Background: There is limited information about colour change following traumatic dental injuries (TDI), and any variable associated with discolouration. It is now increasingly recognised that children’s perception and satisfaction are important and may provide an insight into the psychosocial impact of their oral health and their wider quality of life. Therefore, research to quantify colour change with time following TDI and the patient’s perception is important. This study was designed to identify any association between clinical variables and discolouration following TDI.
Aim: To investigate the change in colour of permanent teeth following TDI in children. To explore what variables are associated with discolouration. To examine methods of measuring colour change including IKAM system (objective measure), the use of a shade guide (clinical pseudo objective measure), patient’s perception (patient reported measure) and to evaluate the agreement between these three methodologies.
Method: Children following TDI were invited to participate in an observational prospective cohort. Colour change was measured using patients’ perception, investigator’s perception (using a shade guide) and an objective digital system (IKAM). Measurements were taken at baseline, 3 months and 6 months following the TDI with IKAM providing objective CIELAB colour scores.
Results: Thirty-nine children, with 73 traumatised teeth, completed the study. Twenty-six children attended two follow-up reviews comprising 52 teeth, and thirteen children attended for one follow-up visit only with 21 teeth. A heterogenous sample of TDI was recruited including various types of hard tissue injuries and periodontal injuries with variable pulpal survival and periodontal healing outcomes.
At the last review (n=73 teeth) the objective overall colour change was ΔE 5.45 (SD +/- 2.80) with a mean change in ΔL* 0.74 (lighter), Δa* 0.69 (redder) and Δb* 1.73 (yellower). There was little consistency between patients reported colour change and that recorded by the investigator using a shade guide.
There was no significant difference in ΔE values as measured by IKAM in comparison with the patients’ or investigator’s perception.
Conclusions: Following TDI, there was an observable colour change identified by an objective measure, IKAM. On average, teeth got predominantly yellow and to a lesser extent lighter and redder. Patients and investigator measures were inconsistent when compared to the objective measure (IKAM). No variables were identified to be associated with colour change. However several variables came to significance (p<0.05). These variables were; time interval between the baseline assessment and the final review, presence of hard tissue injury, splinting, and restoration placed at or before baseline
