Effect of Pediatric Liquid Dietary Supplements on the Color Stability of Restorative Materials: An In Vitro Factorial Study

Abstract

Objective: This in vitro study evaluated the time-dependent color stability of three restorative materials commonly used in pediatric dentistry following cyclic exposure to frequently consumed pediatric dietary supplements.Methods: A 3×6 factorial design was applied using three restorative materials (glass hybrid, compomer, and nanohybrid resin composite) and six immersion solutions (distilled water, multivitamin, iron, zinc, omega-3, and elderberry-based supplement), resulting in 18 groups (n = 10).Specimens underwent a 7-day accelerated cyclic immersion protocol (10 minutes/day at 37 °C). Color measurements were recorded at baseline (T0) and after 1, 3, and 7 days using a digital spectrophotometer. Color differences were calculated with the CIEDE2000 (ΔE₀₀) formula. Data were analyzed using two-way ANOVA and Friedman tests (α = .05) and interpreted according to established perceptibility (0.8) and acceptability (1.8) thresholds.Results: Significant material–solution interactions were detected at all time points (p < 0.001). At T7, clinically unacceptable discoloration (ΔE₀₀ ≥ 1.8) was observed in several combinations, particularly nanohybrid composite–multivitamin (3.095), nanohybrid composite–elderberry (2.555), compomer–omega-3 (2.097), and glass hybrid–zinc (1.941). No material demonstrated consistent resistance across all supplements.Discoloration patterns showed exposure-specific and non-linear progression over time.Conclusion: Pediatric dietary supplements influence restorative color stability in a material – and solution-dependent manner. Pigment-rich multivitamin and elderberry formulations posed the greatest esthetic risk, highlighting the importance of considering supplement use when selecting restorative materials in pediatric patients.