Guided biofilm therapy versus conventional protocol-clinical outcomes in non-surgical periodontal therapy.

BACKGROUND: The aim of the randomized controlled clinical trial study was to evaluate the effectiveness in reducing pathologically increased pocket probing depths (PPD > 3 mm) using the Guided Biofilm Therapy (GBT) protocol (adapted to the clinical conditions in non-surgical periodontal therapy (NSPT): staining, air-polishing, ultrasonic scaler, air-polishing) compared to conventional instrumentation (staining, hand curettes/sonic scaler, polishing with rotary instruments) both by less experienced practitioners (dental students). METHODS: All patients were treated according to a split-mouth design under supervision as diseased teeth of quadrants I/III and II/IV randomly assigned to GBT or conventional treatment. In addition to the treatment time, periodontal parameters such as PPD and bleeding on probing (BOP) before NSPT (T0) and after NSPT (T1: 5 ± 2 months after T0) were documented by two calibrated and blinded examiners (Ethics vote/ Trial-register: Kiel-D509-18/ DRKS00026041). RESULTS: Data of 60 patients were analyzed (stage III/IV: n = 36/ n = 24; grade A/ B/ C: n = 1/ n = 31/ n = 28). At T1, a PPD reduction of all diseased tooth surfaces was observed in 57.0% of the GBT group and 58.7% of the control group (p = 0.067). The target endpoint (PPD ≤ 4 mm without BOP) was achieved in 11.5% for GBT (conventional treatment: 11.2%; p = 0.714). With the exception for number of sites with BOP, which was at T1 15.9% in the GBT group and 14.3% in the control group (p < 0.05) no significant differences between the outcomes of the study were found. At 30.3(28.3) min, the treatment time was significantly shorter in GBT than in the control group at 34.6(24.5) min (p < 0.001). CONCLUSIONS: With both protocols (GBT/ conventional instrumentation) comparably good clinical treatment results can be achieve in NSPT in stage III-IV periodontitis patients. TRIAL REGISTRATION: The study was registered before the start of the study and can be found under the number DRKS00026041 in the German Clinical Trials Register. The registration date was 19/08/2021.

Surface smoothness of resin composites after polishing-A systematic review and network meta-analysis of in vitro studies.

A systematic review and network meta-analysis was performed to provide evidence for the best polishing protocol for different types of resin composites to minimize surface roughness. A search was performed in PubMed, Scopus, Web of Science, LILACS, BBO, EMBASE, and Cochrane Library on July 2, 2019 (updated in December, 2020). In vitro studies that included at least two systems for polishing resin composites and analyzed surface roughness were included. The risk of bias was evaluated. A random-effects Bayesian-mixed treatment comparison model was used to compare surface roughness in resin composites with the different types of polishers. Surface under the cumulative ranking curve (SUCRA) analysis was performed to rank the probability for the best polishing system. After removal of duplicates, title and abstract screening yielded 34 studies. Network meta-analysis was not possible for hybrid and microhybrid composites. SUCRA analysis showed that abrasive paper discs allowed greater surface smoothness for nanohybrid and nanofill composites to a probability of between 83% and 91.6%. Silicon carbide brush had a 78.2% probability of being the best system for microfill composites. The use of abrasive paper disc polishers showed a favorable result in nanofill and nanohybrid resin composites. Silicon carbide brush has a greater chance of promoting a smoother surface for microfill resin composites.

Evaluation of enamel roughness after orthodontic debonding and clean-up procedures using zirconia, tungsten carbide, and white stone burs: an in vitro study.

