsp;\u0026ge;\u0026thinsp;BI\u0026thinsp;\u0026ge;\u0026thinsp;LN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRV\u0026thinsp;\u0026ge;\u0026thinsp;AB\u0026thinsp;\u0026ge;\u0026thinsp;CN\u0026thinsp;\u0026gt;\u0026thinsp;BI\u0026thinsp;\u0026ge;\u0026thinsp;LN\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eT3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAB\u0026thinsp;\u0026gt;\u0026thinsp;LN\u0026thinsp;\u0026ge;\u0026thinsp;CN\u0026thinsp;\u0026gt;\u0026thinsp;RV\u0026thinsp;\u0026ge;\u0026thinsp;BI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAB\u0026thinsp;\u0026ge;\u0026thinsp;RV\u0026thinsp;\u0026gt;\u0026thinsp;CN\u0026thinsp;\u0026ge;\u0026thinsp;LN\u0026thinsp;\u0026ge;\u0026thinsp;BI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAB\u0026thinsp;\u0026ge;\u0026thinsp;RV\u0026thinsp;\u0026gt;\u0026thinsp;CN\u0026thinsp;\u0026ge;\u0026thinsp;BI\u0026thinsp;\u0026ge;\u0026thinsp;LN\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003e(C) Comparison of ΔE* between time intervals.\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRestorative materials\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eAS\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003ePN\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003ePR\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e=\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e=\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e=\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eT3\u0026thinsp;=\u0026thinsp;T2\u0026thinsp;\u0026gt;\u0026thinsp;T1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eT3\u0026thinsp;=\u0026thinsp;T2\u0026thinsp;\u0026gt;\u0026thinsp;T1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eT3\u0026thinsp;\u0026gt;\u0026thinsp;T2\u0026thinsp;\u0026gt;\u0026thinsp;T1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e=\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e=\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e=\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e=\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e=\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e=\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e=\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e=\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e=\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eAbbreviations:\u003c/p\u003e \u003cp\u003eLN\u0026thinsp;=\u0026thinsp;Luna; AB\u0026thinsp;=\u0026thinsp;Activa; BI\u0026thinsp;=\u0026thinsp;Beautifil; CN\u0026thinsp;=\u0026thinsp;CentionN; RV\u0026thinsp;=\u0026thinsp;Riva;\u003c/p\u003e \u003cp\u003eAS\u0026thinsp;=\u0026thinsp;Artificial Saliva; PN\u0026thinsp;=\u0026thinsp;Pola Night; PR\u0026thinsp;=\u0026thinsp;Pola Rapid;\u003c/p\u003e \u003cp\u003eT1\u0026thinsp;=\u0026thinsp;24 hours after bleaching, T2\u0026thinsp;=\u0026thinsp;two weeks after bleaching, T3\u0026thinsp;=\u0026thinsp;one month after bleaching;\u003c/p\u003e \u003cp\u003eIn A, \u0026ldquo;=\u0026rdquo; indicates no significant difference and \u0026ldquo;\u0026gt;\u0026rdquo; indicates a significantly greater ΔE*.\u003c/p\u003e \u003cp\u003eIn B, \u0026ldquo;\u0026ge;\u0026rdquo; denotes a greater value without statistical significance, while \u0026ldquo;\u0026gt;\u0026rdquo; indicates statistical significance.\u003c/p\u003e \u003cp\u003eIn C, \u0026ldquo;=\u0026rdquo; indicates no statistically significant difference between time intervals.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"DISCUSSION","content":"\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003eEffects of Bleaching Products on IRMs\u003c/h2\u003e \u003cp\u003eAs bleaching products significantly affected the ΔE* values, the first null hypothesis was rejected. In general, the L* and a* values increased, while the b* value decreased after bleaching. Changes in the L* and b* dimensions were more pronounced than those in the a* dimension. When mapped to the Munsell color space, the specimens\u0026rsquo; colors shifted towards a lighter and bluish hue, resulting in a lightening of the restorative materials [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. Furthermore, the a* and b* values approached the zero or neutral axis (i.e., negative a* values increased, positive b* values decreased), causing desaturation and a duller appearance [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. These findings align with studies by Karamangar et al. and Korać et al., which identified an increase in L* as the primary contributor to color changes [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. RV and AB specimens bleached with PN and PR exhibited a larger change in the b* value compared to the L* value, consistent with Yu et al., who reported significant declines in the b* values of resin-modified GIC and compomer after bleaching [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe bleaching mechanism involves hydrogen peroxide oxidizing surface pigments and amides directly related to the restoration's shade [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. In resin-based materials, discoloration is exacerbated by the resin matrix\u0026rsquo;s water sorption properties. Water absorption promotes the elution of residual monomers, adversely affecting color stability [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. For IRMs, the glass matrix acts as a permeable hydrogel, facilitating ion and water diffusion and allowing dissociated peroxides to penetrate the material [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. These reactive oxygen species and perhydroxyl ions attack the resin-filler interface, leading to plasticization and matrix dissolution. This process forms micropores that alter reflectance and optical properties [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. Additionally, the erosion caused by bleaching agents is influenced by their acidity [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. The pH of bleaching products ranges from 3.6 to 7.3, with fluoroaluminosilicate fillers dissolving more rapidly under acidic conditions, resulting in higher particle elution [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eInterestingly, AS induced more color change in LN and AB than bleaching. This may be attributed to differences in surface roughness between control and bleached samples.\u003csup\u003e25\u003c/sup\u003e Polished specimens might initially expose fillers at the surface, which are dissolved by hydrogen peroxide during bleaching, resulting in smoother surfaces. Consequently, bleached samples exhibit lower surface roughness compared to those immersed in artificial saliva, enhancing optical appearance [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. Another plausible explanation is the ability of bleaching products to reverse discoloration caused by artificial saliva. The oxidizing agents in bleaching procedures can cleave staining chromophores formed during prolonged AS immersion [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eBoth PR and PN exhibited comparable effects on all IRMs, consistent with prior research [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. The similarity in outcomes may stem from differences in bleaching protocols and formulations. PR, with a high hydrogen peroxide concentration (38%) and a short application duration (24 minutes), contrasts with PN, which uses a lower hydrogen peroxide concentration (6.6%) but requires a longer application time (315 minutes).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eComparison Between Restorative Materials\u003c/h2\u003e \u003cp\u003eDifferent IRMs exhibited varying color stability, indicating that the second null hypothesis was rejected. Variations in color stability among materials can be attributed to differences in filler content, size, and the type of organic monomer used. Consistent with previous studies, the resin-based composite LN demonstrated superior color stability against bleaching agents compared to IRMs [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. Methacrylate-based composites form tightly cross-linked, high-molecular-weight polymers that limit the penetration of oxidizing agents into the material [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAmong the IRMs, RV and AB were significantly affected by bleaching, potentially due to the degradation of metal polyacrylate salts within their matrices [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. AB exhibited the highest ΔE* values at T3. With the lowest filler content (55.4%), AB contains a higher proportion of resin matrix, which is prone to water sorption and subsequent discoloration. In contrast, BI demonstrated comparable ΔE* values to LN, owing to its high filler content (83% by weight) and hydrophobic monomers like UDMA [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]. CN\u0026rsquo;s color stability is supported by its hydrophobic resin matrix comprising UDMA, DCP, aromatic-aliphatic UDMA, and PEG-400 DMA, combined with high filler content. Additionally, CN employs thiocarbamide as a photoinitiator instead of oxidation-prone tertiary amines, reducing long-term discoloration [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eComparison Between Time Intervals\u003c/h2\u003e \u003cp\u003eThe third null hypothesis was rejected, as there were significant changes in ΔE* values over time. The ΔE* values of most IRMs increased insignificantly over time, likely due to the water and color stabilization of restorative materials which has occurred within the first 7\u0026ndash;14 days of artificial saliva immersion [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e, \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e]. However, AB exhibited a significant ΔE* increase over time, possibly due to its larger resin component, which enhances water sorption [\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eClinical Perceptibility and Acceptability of Color Change\u003c/h2\u003e \u003cp\u003eThresholds for perceptibility and acceptability of color changes are essential for evaluating the clinical significance of restoration discoloration. Reported threshold values in the literature range from 0.4 to 2.6 for perceptibility and 1.7 to 5.5 for acceptability [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eMost groups in this study exceeded the perceptibility threshold (ΔE*=1.2) at T1, except for LN bleached with PN, which only slightly exceeded this threshold at T3 (ΔE*=1.22). RV bleached with both PN and PR, and CN bleached with PR, exceeded the acceptability threshold (ΔE*=2.7) at T1. Notably, AB exhibited significant and progressive color deterioration over time, resulting in clinically unacceptable color alterations in the AS, PN, and PR groups by T3.