The effect of prophylaxis paste and air-powder polishing on color stability and surface roughness of different composite resins

Turan Emre Kuzu; Ozcan Karatas

doi:10.4103/jorr.jorr_14_22

ORIGINAL ARTICLE

Year : 2023 | Volume : 15 | Issue : 1 | Page : 34-39

The effect of prophylaxis paste and air-powder polishing on color stability and surface roughness of different composite resins

Turan Emre Kuzu¹, Ozcan Karatas²
¹ Department of Periodontology, Nuh Naci Yazgan University, Kayseri, Turkey
² Department of Restorative Dentistry, Nuh Naci Yazgan University, Kayseri, Turkey

Date of Submission	06-Apr-2022
Date of Decision	08-Aug-2022
Date of Acceptance	17-Aug-2022
Date of Web Publication	29-Dec-2022

Correspondence Address:
Ozcan Karatas
Departments of Restorative Dentistry, Nuh Naci Yazgan University, Kayseri
Turkey

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/jorr.jorr_14_22

Abstract

Aim: This study examined the impact of periodontal prophylaxis paste and air-powder treatment on nano- and microhybrid composite resin surface roughness and color change.
Materials and Methods: Thirty specimens were prepared from a nanohybrid and a microhybrid composite resin. The specimens were distinct into three subgroups, and the first color measurements were done. Then, a periodontal prophylaxis paste was applied to one of the subgroups prepared from each composite, and air-powder polishing was applied to the second subgroups, and specimens in the third subgroup were kept in distilled water. Then, the specimens were washed and stored in distilled water for 24 h. After storing, the specimens' mean color change and surface roughness values were calculated. The data were recorded and statistically analyzed.
Results: The highest mean color change was observed in the microhybrid composite air-powder group while the lowest in the nanohybrid composite control group. The surface roughness of the air-powder specimens was statistically significantly higher than in the other groups.
Conclusions: Depending on the kind of composite resin, periodontal surface treatments may have an impact on color and surface roughness. After periodontal therapy, the dentist should assess the current composite resin restorations.

Keywords: Air-powder polishing, color change, composite resin, periodontal paste, surface roughness

How to cite this article:
Kuzu TE, Karatas O. The effect of prophylaxis paste and air-powder polishing on color stability and surface roughness of different composite resins. J Oral Res Rev 2023;15:34-9

How to cite this URL:
Kuzu TE, Karatas O. The effect of prophylaxis paste and air-powder polishing on color stability and surface roughness of different composite resins. J Oral Res Rev [serial online] 2023 [cited 2023 May 31];15:34-9. Available from: https://www.jorr.org/text.asp?2023/15/1/34/365914

Introduction

One of the most important purposes of periodontal treatment is to ensure an acceptable root surface with the preservation of healthy tissues.^[1] One of the fundamentals of ensuring and maintaining optimal health is the removal of bacteria and its products from the surface of hypomineralized enamel and cement tissue. Today, for removal and curettage procedures, hand tools, sonic and ultrasonic devices, laser, and chemical agents are used.^[2] Conventionally, following the scraping and root straightening processes, different prophylaxis paste applications are performed with prophylaxis paste and air-powder polishing systems. The primary purpose of the prophylaxis paste application is to achieve a smooth surface and eliminate extrinsic colorations.^[3],[4]

Due to the increased esthetic expectations in dental treatments, the demand for anterior region esthetic composite resin restoration applications has increased in recent years. Advances in composite resins have enabled the production of restorative materials with tooth color and sufficient mechanical properties.^[5] Microhybrid composite resins are frequently used in restorative treatment because of their high mechanical, physical, and optical properties and good color compatibility. These composites, which meet esthetic expectations with their good polishability properties, are preferred in restorations where mechanics and esthetics such as laminate, diastema closure, fracture treatment, and Class V restorations are important.^[6] Nanohybrid composites, which have been developed in recent years and have very high polishability and translucency properties with nanoparticle contents, have been an important step for esthetic restorations. Although these composites have weaker physical and mechanical properties than microhybrid composites, they are preferred with their esthetic properties in anterior region restorations where chewing strength is not very high.^[7]

Two important parameters in preserving the esthetic feature of composite restorations are color stability and surface roughness.^[8] Extensive coloration that may occur in composite resins as a result of exposure to different foods and beverages in the mouth will distort tooth restoration color harmony over time and lead to patient dissatisfaction.^[9] One reason for extrinsic coloration is surface roughness. The increased surface roughness with the exposure of restoration to different abrasive factors will both decrease the durability of the restoration and disrupt the esthetic structure by creating reactive areas for the colorant molecules. As a result, when the surface polish of the composite increases, the surface roughness decreases, and the color stability increases.^[10]

The surface qualities of composite resin restorations may be impacted by surface treatments utilized during periodontal treatments, including prophylaxis paste and air-powder. To the best of our knowledge, the impact of periodontal surface treatments on the color and roughness of composite resin restorations has not been adequately studied in the literature. In light of this information, the purpose of this study is to look into how prophylaxis paste and air-powder polishing treatments affect the surface roughness and color stability of nano- and microhybrid composite resins. The null hypothesis is determined that prophylaxis paste and air-powder polishing do not affect the composite resins' color stability (1) and surface roughness (2).