BACKGROUND: The main goal of orthodontic debonding is to restore the enamel surface as closely as possible to its pretreatment condition without iatrogenic damage. This study aimed to compare the effects of different adhesive removal burs; zirconia burs, tungsten carbide burs, and white stone burs on enamel surface roughness. MATERIALS AND METHODS: Total sample of 72 extracted premolars was randomly divided into three equal groups (n = 24) depending on the method of adhesive removal: zirconia burs (ZB); tungsten carbide burs (TC); and white stones (WS). The metal brackets were bonded using Transbond XT orthodontic adhesive (3 M Unitek, Monrovia, CA, USA) and debonded after 24 h using a debonding plier, then the ARI was assessed. The adhesive remnants were removed using the different burs and Final polishing was performed using Sof-lex discs and spirals. Thirteen samples from each group were evaluated using a Mitutoyo SJ-210 profilometer to determine average surface roughness (Ra) and three samples from each group were examined under Scanning Electron Microscopy (SEM) to determine EDI score. The evaluations were performed at three time points; before bonding (T0), after adhesive removal (T1) and after polishing (T2) and the time consumed for adhesive removal by burs was recorded in seconds. The data were analyzed statistically by ANOVA, Tukey's test and Kruskal-Wallis H-test. RESULTS: Kruskal-Wallis H-test showed no statistically significant difference of ARI in all studied groups (p = 0.845) and two-way mixed ANOVA revealed that all burs significantly increased surface roughness at T1 compared to T0 (p < 0.001) in all groups with the lowest Ra values were observed in the ZB group, followed by the TC group, and WS group. The fastest procedure was performed with WS, followed by ZB, then TC bur (p < 0.001). After polishing (T2), Ra values showed no significant difference in ZB group (P = 0.428) and TC group (P = 1.000) as compared to T0, while it was significant in WS group (p < 0.001). CONCLUSION: zirconia bur was comparable to tungsten carbide bur and can be considered as alternative to white stone which caused severe enamel damage. The polishing step created smoother surface regardless of the bur used for resin removal.

Spectrophotometric assessment of the color stability of composite resins polished with different techniques.

This study aimed to use spectrophotometry to assess the color stability of composite resins polished with different polishing techniques and scanning electron microscopy (SEM) to evaluate the surface micromorphology of the specimens. In this in vitro experimental study, a total of 96 disc-shaped specimens were fabricated from microfilled (Renamel Microfill, shade SB3) and nanohybrid (Estelite Sigma Quick, shade BW) composite resins in bright white shades (n = 48). Each group was randomized into 1 control and 2 experimental subgroups (n = 16): no polishing (control), polishing with aluminum oxide discs (experimental), or polishing with diamond-impregnated spiral wheels (experimental). In each subgroup, half of the specimens were immersed in a coffee solution and the other half in a tea solution for 48 hours after finishing (control) or polishing (experimental). Spectrophotometry was used to measure the color of the specimens at baseline, after finishing, after polishing (experimental groups only), and after immersion in tea and coffee. The surface micromorphology of a randomly selected specimen from each subgroup was assessed under SEM. The color change (ΔE*) of the specimens between measurements was calculated and analyzed using 1-way, 2-way, and 3-way analyses of variance (ANOVAs) and the Tukey test. Both tea and coffee caused significant color change in the composite resin specimens, with specimens immersed in coffee undergoing significantly greater color change than those immersed in tea (P < 0.001; 2-way ANOVA). The nanohybrid composite specimens polished with polishing discs had a significantly greater color change than nanohybrid specimens polished with spiral wheels (P = 0.041). The Tukey test revealed that there was no overall significant difference between the 2 polishing techniques (P = 0.505), but both of these subgroups exhibited a significantly lower color change than the control group (P < 0.001). In general, SEM did not reveal substantial differences between the 2 polishing techniques, but specimens polished by spiral wheels appeared to have a smoother surface. All polished specimens demonstrated clinically acceptable mean color change values (ΔE* < 3.5). The type of coloring agent had a greater effect on color stability than either the polishing technique or type of composite resin, with coffee causing a greater color change than tea.

Ceramic versus Composite Resin Polishing Systems on the Surface Roughness of Milled Leucite-Reinforced Ceramics.

Background and Objective: This study aimed to compare the surface finish of milled leucite-reinforced ceramics polished with ceramic and composite polishing systems based on the manufacturers' recommendations. Materials and Methods: Sixty subtractive computer-aided manufactured (s-CAM) leucite-reinforced glass-ceramic specimens (IPS-Empress-CAD) were assigned into six groups: no polishing, a ceramic polishing kit, and four composite kit groups. The roughness average (Ra) was evaluated in microns using a profilometer, and scanning electron micrographs were obtained for qualitative analysis. A Tukey HSD posthoc test (α = 0.05) was used to determine significant intergroup differences. Results: After surface evaluation of the ceramics, the Ra values of the polishing systems ranked OptraFine (0.41 ± 0.26) < Enhance (1.60 ± 0.54) < Shofu (2.14 ± 0.44) < Astropol (4.05 ± 0.72) < DiaComp (5.66 ± 0.62) < No Polishing (5.66 ± 0.74). Discussion: Composite polishing systems did not provide as smooth surfaces as the ceramic polishing kit for CAD-CAM leucite-reinforced ceramics. Thus, using ceramic polishing systems, polishing leucite ceramics is recommended, whereas composite polishing systems should not be considered as an alternative for use in minimally invasive dentistry.