\u003c/p\u003e \u003cp\u003eUgurlu et al. (2022) investigated the color change of bleached natural tooth structure in vivo and reported a ΔE* of 14.22 immediately after bleaching, which decreased to 7.51 over two years [\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e]. This substantial change highlights the discrepancy in color stability between natural teeth and restorations, reinforcing the need to replace restorations following bleaching procedures.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eLimitations of the Study\u003c/h2\u003e \u003cp\u003eThis study does not fully replicate the oral environment, as it lacks factors such as biofilm adhesion and thermal variations. While AS includes ions that mimic natural saliva, it lacks glycoproteins that influence viscosity and impact diffusion and reaction rates between biomaterials and immersion media [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. Future studies could enhance aging protocols by incorporating thermocycling to simulate thermal changes.\u003c/p\u003e \u003cp\u003eA limitation of the CIE-Lab color space used in this study is its measurement of only three parameters\u0026mdash;lightness (L*), red-to-green (a*), and yellow-to-blue (b*). As discussed, human color perception varies with lighting and surrounding objects, and humans are more sensitive to reddish (a*) than yellowish (b*) changes [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e, \u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e]. The CIEDE2000 (ΔE00) formula, which accounts for variations in lightness, chroma, hue, and illumination conditions, offers a more accurate assessment of clinically relevant color changes [\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e]. Future research should adopt ΔE00 for more clinically relevant evaluations, noting that its perceptibility and acceptability thresholds differ from ΔEab values.\u003c/p\u003e \u003cp\u003eThe correlation between color stability and surface roughness, microhardness, water sorption, and solubility was not assessed in this study. Future investigations should explore these material properties alongside optical attributes such as gloss, translucency, fluorescence, and opalescence to provide a more comprehensive understanding of restorative materials' performance [\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003eWithin the limitations of this study, all null hypotheses were rejected and the following conclusions are drawn:\u003c/p\u003e \u003cp\u003e \u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eThe bleaching products significantly influenced the color stability of IRMs. However, there were no differences in the ΔE* between PR and PN.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eThe IRMs showed differing color stability. RV exhibited significantly greater ΔE* after bleaching indicating poor color stability, while BI and CN showed no significant change.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eThe IRMs\u0026rsquo; color significantly changed over time. Specifically, AB\u0026rsquo;s ΔE* significantly increased from T1 to T3. AB had the greatest color changes for all bleaching groups after one month.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25.3033%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAbbreviation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74.6967%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDefinition\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25.3033%;\"\u003e\n \u003cp\u003ea*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74.6967%;\"\u003e\n \u003cp\u003eColour along the red and green dimension\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25.3033%;\"\u003e\n \u003cp\u003eAB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74.6967%;\"\u003e\n \u003cp\u003eActiva Bioactive Restorative\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25.3033%;\"\u003e\n \u003cp\u003eANOVA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74.6967%;\"\u003e\n \u003cp\u003eAnalysis of Variance\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25.3033%;\"\u003e\n \u003cp\u003eAromatic\u0026nbsp;Aliphatic-UDMA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74.6967%;\"\u003e\n \u003cp\u003eTetramethyl-xylylendiurethane\u0026nbsp;dimethacrylate\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25.3033%;\"\u003e\n \u003cp\u003eAS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74.6967%;\"\u003e\n \u003cp\u003eArtificial saliva\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25.3033%;\"\u003e\n \u003cp\u003eb*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74.6967%;\"\u003e\n \u003cp\u003eColour along the yellow and blue dimension\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25.3033%;\"\u003e\n \u003cp\u003eBI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74.6967%;\"\u003e\n \u003cp\u003eBeautifil II LS\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25.3033%;\"\u003e\n \u003cp\u003eBis-GMA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74.6967%;\"\u003e\n \u003cp\u003eBisphenol-a glycidyl methacrylate\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25.3033%;\"\u003e\n \u003cp\u003eBis-MPEPP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74.6967%;\"\u003e\n \u003cp\u003e2,2-bis (4-methacryloxypolyethoxyphenyl) propane\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25.3033%;\"\u003e\n \u003cp\u003eCIE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74.6967%;\"\u003e\n \u003cp\u003eCommission Internationale Del\u0026rsquo;eclairege\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25.3033%;\"\u003e\n \u003cp\u003eCN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74.6967%;\"\u003e\n \u003cp\u003eCention-N\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25.3033%;\"\u003e\n \u003cp\u003eCR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74.6967%;\"\u003e\n \u003cp\u003eComposite resin\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25.3033%;\"\u003e\n \u003cp\u003eDC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74.6967%;\"\u003e\n \u003cp\u003eTricyclodecan-dimethanol dimethacrylate\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25.3033%;\"\u003e\n \u003cp\u003eF-PRG\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74.6967%;\"\u003e\n \u003cp\u003eFull pre-reacted glass ionomer\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25.3033%;\"\u003e\n \u003cp\u003eGIC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74.6967%;\"\u003e\n \u003cp\u003eGlass ionomer cement\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25.3033%;\"\u003e\n \u003cp\u003eHEMA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74.6967%;\"\u003e\n \u003cp\u003e2-hydroxyethyl methacrylate\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25.3033%;\"\u003e\n \u003cp\u003eHVGIC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74.6967%;\"\u003e\n \u003cp\u003eHigh viscosity glass ionomer cement\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25.3033%;\"\u003e\n \u003cp\u003eIRM\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74.6967%;\"\u003e\n \u003cp\u003eIon-releasing restorative material\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25.3033%;\"\u003e\n \u003cp\u003eISO\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74.6967%;\"\u003e\n \u003cp\u003eInternational Standarisation Organisation\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25.3033%;\"\u003e\n \u003cp\u003eL*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74.6967%;\"\u003e\n \u003cp\u003eLightness from black to white\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25.3033%;\"\u003e\n \u003cp\u003eLC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74.6967%;\"\u003e\n \u003cp\u003eLight cure\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25.3033%;\"\u003e\n \u003cp\u003eLED\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74.6967%;\"\u003e\n \u003cp\u003eLight-emitting diode\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25.3033%;\"\u003e\n \u003cp\u003eLN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74.6967%;\"\u003e\n \u003cp\u003eLuna\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25.3033%;\"\u003e\n \u003cp\u003ePEG-400 DMA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74.6967%;\"\u003e\n \u003cp\u003ePolyethylene\u0026nbsp;glycol\u0026nbsp;400\u0026nbsp;dimethacrylate\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25.3033%;\"\u003e\n \u003cp\u003ePN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74.6967%;\"\u003e\n \u003cp\u003ePola Night\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25.3033%;\"\u003e\n \u003cp\u003ePR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74.6967%;\"\u003e\n \u003cp\u003ePola Rapid\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25.3033%;\"\u003e\n \u003cp\u003eRMGIC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74.6967%;\"\u003e\n \u003cp\u003eResin-modified glass ionomer cement\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25.3033%;\"\u003e\n \u003cp\u003eRV\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74.6967%;\"\u003e\n \u003cp\u003eRiva light cure HVGIC\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25.3033%;\"\u003e\n \u003cp\u003eS-PRG\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74.6967%;\"\u003e\n \u003cp\u003eSurface pre-reacted glass ionomer\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25.3033%;\"\u003e\n \u003cp\u003eSubscript 0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74.6967%;\"\u003e\n \u003cp\u003eThe measurement value at baseline (T0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25.3033%;\"\u003e\n \u003cp\u003eSubscript i\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74.6967%;\"\u003e\n \u003cp\u003eThe measurement value at 24 hours (T1), two weeks (T2), and one month (T3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25.3033%;\"\u003e\n \u003cp\u003eT0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74.6967%;\"\u003e\n \u003cp\u003eBefore bleaching at baseline\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25.3033%;\"\u003e\n \u003cp\u003eT1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74.6967%;\"\u003e\n \u003cp\u003e24 hours after bleaching\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25.3033%;\"\u003e\n \u003cp\u003eT2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74.6967%;\"\u003e\n \u003cp\u003eTwo weeks after bleaching\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25.3033%;\"\u003e\n \u003cp\u003eT3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74.6967%;\"\u003e\n \u003cp\u003eOne month after bleaching\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25.3033%;\"\u003e\n \u003cp\u003eTEGDMA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74.6967%;\"\u003e\n \u003cp\u003eTriethylene glycol dimethacrylate\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25.3033%;\"\u003e\n \u003cp\u003eUDMA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74.6967%;\"\u003e\n \u003cp\u003eUrethane dimethacrylate\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25.3033%;\"\u003e\n \u003cp\u003e\u0026Delta;a*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74.6967%;\"\u003e\n \u003cp\u003eChange in the colour along the red and green dimension\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25.3033%;\"\u003e\n \u003cp\u003e\u0026Delta;b*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74.6967%;\"\u003e\n \u003cp\u003eChange in the colour along the yellow and blue dimension\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25.3033%;\"\u003e\n \u003cp\u003e\u0026Delta;E*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74.6967%;\"\u003e\n \u003cp\u003eColour change\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25.3033%;\"\u003e\n \u003cp\u003e\u0026Delta;E\u003csub\u003e00\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74.6967%;\"\u003e\n \u003cp\u003eCIEDE2000 colour-difference formula\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 25.3033%;\"\u003e\n \u003cp\u003e\u0026Delta;L*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74.6967%;\"\u003e\n \u003cp\u003eChange in the lightness\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eDisclosure and Acknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research was funded by the Dental Postgraduate Research Grant (DPRG 01/24) from the Faculty of Dentistry, Universiti Malaya. The authors wish to express their appreciation to SDI Limited (Bayswater, Australia) and Shofu Inc. (Kyoto, Japan) by providing materials, and to Dr. Alias Abdul Aziz for providing statistical support.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics Approval and Consent to Participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for Publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research was funded by the Dental Postgraduate Research Grant (DPRG 01/24) from the Faculty of Dentistry, Universiti Malaya. Additionally, materials were sponsored by SDI Limited (Bayswater, Australia) and Shofu Inc. (Kyoto, Japan).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eLJS was responsible for carrying out the research, analysing the data, and writing the manuscript. NAY, AAA, and AUJ designing and supervised the project, provided guidance throughout, and reviewed the manuscript. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors acknowledge all the staff of the Biomaterials Research Laboratory, Faculty of Dentistry, Universiti Malaya, for their support, and thank Dr Alias bin Abdul Aziz for providing statistical assistance.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eDemarco FF, Collares K, Coelho-de-Souza FH, Correa MB, Cenci MS, Moraes RR, Opdam NJ. Anterior composite restorations: A systematic review on long-term survival and reasons for failure. 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J Dent. 2011. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.jdent.2011.09.007\u003c/span\u003e\u003cspan address=\"10.1016/j.jdent.2011.09.007\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJoiner A. Tooth color: a review of the literature. J Dent. 2004. