The effects of Ledermix paste on discolouration of immature teeth

Aim: The aims of this study were to: (i) investigate the effects of Ledermix paste as an intracanal medicament on discolouration of immature teeth, (ii) examine whether the discolouring effects were related to the method of application, (iii) examine the effects of sunlight upon discolouration of immature teeth and (iv) compare the degree of discolouration between mature and immature teeth. Methodology: The root canals of 45 immature extracted human teeth were prepared and filled with either Ledermix paste, calcium hydroxide [Ca(OH)₂], or saline. In group 1, Ledermix paste was only placed apical to the cemento-enamel junction (CEJ) whilst in groups 2 and 3, the paste filled the entire pulp chamber and the root canals. In group 4, Ca(OH)₂ paste and in group 5, saline (control) were allowed to fill the pulp chamber and the root canals. Group 3 teeth were kept in the dark and the other groups were exposed to daylight for 12 weeks. Results: After 12 weeks, sunlight exposure had caused dark grey-brown staining in the Ledermix groups but this did not occur when the teeth were kept in the dark. More severe staining was noted when Ledermix paste filled the pulp chamber than when the paste was restricted to below the CEJ and when teeth were exposed to sunlight. When compared to the results of a similar study using mature teeth, the results were similar but the immature teeth were more severely stained than the mature teeth. The Ca(OH)₂ paste caused an increase in lightness and yellowness in immature teeth. Conclusion: It was concluded that Ledermix paste may cause discolouration of immature teeth. Such effects can be minimized if placement of the paste is restricted to below the gingival margin. Clinicians should ensure that Ledermix paste is not left on the walls of access cavities, especially in immature teeth.