Knowledge and practice of dentists in processing polishing points: A cross-sectional study.

BACKGROUND: Adequately processing polishing points used to polish composite resin restorations is necessary for microbiological control in dentistry, but there is no specific protocol to guide professionals. Therefore, this study aimed to assess the knowledge and practice of dentists in processing these instruments. METHODS: This cross-sectional observational study included the application of an online questionnaire via Google Forms and social media promotion. The study evaluated the association of field of activity, time since graduation, age, and sex of professionals with processing practice. The statistical analysis was performed with absolute and relative frequencies and logistic and Poisson regressions at a 5% significance level. RESULTS: Overall, 473 questionnaires were analyzed. A rate of 51% of professionals reported using inadequate processing methods, and almost 68% claimed to have good knowledge of the topic. Both regression analyses were significantly associated, showing a direct effect of age and time since graduation on adequate processing practices. CONCLUSIONS: Although most professionals reported understanding the processing of polishing points, they do not perform it most adequately. CLINICAL SIGNIFICANCE: An expressive number of dentists process polishing points improperly. The topic is significant for representing a semi-critical instrument extensively used in esthetic restorations.

The effect of contemporary finishing and polishing systems on the surface roughness of bulk fill resin composite and nanocomposites.

OBJECTIVE: To evaluate the effects of various finishing and polishing (F/P) systems regarding the surface roughness (Ra ) value of two nanocomposites and a bulk fill resin composite. METHODS AND MATERIALS: Three resin composites (Filtek Z550, Filtek Ultimate Body, Filtek Bulk Fill Posterior) were tested. Forty disk-shaped specimens of each material were cured under Mylar strip and then randomly divided into four subgroups according to the F/P method (n = 10): Control, Sof-Lex Spiral Wheels, Astropol, and Clearfil Twist Dia. Ra values was measured and the surfaces were examined under scanning electron microscope. The data were analyzed by generalized linear models (p < 0.05). RESULTS: The Filtek Bulk Fill Posterior had the highest Ra value while Filtek Ultimate Body was the resin composite with the lowest roughness (p < 0.05). Considering the average Ra values after polishing, while the lowest Ra in all groups was obtained with the control group, the Clearfil Twist Dia showed similar Ra to the control group (p > 0.05). The samples polished with Sof-Lex Spiral Wheels had the highest Ra (p < 0.05). CONCLUSIONS: In addition to the resin composite type, the F/P technique greatly affected the Ra value of resin composite. The nanocomposites exhibited with the lowest Ra compared to the bulk fill resin composite after F/P. It was observed that the diamond containing-polishing system created smoother surfaces than the aluminum oxide containing- and silicon carbide containing-polishing systems. CLINICAL SIGNIFICANCE: In terms of Ra , the nanocomposites exhibited better performance than the bulk fill resin composites. Nowadays, newly developed polishing systems containing diamonds can be successful at a comparable level to existing polishing systems. For this reason, these systems are preferable for polishing both nanocomposites and bulk fill resin composites.

Surface roughness and oxygen inhibited layer control in bulk-fill and conventional nanohybrid resin composites with and without polishing: in vitro study.