Materials and Methods

Specimens preparation

Thirty disc-shaped specimens with a 10-mm diameter and 2-mm thickness were prepared from a microhybrid composite (Filtek Z250, 3M ESPE, St. Paul, MN, USA) and a nanohybrid composite resin (Filtek Z550, 3M ESPE, St. Paul, MN, USA). [Table 1] contains a list of the materials used in the study. Composite resins were placed in a Teflon mold, given top- and bottom-surface strip bands supported by a glass slide, and polymerized with a light-curing unit for (LCU, Valo LED, Ultradent Products, South Jordan, USA; 1000 mW/cm²) 20 s. In all specimens, one surface was marked on the round burs and it was determined as the upper surface of the disc. On the composite resin specimens, the LCU was kept in contact with the glass slide throughout the polymerization process. The power of the LCU was measured with a radiometer every ten specimens.

Table 1: Materials used in this study

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Color measurement

Specimens, whose polymerization was completed for each composite, were separated into three subgroups (n = 10), and the colors of the specimens in all groups were measured using a digital spectrophotometer (ShadePilot, Degudent, Hanau, Germany) and the commission internationale de l'éclairage (CIE) L*a*b* color coordinates. On a white background, measurements of color were performed. Then, equal amount of prophylaxis paste was used in groups, and these amounts were determined by weighing on a precision balance. The first group of specimens was prepared from each composite. The clinician did not apply extra force while applying the prophylaxis paste with polyurethane tire; only contact to disk specimens with the weight of the instrument was achieved. The air-powder (airflow) polishing system was applied to the specimens' upper surface in the second group. While using the air-powder polishing instrument (Nsk Prophy Mate Neo, Nakanishi Inc., Japan), it was kept at the perpendicular angle and distance of 1–1.5 cm to the applied disc surface. The rotation speed is determined as 1000 rpm. Prophylaxis paste and air-powder were applied to each specimen's top surface for 5 s in accordance with the literature.^[11] Then, the top surface of each specimen was marked and washed under water for 3 min and stored in distilled water at 37°C for 24 h. No surface treatment was applied to the third group of composite specimens (control groups). After 24 h, ΔE values were calculated by repeating the color measurements of the specimens with this formula:

ΔE = ([ΔL*]² + [Δa*]² + [Δb*]) ½.

The mean ΔE = 3.3 value was taken as a reference for clinically acceptable color change.

Surface roughness measurement and statistical analysis

Each composite resin specimen's upper surface roughness was determined after color assessment using three randomly chosen spots with the help of a contact mode profilometer with 5-μm radius diamond tip (Surtronic 25, Taylor Hobson, Leicester, UK) with a 0.25-mm cut-off value, a range of 100 μm, a transverse length of 1.25 mm, and at a 1 mm/s speed. Each composite resin specimen's mean surface roughness (Ra) values were computed.

The one-way ANOVA and Tukey multiple comparison tests were used to statistically analyze the surface roughness and color change data using the SPSS 20 software (SPSS Inc., Chicago, IL, USA). Using Q-Q graphs and the Shapiro–Wilk test, data normality was established.

Results

Significant differences between the mean color change values of the groups were observed after statistical analysis [Table 2] (P < 0.05). In comparison to microhybrid composite resin groups, the mean ΔE values of nanohybrid composite resin groups were lower [Table 3]. The nanohybrid composite control group had the lowest ΔE value, whereas the microhybrid composite air-powder group had the highest value. The air-powder groups showed higher ΔE values than the other groups in both composite resins [Figure 1].

Table 2: ANOVA test results of color change values of composite resins

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Table 3: Color change values of microhybrid and nanohybrid composite resin groups

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Figure 1: ΔE values of microhybrid and nanohybrid composite resin groups. Different letters indicate a statistically significant difference between the groups (P < 0.05)

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Different surface treatments were applied to various composite resin specimens; consequently, statistically significant differences were discovered between the groups' mean surface roughness values [Table 4] (P < 0.05). For both composite resins, the air-powder groups' mean surface roughness values were statistically substantially greater than those of the other groups (P < 0.05). In both composite resins, the prophylaxis paste groups' mean surface roughness values were higher than the control groups, and the microhybrid composite resin groups' mean surface roughness values were higher than the nanohybrid [Figure 2].

Table 4: ANOVA test results of surface roughness values of composite resins

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Figure 2: Ra values of microhybrid and nanohybrid composite resin groups. Different letters indicate a statistically significant difference between the groups (P < 0.05)

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Discussion

In dental restorations, color matching with the tooth and color stability properties are important factors that ensure composite resin restoration success and patient satisfaction.^[12] Prophylaxis paste and air-powder polishing treatments applied to provide oral hygiene of patients, to clean the dental stones, and to regulate the root surface may also be used to remove extrinsic tooth coloration and clean the composite resin restoration surfaces.^[13] This study looked at how these applications affected the surface qualities and color stability of composite resins. For this purpose, color elevation of the composite resin specimens was done with a spectrophotometer device, which gives simple and precise results and is often used in the literature, and the color values were recorded in CIE L* a* b* color system coordinates.^[14] It is reported in the literature that ΔE > 1 value in composite resins will cause a visible color change.^[15] Ruyter et al.^[16] found that the value of E = 3.3 was the limit of clinically acceptable color change.

