Effect of various finishing and polishing systems on
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Effect of various finishing and polishing systems on
Original article Effect of various finishing and polishing systems on surface roughness of composite resin: a profilometric study Claudio Poggio Marco Lombardini Alberto Dagna Andrea Scribante Marco Chiesa University of Pavia, Italy Department of Operative Dentistry Policlinico “San Matteo”, Pavia, Italy Correspondence to: Prof. Claudio Poggio Reparto di Odontoiatria Conservatrice Policlinico “San Matteo” Piazzale Golgi, 3 - 27100 Pavia, Italy Ph. +39 0382 516257, +39 3398124925 Fax +39 0382 516224 E-mail: [email protected] Submitted for publication: 08/06/2006 Accepted for publication: 23/02/2007 Summary Effect of various finishing and polishing systems on surface roughness of composite resin: a profilometric study. Aims. The aim of the study was to evaluate the surface roughness of a nano-ceramic composite resin (CeramX Mono, Dentsply-DeTrey GmbH, Germany) after finishing and polishing with different systems. Materials and methods. Ninety specimens were made in composite resin (5 mm in diameter, 3 mm high) and divided into 9 groups according to different finishing/polishing procedures: group 1: three diamond burs (Komet, Gebr. Brasseler GmbH & Co. Germany), group 2: three diamond burs (SS White Burs, Inc. Lakewood), group 3: two tungsten carbide burs (Komet, Gebr. Brasseler GmbH & Co. Germany), group 4: two tungsten carbide burs (SS White Burs, Inc. Lakewood, New Jersey), group 5: three polisher interspersed with diamond grit (Komet, Gebr. Brasseler GmbH & Co. KG), group 6: resin reinforced by zircon-rich glass fiber Whitech points (Isasan, Rovello Porro, Italy), group 7: PoGo polishing discs (Dentsply-DeTrey GmbH, Germany), group 8: Enamel Plus Shiny polishing paste (Micerium, Avegno, Italy), group 9: control group (composite resin cured under Mylar strip - no finishing/polishing procedures). Specimens were analysed using a profilometer to measure the mean surface roughness (Ra); the data were subjected to one-way ANOVA and post-hoc Scheffè tests. Results. Control group showed the lowest roughness values among the finishing methods, groups 1 and 2 Annali di Stomatologia 2006; LV (2-4): 61-65 showed significantly higher roughness values than groups 3 and 4 (P<0.02). As for polishing procedures groups 5 and 6 showed significantly higher roughness values than groups 7 and 8 (P<0.05). Discussion. Multi-step diamond burs and composite points obtained the worst results: they gave high roughness values. Enamel Plus Shiny polishing paste gave very low roughness values, as PoGo polishing discs, which obtained the smoothness surfaces, comparable to that of control group (Mylar strip). Key words: nano-filled composite resin, surface roughness, finishing and polishing. Sommario Effetto di diversi sistemi di rifinitura e lucidatura sulla ruvidità di superficie di una resina composita: studio profilometrico. Obiettivi. Lo scopo della ricerca è stato valutare la ruvidità di superficie di una resina composita nano-riempita (Ceram-X Mono, Dentsply-DeTrey GmbH, Germania) sottoposta a differenti procedure di rifinitura e lucidatura. Materiali e metodi. Sono stati realizzati 90 campioni di composito (diametro 5 mm, altezza 3 mm), suddivisi in 9 gruppi e sottoposti a differenti procedure di rifinitura/lucidatura: gruppo 1: tre frese diamantate (Komet, Gebr. Brasseler GmbH & Co., Germania); gruppo 2: tre frese diamantate (SS White Burs, Inc. Lakewood, New Jersey); gruppo 3: due frese al carburo di tungsteno; gruppo 4: due frese al carburo di tungsteno (SS White Burs, Inc. Lakewood); gruppo 5: tre gommini con grana diamantata (Komet, Gebr. Brasseler GmbH & Co. KG); gruppo 6: punte Whitech in resina rinforzata con fibre di zirconio (Isasan, Rovello Porro, Italia); gruppo 7: gommini a disco PoGo (Dentsply-DeTrey GmbH, Germania); gruppo 8: paste da lucidatura Shiny A,B,C (Micerium, Avegno, Italia); gruppo 9: controllo (nessuna procedura di rifinitura/lucidatura). Mediante rugosimetro è stata misurata la rugosità media di superficie dei campioni (Ra). Si è poi provveduto all’analisi statistica dei dati ottenuti mediante test one-way ANOVA e Post-hoc di Scheffe’. Risultati. Il gruppo di controllo ha fornito i valori di ruvidità inferiori. Tra i metodi di rifinitura, i gruppi 1 e 2 hanno dato valori di ruvidità più alti dei gruppi 3 e 4 in modo statisticamente significativo (P<0.02). Tra i metodi di lucidatura, i gruppi 5 e 6 hanno fornito valori di ruvidità significativamente più elevati dei gruppi 7 e 8 (P<0.05). Conclusioni. Le frese diamantate multi-step e le punte in composito hanno ottenuto i risultati peggiori: hanno dato alti valori di ruvidità. La pasta Enamel Plus Shiny ha dato valori molto bassi di ruvidità, cosi come i dischi PoGo, che hanno ottenuto le superfici più lisce, comparabili a quelle del gruppo di controllo (matrici Mylar). Parole chiave: resina composita nano-riempita, ruvidità di superficie, rifinitura e lucidatura. 