BACKGROUND: It has been demonstrated that dental restorations with rough surfaces can have several disadvantages such as pigment retention or plaque accumulation, which can facilitate caries formation, color variation, loss of brightness, degradation of restoration, among others. The present study aimed to assess surface roughness in bulk fill and conventional nanohybrid resins with and without polishing, controlling the oxygen inhibited layer. METHODS: This in vitro and longitudinal experimental study consisted of 120 resin blocks of 6 mm diameter and 4 mm depth, divided into two groups: Bulk Fill (Tetric® N-Ceram Bulk-fill, Opus Bulk Fill APS, Filtek™ Bulk Fill) and conventional nanohybrid (Tetric® N-Ceram, Opallis EA2, Filtek™ Z250 XT). Each resin group was divided into two equal parts, placing glycerin only on one of them, in order to control the oxygen inhibited layer. Subsequently, the surface roughness was measured before and after the polishing procedure with Sof-Lex discs. The data were analyzed with the T-test for related measures, and for comparison between groups before and after polishing, the non-parametric Kruskal Wallis test with the Bonferroni post hoc was used, considering a significance level of p < 0.05. RESULTS: Before polishing, the resin composites with the lowest surface roughness were Opus Bulk Fill APS (0.383 ± 0.186 µm) and Opallis EA2 (0.430 ± 0. 177 µm) with and without oxygen inhibited layer control, respectively; while after polishing, those with the lowest surface roughness were Opus Bulk Fill APS (0.213 ± 0.214 µm) and Tetric N-Ceram (0.097 ± 0.099 µm), with and without oxygen inhibited layer control, respectively. Furthermore, before and after polishing, all resins significantly decreased their surface roughness (p < 0.05) except Opus Bulk Fill APS resin with oxygen inhibited layer control (p = 0.125). However, when comparing this decrease among all groups, no significant differences were observed (p < 0.05). CONCLUSION: The Opus Bulk Fill APS resin with oxygen inhibited layer control presented lower surface roughness both before and after polishing, being these values similar at both times. However, after polishing the other bulk fill and conventional nanohybrid resins with and without oxygen inhibited layer control, the surface roughness decreased significantly in all groups, being this decrease similar in all of them.

[Efficacy of combined application of glycine powder air-polishing in non-surgical treatment of peri-implant diseases].

OBJECTIVE: To compare the clinical efficacy of combined application of glycine powder air-polishing and mechanical submucosal debridement in non-surgical treatment of peri-implant diseases. METHODS: A randomized controlled clinical study was carried out on patients diagnosed with peri-implant diseases in the Department of Periodontology, Peking University School and Hospital of Stomatology, between May of 2020 and June of 2021.Twenty-eight patients with totally sixty-two implants were enrolled.The patients were randomly divided into the test group and control group. The patients in the test group (13 subjects/32 implants) received mechanical submucosal debridement using titanium curettes combined with application of glycine powder air-polishing, while the control group (15 subjects/30 implants) received mechanical submucosal debridement using titanium only. Clinical parameters, such as plaque index (PLI), pocket probing depth (PPD), bleeding index (BI) and the percentage of suppuration on probing on implants' level (SoP%) were measured at baseline and 8 weeks after non-surgical intervention. Changes and group differences of clinical parameters of the implants before and 8 weeks after non-surgical intervention were compared. RESULTS: Mean PLI, PPD, BI of both the test group and control group significantly reduced 8 weeks after non-surgical intervention (P < 0.05). Compared with the control group, the test group achieved lower BI (2.7±0.8 vs. 2.2±0.7, P < 0.05), more reduction of BI (0.6±0.7 vs. 1.1±0.6, P < 0.01) and more reduction of SoP% (21.9% vs. 10%, P < 0.05) after non-surgical intervention. Both the control and test groups exhibited comparable PLI and PPD reductions (P>0.05). For the implants diagnosed with peri-implant mucositis, the test group revealed more signi-ficant reduction in BI and SoP% than the control group (1.0±0.7 vs. 0.4±0.7, P=0.02; 6.3% vs. 0, P=0.012). There was no significant difference existing in PLI and PD improvement between the control group and test group (P>0.05). For the implants diagnosed with peri-implantitis, there was no significant difference existing in PLI, PPD, BI and SoP% improvement values between the test and control groups (P>0.05). No complications or discomforts were reported during the study. CONCLUSION: Both treatment procedures could relieve the inflammation of peri-implant soft tissue. Non-surgical mechanical submucosal debridement combined application of glycine powder air-polishing is associated with significant reduction of soft tissue bleeding and suppuration on probing especially in the implants diagnosed with peri-implant mucositis.

Do composite resin polishing systems damage enamel?