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.jdent.2003.10.013\u003c/span\u003e\u003cspan address=\"10.1016/j.jdent.2003.10.013\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-oral-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ohea","sideBox":"Learn more about [BMC Oral Health](http://bmcoralhealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/ohea/default.aspx","title":"BMC Oral Health","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Ion-releasing restoratives, tooth bleaching agents, spectrophotometry, CIE-Lab, color stability","lastPublishedDoi":"10.21203/rs.3.rs-6589441/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6589441/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eContemporary ion-releasing restoratives have been developed to prevent secondary caries while maintaining the mechanical strength and esthetic qualities of conventional composite resins. Dental bleaching procedures may affect the physical properties of restorations. This study aimed to evaluate the effect of bleaching agents on the color stability of these ion-releasing restoratives.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eForty-five disc-shaped specimens of Activa Bioactive, Beautifil II LS, Cention-N, Riva LC HVGIC, and Luna were fabricated using customised cylindrical teflon molds. Baseline CIE-Lab color measurements were recorded using a spectrophotometer. Specimens were assigned to three subgroups (n\u0026thinsp;=\u0026thinsp;15) and exposed to take-home bleaching (Pola Night), in-office bleaching (Pola Rapid), or artificial saliva (control) per manufacturers\u0026rsquo; protocols. Color measurements were repeated at 24 hours (T1), two weeks (T2), and one month (T3), with color change (ΔE*) calculated. Data were analyzed using two-way ANOVA, two-way repeated measures ANOVA and post-hoc tests (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eΔL* ranged from \u0026minus;\u0026thinsp;0.02\u0026thinsp;\u0026plusmn;\u0026thinsp;1.23 to 4.94\u0026thinsp;\u0026plusmn;\u0026thinsp;1.37; Δa* from \u0026minus;\u0026thinsp;0.31\u0026thinsp;\u0026plusmn;\u0026thinsp;0.12 to 0.65\u0026thinsp;\u0026plusmn;\u0026thinsp;0.13; Δb* from \u0026minus;\u0026thinsp;3.08\u0026thinsp;\u0026plusmn;\u0026thinsp;1.24 to 0.31\u0026thinsp;\u0026plusmn;\u0026thinsp;0.86; and ΔE* from 0.94\u0026thinsp;\u0026plusmn;\u0026thinsp;0.48 to 5.99\u0026thinsp;\u0026plusmn;\u0026thinsp;1.33. At T1, Riva LC HVGIC showed the highest ΔE*, while Luna had the least. Both bleaching products had similar effects on ΔE*. Activa Bioactive\u0026rsquo;s ΔE* increased significantly from T1 to T3, reaching the highest value at T3.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eThe impact of bleaching on ion-releasing restoratives\u0026rsquo; color stability was material-dependent.\u003c/p\u003e","manuscriptTitle":"The Effects of Bleaching Products on the Color Stability of Ion-releasing Restoratives","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-06-02 17:43:05","doi":"10.21203/rs.3.rs-6589441/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-06-16T11:41:01+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-06-14T15:58:33+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-06-04T10:43:19+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"89885585319723660643346102558643786056","date":"2025-06-03T05:30:42+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"58933172445479740457226308241275718212","date":"2025-06-01T01:48:02+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"109959198627561412818701664669962373168","date":"2025-05-31T08:38:53+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-05-30T14:58:53+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"173250933426069448676559922631123983477","date":"2025-05-29T15:27:56+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-05-29T08:02:14+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-05-15T15:59:23+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-05-15T14:05:38+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-05-15T14:02:42+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Oral Health","date":"2025-05-04T16:34:12+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-oral-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ohea","sideBox":"Learn more about [BMC Oral Health](http://bmcoralhealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/ohea/default.aspx","title":"BMC Oral Health","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"d1bf62d7-dbc2-4ca0-8950-695062695836","owner":[],"postedDate":"June 2nd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-11-10T16:00:16+00:00","versionOfRecord":{"articleIdentity":"rs-6589441","link":"https://doi.org/10.1186/s12903-025-06681-0","journal":{"identity":"bmc-oral-health","isVorOnly":false,"title":"BMC Oral Health"},"publishedOn":"2025-11-05 15:57:19","publishedOnDateReadable":"November 5th, 2025"},"versionCreatedAt":"2025-06-02 17:43:05","video":"","vorDoi":"10.1186/s12903-025-06681-0","vorDoiUrl":"https://doi.org/10.1186/s12903-025-06681-0","workflowStages":[]},"version":"v1","identity":"rs-6589441","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6589441","identity":"rs-6589441","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}