In Vitro Efficacy of Sodium Bicarbonate Powder and Pumice Flour for Removal of Iron Induced Pigmentations

Background and Aim: Management of iron-induced tooth pigmentation is challenging. This study aimed to compare the efficacy of sodium bicarbonate powder and pumice flour for removal of iron-induced pigmentation from primary anterior teeth. Materials and Methods: In this in vitro, experimental study, 60 sound primary anterior teeth were collected. After cutting the roots and sealing the pulp chamber with composite resin, all teeth were coated with acid gel for 30 s and then immersed in 250 cc of ferrous sulfate iron drop for 48 h to induce iron discoloration. Afterwards, the teeth were randomly divided into two experimental groups (n=30). In group A, discolored teeth were cleaned with pumice/water slurry. Samples in group B were cleaned similarly for 30 s using sodium bicarbonate/water slurry. The shade of all teeth was evaluated at baseline, after inducing iron staining and following stain removal using Vita Easy Shade spectrophotometer. The data were analyzed using Kolmogorov-Smirnov test, t-test and ANCOVA. P<0.05 was considered statistically significant. Results: All teeth showed color improvement following the cleaning procedures. However, teeth in pumice group showed a significantly greater mean ΔE2 value compared with sodium bicarbonate, representing more efficient stain removal (P=0.926 for L, P=0.162 for a*, P=0.980 for b*). Conclusion: Both sodium bicarbonate and pumice were effective for tooth stain removal, although pumice powder showed significantly higher efficacy.