Finishing and polishing of composite resin restorations may cause damage to the bordering enamel. Although many studies have investigated the effect of polish on restorative materials, few have quantified the effect on bordering enamel. The objective of this study was to compare enamel loss surrounding composite restorations after finishing and polishing sequences. The null hypothesis was that there would be no difference in enamel loss between different finishing and polishing sequences. Class V preparations on the buccal and lingual surfaces of 15 extracted human molars were restored with a composite resin and assigned to 1 of 2 finishing and polishing sequences, so that each tooth underwent both sequences (n = 15 per sequence). In sequence 1, a tungsten carbide finishing bur and aluminum oxide polishing discs were used; in sequence 2, a diamond finishing bur, aluminum oxide-impregnated finishing cup, and diamond-impregnated polishing cup were used. Tooth surfaces were scanned with an optical scanner after preparation, finishing, initial polishing, and final polishing. The finishing and polishing scans were aligned to the preparation scan using Cumulus software. The depth of enamel surface loss was calculated and statistically analyzed (α = 0.05; paired t test). Most enamel loss (mean [SD]) resulted from the finishing step with the tungsten carbide bur (51.8 [21.3] µm) or diamond bur (43.3 [12.6] µm). Each polishing step increased mean enamel loss by only a few microns. There was no statistically significant difference between the 2 finishing and polishing sequences. The majority of enamel damage during finishing and polishing of composite resin restorations resulted from the finishing burs. Little enamel was removed by either of the tested composite resin polishing systems.

Analysis of Biofilm Adhesion on CAD/CAM Lithium Disilicates Under Different Types of Intraoral Polishing.

PURPOSE: To evaluate the adhesion of Streptococcus mutans (S. mutans) on lithium disilicate ceramics, submitted to different intraoral polishing protocols, and the degree of surface smoothness obtained. MATERIALS AND METHODS: Fifty lithium disilicate specimens were divided into 5 groups (n=10): G1-Glaze Group (positive control); G2-Glaze Group + Wear + Glaze; G3-Wear Group (negative control); G4-Ceramisté Wear Group; G5-Optrafine Wear Group. Surface roughness (Ra - µm) was evaluated and the surface characteristics were assessed using a scanning electron microscope (SEM); to assess S. mutans biofilm, the number of cultured cells was evaluated by counting colony-forming units (CFU/mL). The data underwent one-way ANOVA followed by Tukey's test (P⟨.05). RESULTS: There was a significant difference in the surface roughness of all groups compared with G3. There was no significant difference between the G4 and G5 groups that received polishing. G1 group had the lowest mean roughness values. There was a difference in Log values (CFU/mL) between the G3 group and the groups that received glaze (G1 and G2). The G3 group had the highest adhesion of S. mutans (4.53 Log). CONCLUSION: The most effective polishing protocol after wear is glazing, presenting the lowest roughness and CFU/mL values.

Dispersible chitosan particles showing bacteriostatic effect against Streptococcus mutans and their dental polishing effect.

Nontoxic and biodegradable chitosan is potentially useful in various applications. We prepared submicron chitosan particles with high dispersibility in aqueous solution utilizing the electrostatic interaction phase separation method described in a previous report, but using citric acid as the polyvalent anionic compound instead of sodium sulfate. The submicron chitosan particles showed significant antibacterial activity and anti-adhesive action against Streptococcus mutans, even at around neutral pH. However, chitosan granules showed no antibacterial activity under the same conditions. The addition of the chitosan particles to dental polishing paste provided stainless steel discs (the same hardness as dental enamel) with a smoother surface than polishing paste without additives. In view of their submicron size and antibacterial activity, chitosan particles could potentially be multifunctional components of oral and dental cleaning materials.

Auxiliary UV light devices for removal of fluorescent resin residues after bracket debonding.