In this study, the mean ΔE value was found above this value in all groups outside the nanohybrid composite resin control group. It was found that microhybrid composite resin groups had a higher mean color change. The color change of composite resin may change depending on factors such as resin matrix structure, monomer structure, amount and type of filler particles, water absorption, and degree of polymerization.^[17] In general, as the amount of filler particles of composite resin increases, its resistance to coloration increases.^[17] The nanohybrid composite (82 wt%) used in this study contains a higher amount of filler than microhybrid composite (75 wt%). In addition, nano-sized fillers in this composite structure are factors that increase resistance to coloration. The microhybrid composite used in this study contains triethylene glycol dimethacrylate (TEGDMA) molecule. It has been reported that composites containing TEGDMA molecules release more monomers into the environment and cause more coloration.^[18] In addition, water absorption of composite resin is an important factor that can lead to coloration.^[19]

The surface roughness of the composite resin specimens was raised by the prophylaxis paste and air-powder polishing method in this study. It is understood that as composite resins' roughness rises, water absorption increases.^[20] In this study, the specimens in the experimental group were treated on the surface and then kept in distilled water for a day. The fact that the mean ΔE value of the specimens in the experimental groups was higher than the control group may be related to water absorption. The first null hypothesis, which claimed that prophylaxis paste and air-powder polishing methods would not have an impact on the color stability of various composite resins, was rejected in light of these findings. In addition, the color pigment contents of the prophylaxis paste and powder used in air-powder may cause to increase the ΔE value of the composite specimens in this study.

In addition to water absorption, surface roughness also leads to the retention of plaque, bacteria, and colored pigments on the surface of the restoration. Long term, this has a negative impact on some physical and mechanical characteristics of the composite restoration. Consequently, a crucial factor in composite resin restoration is the surface smoothness.^[21] Studies have reported that a Ra <0.2 mm prevents plaque uptake on the composite resin surface.^[22] In this study, the mean Ra values were found above this value in all groups, and it was observed that the mean Ra values of the specimens prepared from nanohybrid composite were lower than those of microhybrid composite. It is emphasized in the literature that the smoothest surface will be obtained by placing strip tape on the surface during the preparation of the composite resin specimen.^[23] For this study, a strip tape was placed on the specimen surfaces prior to polymerization and no additional polishing was done. However, as a result, the mean Ra values in all groups, including the control groups, were above the acceptable limit. Smaller particle size (5–20 nm) and higher filler content of the nanohybrid composite used in the study were created smoother surfaces than the microhybrid composite (0.01–3.5 μm).

Subgingival and supragingival calculus cleaning and periodontal prophylactic procedures are very important for the protection of dental health.^[24] The periodontal prophylaxis paste and air-powder, which are frequently applied for this purpose, contain abrasive particles to remove dental plaque and calculus. It is reported in the literature that these particles break the surface properties by removing microparticles from the tooth surface.^[25],[26] The same condition is true if these procedures are applied to the composite resin restoration surface. Covey et al.^[26]found that periodontal prophylaxis pastes increased the surface roughness of composite resin restorations. The outcome of this research, similar to Covey et al.^[26] mean Ra values were found to be higher than the control groups. Kawamoto et al.^[27] also found that periodontal prophylaxis paste produced more surface roughness as their effectiveness in plaque removal increased. As the abrasive particle size increases, there is a greater risk of particle breakage from the composite resin surface. The air-powder polishing system we use in this study contains more abrasive particles than prophylaxis paste, and these particles impact the surface of the composite resin specimens. These systems, which are frequently used by periodontologists with their effectiveness for plaque and calculus removing from tooth surfaces and with the advantage of fast working, have a high abrasive effect.^[28] The air-powder groups' highest Ra values in this research for both composites may be explained by the high erosion effect of this system. Considering these results, the second null hypothesis that prophylaxis paste and air-powder polishing application will not change the composite resins' surface roughness was rejected. According to Neme et al.^[29] and Yap et al.,^[30] the structural characteristics of the resin may have an impact on how abrasive the periodontal prophylaxis processes are on the composite resin surface. As the filling content of the composite resin increases, the surface hardness increases, and the abrasive effect of the prophylaxis paste and air-powder decreases. In this study, compared to the control group, periodontal surface treatments raised the surface roughness of the nanohybrid composite less than the microhybrid composite.

Conclusions

Within the constraints of this investigation, air-powder polishing and periodontal prophylaxis paste may have an impact on the color stability and surface smoothness of composite resins. The structural characteristics of the resin and the abrasive nature of the substance employed in the prophylaxis process may affect this to a different extent. The clinician should evaluate the color change of the composite resin restorations after periodontal prophylactic procedures, restore the surface roughness, and ensure color stability by applying polishing to the restorations in the relevant teeth.

Ethical statement

Ethics committee approval was not required because the study contained in vitro material.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

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