Analysis of the color alteration and radiopacity promoted by bismuth oxide in calcium silicate cement

The aim of the study was to determine if the increase in radiopacity provided by bismuth oxide is related to the color alteration of calcium silicate-based cement. Calcium silicate cement (CSC) was mixed with 0%, 15%, 20%, 30% and 50% of bismuth oxide (BO), determined by weight. Mineral trioxide aggregate (MTA) was the control group. The radiopacity test was performed according to ISO 6876/2001. The color was evaluated using the CIE system. The assessments were performed after 24 hours, 7 and 30 days of setting time, using a spectrophotometer to obtain the δE, δa, δb and δL values. The statistical analyses were performed using the Kruskal-Wallis/Dunn and ANOVA/ Tukey tests (p < 0.05). The cements in which bismuth oxide was added showed radiopacity corresponding to the ISO recommendations ( > 3 mm equivalent of Al). The MTA group was statistically similar to the CSC/30% BO group (p > 0.05). In regard to color, the increase of bismuth oxide resulted in a decrease in the δE value of the calcium silicate cement. The CSC group presented statistically higher δE values than the CSC/50% BO group (p < 0.05). The comparison between 24 hours and 7 days showed higher δE for the MTA group, with statistical differences for the CSC/15% BO and CSC/50% BO groups (p < 0.05). After 30 days, CSC showed statistically higher δE values than CSC/30% BO and CSC/50% BO (p < 0.05). In conclusion, the increase in radiopacity provided by bismuth oxide has no relation to the color alteration of calcium silicate-based cements.