OBJECTIVE: The purpose of this clinical report was to describe the detection of fluorescent resin residue after orthodontic bracket debonding with two UV light devices and analyze the surface morphology of enamel after 1 year. CLINICAL CONSIDERATIONS: A 22-year-old woman had orthodontic brackets removed by a previous dentist; however, resin residue was left on the enamel of the maxillary teeth. After confirming the fluorescent property of the resin, different protocols were used for each half of the maxillary arch. The first method, a black light lens was attached to a light-curing device to detect resin fluorescence, followed by polishing with silicone rubber tips. The second method used a light emitting diode light system attached to and activated by a high-speed handpiece, followed by polishing with discs. Both methods were completed with diamond polishing paste applied with felt discs. Polyvinyl siloxane impressions were made initially, after residue removal, after finishing and after polishing for morphologic analysis. The results were evaluated with photographs and the scanning electron microscope images made of resin casts from the impressions. A follow-up was made after 1 year. CONCLUSIONS: Both methods yielded a satisfactory clinical outcome, with a smooth surface, acceptable surface gloss and minimal tooth wear. The use of a UV device that excites fluorescence is recommended for the controlled removal of resin residue on enamel. CLINICAL SIGNIFICANCE: The controlled removal of resin residue from enamel after orthodontic treatment is challenging but can be improved with auxiliary methods for detecting resin residues. This clinical report describes two types of devices that excite fluorescent resins in a more rapid and precise technique to guide the practitioner in the controlled removal of residual resin on teeth.

The Effect of a Continuous Mechanical Polishing Protocol on Surface Roughness, Biofilm Adhesion, and Color Stability of Acrylic Resin Artificial Teeth.

PURPOSE: Acrylic resin properties are susceptible to change over the duration of use, thereby decreasing prosthesis longevity. To make the material less susceptible to the action of external agents such as stain-causing liquids and cleaning solutions, polishing procedures are recommended. A specific mechanical polishing procedure performed regularly was evaluated regarding the biofilm adhesion, surface roughness (Ra), color stability (ΔE), and mass changes in acrylic resin artificial teeth. MATERIALS AND METHODS: Sixty artificial teeth divided into two groups (n = 30) were immersed in distilled water (WT) and coffee (CF). These groups were then subdivided (n = 10) according to the type of polishing procedure administered: no polishing, biweekly polishing (once every 2 weeks) (pol 1), or monthly polishing (once a month) (pol 2), using aluminum oxide paste and a felt polishing wheel attached to an electric motor at a speed of 3000 rpm. Properties were evaluated at baseline and after 4, 8, 12, and 24 months of simulated immersion. At the end, the adhesion of Candida albicans and Streptococcus mutans multispecies biofilm in all groups was assessed. RESULTS: The CF group showed an increased Ra and weight, and a significantly greater ΔE compared to the WT group. The polishing procedure reduced Ra and minimized the stains caused by coffee, without losing mass, with the biweekly regime more effective than the monthly regime. Also, polishing reduced the adhesion of biofilm in the CF groups, again with the biweekly regime the most effective. CONCLUSIONS: When performed regularly, the mechanical polishing procedure tested reduces the changes in artificial teeth subjected to immersion in coffee, with the biweekly frequency most effective regarding the properties evaluated.

Polishing Methods' Influence on Color Stability and Roughness of 2 Provisional Prosthodontic Materials.

PURPOSE: To evaluate the roughness and color change of a conventional acrylic resin and a bis-acryl resin, submitted to different types of polishing and exposed to a staining solution. MATERIALS AND METHODS: One hundred specimens were manufactured from an autopolymerizing conventional acrylic resin (Duralay, shade 66) (n = 50) and a bis-acryl resin (Protemp 4, shade A3) (n = 50) according to the manufacturers' instructions. Specimens were subdivided into 10 groups (n = 10), according to the type of resin and polishing method, including no-polishing (control groups for acrylic resin [tungsten bur finishing] and bis-acryl resin [cotton and alcohol]), Enhance System, Edenta kit, Labordental kit, and sandpaper. The specimens were immersed in a staining solution (coffee at 60°C) for 7 days. Surface roughness was evaluated before the first immersion (baseline - Ra1) and after 7 days (Ra2). The color change (∆E) was determined after 24 hours (∆E1) and 7 days (∆E2), by CIE L* a* b* scale. Data were statistically analyzed with 3-way ANOVA for repeated measures test and Tukey test (α = 0.05). RESULTS: According to 3-way ANOVA test, material, polishing techniques, and polishing*material factors exhibited statistically significant influence (p < 0.0001) on the roughness, and, for color change, material, polishing techniques, time, polishing*material, and material*time factors were statistically significant (p < 0.0001). The polishing techniques successfully reduced the surface roughness of acrylic resin groups, when compared to control (p < 0.001), but for bis-acryl resin, results were not different from the control group (Enhance: p = 0.954, Edenta: p = 0.866, sandpaper: p = 0.366, Labordental: p = 0.945). Surface roughness was not affected by the immersion in staining solution for 7 days. Color change of acrylic resin groups after 24 hours and 7 days of immersion exhibited a clinically acceptable value (ΔE < 3.7) with the exception of the Enhance group, and all bis-acryl resin groups exhibited a clinically unacceptable color change value (ΔE > 3.7) independent of polishing technique and time interval (∆E1 and ∆E2). CONCLUSIONS: Roughness of both materials was similar when the polishing techniques studied were performed, although Ra values were superior to the clinically acceptable values (0.20 µm), and were not affected by the immersion protocol studied; however, when esthetics are critical, the selection of material type is more important than the surface treatment technique used, and bis-acryl resin was more susceptible to clinically unacceptable color change after immersion in a staining solution.

The effect of immediate and delayed polishing on the color stability of a composite resin.

Polishing techniques are known to enhance the longevity and appearance of composite resin restorations. However, the influence of the timing of polishing on the final results of a restoration is not well documented. The aim of this study was to determine the effect of immediate and delayed polishing on the color stability of a composite resin. Sixty composite resin specimens were fabricated and randomly divided into 2 groups according to immersion solutions: group 1, deionized water (control); and group 2, coffee (as staining solution). The groups were further divided according to polishing time periods (immediate, 1 day, 7 days, 14 days, and 21 days). The polishing was performed by 1 calibrated operator using a sequence of aluminum oxide discs with different granulations. Color measurements were assessed at baseline and after a 48-hour immersion in the assigned medium by a reflection spectrophotometer, according to CIE L*a*b* parameters. The data were submitted to an analysis of variance (ANOVA) and the post hoc Tukey test at a significance level of 0.05. The ANOVA showed that the immersion solutions had a statistically significant difference (α = 0.05) on color stability. The composite resin color stability was not influenced by the timing of polishing, and all subgroups showed clinically unacceptable discoloration after exposure to coffee. Thus, with regard to color stability, the timing of final polishing may be established according to the preferences of the clinician.

Color Stability and Surface Roughness of Composite submitted to Different Types and Periods of Finishing/Polishing: Physical Properties of Composites.

AIM: The aim of this study was to evaluate the influence of accelerated artificial aging (AAA) on color stability (AE) and surface roughness of composite submitted to different systems and periods of finishing/polishing. MATERIALS AND METHODS: A Teflon matrix was used to fabricate 60 specimens that were separated into four groups, according to the finishing/polishing system: G1: no polishing; G2: abrasive papers; G3: rubber polishing disks; and G4: G2 + G3. Polishing was performed at three different time intervals (n = 6): immediately (Im), 24 hours (24 hours) and 7 days (7 day) after specimen fabrication. Initial color and surface roughness readouts were taken. Afterwards, specimens were submitted to AAA (480 hours) and new readouts were taken. RESULTS: Results demonstrated that G2 (7 day) presented lower AE, statistically different from G1 and G4 (7 days) (two-way analysis of variance (ANOVA), Bonferroni, p < 0.05). CONCLUSION: Regarding roughness, there was no difference among groups and periods. Polishing performed with abrasive papers, 7 days after performing the restoration, promoted less color alteration. CLINICAL SIGNIFICANCE: Most of composite restorations are replaced within a period shorter than 5 years due to esthetic failure, and correct finishing and polishing procedures are fundamental to avoid these problems.

Effect of Hydrothermal, Chemical, and Mechanical Degradation on Flexural Strength and Phase Transformation of Ground, Glazed, and Polished Zirconia.

Objectives: Evaluation of the effect of grinding on flexural strength of zirconia after low temperature degradation (LTD) and pH-cycling. Materials and Methods: Sixty-four bar-shaped specimens of yttria-stabilized tetragonal polycrystalline zirconia were milled, sintered, wet-polished, and divided into 8 groups (N=8). The four control groups were not aged while artificial aging was performed in the 4 experimental groups in three steps including LTD in steam for 40h, pH-cycling, and tooth brushing for artificial aging. All groups underwent surface preparations as follows: standard polishing without surface treatment (Sp), grinding with a blue-yellow band diamond instrument (Gr); grinding with a diamond rotary instrument (DRI) and then over-glazing (Gl); grinding with a DRI followed by two-step intraoral polishing (Po); standard polishing and aging (Sp-Ag); grinding and aging (Gr-Ag), grinding, over-glazing and aging (Gl-Ag); and grinding, polishing and aging (Po-Ag). Monoclinic content was assessed in one specimen of each group by X-ray diffraction (XRD). The 3-point flexural strength test was performed in a universal testing machine. The results were analyzed with two-way ANOVA and Tukey's test (α=0.05). Results: Mean flexural strength (Mpa) was significantly higher in groups Gr and Po compared to group Sp (both, P<0.0001) and group Gl (both, P<0.0001). In XRD analyses, the highest monoclinic phase before aging was observed in group Gr (12.6%), and after aging in group Gr-Ag (51.2%). Conclusion: Grinding and polishing increased the flexural strength, while glazing did not exhibit any significant effect on this parameter. Furthermore, aging did not adversely affect flexural strength.

In Vitro Study on the Influence of the Buccal Surface Convexity of the Tooth upon Enamel Loss after Bracket Removal.

Polishing after the removal of brackets is the final step in orthodontic treatment. It is simple to perform, though some studies have reported that polishing causes damage to the enamel surface. An in vitro study was made of the influence of the buccal surface convexity of the tooth upon possible enamel loss when the remaining resin and adhesive are removed after bracket decementing using two different polishing modes: a tungsten carbide bur at low and high speeds. The convexity of the buccal surface was quantified in 30 incisors and 30 premolars. A stereoscopic microscope was used to obtain photographs of the profile of the crown, and Image J software was used to calculate convexity by dividing the length of a line from the cementoenamel junction to the incisal margin by another line from the mentioned junction to the maximum convexity of the buccal surface. Brackets were cemented on all the teeth and were decemented 24 h later. In both groups, the residual composite was removed with a tungsten carbide bur at a low speed in one-half of the teeth and at a high speed in the other half. The buccal surface of each tooth was then photographed again, and the convexity was calculated and compared against the baseline value. The difference between the two values were taken to represent the enamel loss. The convexity of the premolars was significantly greater than that of the incisors, but this did not result in greater enamel loss when the same polishing mode was used. However, the tungsten carbide bur at a high speed proved more aggressive, causing significantly greater enamel loss than when used at a low speed.

Effect of Finishing Protocol on Obtaining and Maintaining Gloss in Four Nanohybrid Resin Composites.

OBJECTIVE: Within the clinical objectives of performing direct restorations with resin composites is the achievement of an optimal surface in mechanical terms, while also resembling the natural optical characteristics of dental enamel. The aim of this study is to compare the gloss levels achieved in four nanohybrid resins using four different finishing/polishing (F/P) protocols and assess the retention of gloss after an aging process. METHODS: Forty-eight A2-colored samples from four commercial brands (Filtek Z250 XT, Tetric N-Ceram, Zafira, and Spectra Smart) were prepared, with 12 specimens per resin. The samples were divided into four subgroups based on the F/P treatment: T1 (clinical polishing sequence with ShapeGuard system), T2 (metallographic polishing sequence), T3 (clinical polishing sequence with PermaSeal), and T4 (final polymerization through glycerin and clinical polishing sequence). Gloss measurements were taken before and after aging. ANOVA one-way was done. RESULTS: Before aging, Z250 showed the highest average gloss in T1 (77.2 gloss units - GU), while Zafira (43.8 GU), Tetric (39.5 GU), and Spectra (33.5 GU) had lower values. In T2, Zafira (92.7 GU) and Spectra (87.4 GU) had the highest average gloss, and Tetric (75.7 GU) and Z250 (78.3 GU) had the lowest. No significant differences were found in T3, and in T4, Z250 had the highest average gloss (78.9 GU), followed by Tetric (74.7 GU) and Zafira (52.5 GU), with Spectra having the lowest (42.7 GU). Control group gloss levels ranged from 61.8 to 71.8 GU and remained consistent after aging, except for Tetric in T1 (p=0.045). CONCLUSIONS: The impact of F/P strategies on gloss retention varies with the material, even within the same resin composite classification. The initial gloss level appears to be a more critical factor for long-term gloss retention than the specific F/P protocol used.