61 C. Poggio et al. Introduction The longevity and the aesthetic appearance of composite restorations greatly depend on the quality of finishing and polishing techniques (Joniot, 2000). Plaque retention, surface discoloration and aesthetics of restorations have been related to the smoothness of their surface. Surface roughness seems to affect the initial adhesion of cells, moreover gingival health is subjected to surface texture of the restoration (Paravina, 2004). Many studies demonstrated that the smoothest surface is achieved using a polyester matrix in contact with the surface of composite during curing (Pirani, 2004; ÜçtaŞli, 2004). However, the use of this strip is limited by complexity of tooth anatomy and by different restorative procedures. The trimming procedure for resin-based restorations allows four steps (Türkün, 2004): coarse finishing or reduction of excess, contouring, fine finishing, polishing. A highly polished surface of composite resin restoration is difficult to achieve. Resin matrix and filler particles of composites do not abrade to the same degree due to different hardness: craters are often formed around hard quartz particles of conventional composites, so that irregularities appear on the surface of the restoration. The filler content of composite also affects its roughness, as micro-filled composites show smoother surfaces than hybrid ones (Ryba, 2002). Nano-ceramic composite resin should have good mechanical properties with high aesthetic features. The structure made by small particles clusters leads to great possibility to obtain a smoother surface. Various techniques for polishing and finishing aesthetic materials have been investigated. These methods include the use of aluminium oxide finishing disks, fine diamond finishing burs, carbide finishing burs, resin polishing points, polishing pastes (Chung, 1994; Şen, 2002). Several studies suggested that certain polishing techniques may be best suited to specific materials (Yap, 2004). Differences in smoothness surface have been demonstrated using identical finishing systems on different composite resins (Borges, 2004). The purpose of this study was to compare the surface roughness achieved using different finishing and polishing techniques on a nano-ceramic composite resin. The null hypothesis of the study was that there is no significant difference in surface roughness values among the different finishing/polishing techniques. Materials and methods A nano-ceramic composite resin intended for both anterior and posterior restorations (Ceram-X Mono, DentsplyDeTrey GmbH, Germany) was used in the present study. It is made of a resin dimetacrylate which contains the inorganic filler made of nano-ceramic clusters; the filler content is 76% in weight. The composite resin was cured into acrylic rings (5 mm in diameter, 3 mm high). Cavities were slightly overfilled with material, covered by a Mylar strip, placed between two glass slides (Hoelscher, 1998) and cured for 40s on each side using Elipar Trilight (3M ESPE, St. Paul, MN, USA) curing light with an output of 800 mW/cm 2. The curing light-guide was placed perpendicular to the specimen surface, at or less than distance of 1.0 mm. After polymerisation and during all the experimentation, the specimens were stored in distilled water at 37˚C. A total of ninety specimens was prepared. The specimens were randomly assigned to 9 groups (10 specimens for each group) and submitted to different finishing and polishing procedures. Finishing procedures: – group 1: three diamond burs (Komet, Gebr. Brasseler GmbH & Co., Germany); – group 2: three diamond burs (SS White Burs, Inc. Lakewood, New Jersey); – group 3: two tungsten carbide burs (Komet, Gebr. Brasseler GmbH & Co.); Table I - Finishing systems investigated. Finishing systems (Manufacturers’ code) Type 8852.314.014 852EF.314.014 852UF.314.014 Diamond burs 30 micron 15 micron 8 micron 806.314.167.504.016 806.314.167.514.016 806.314.167.494.016 Diamond burs 30 micron 15 micron 8 micron H134Q.314.014 H134UF.314.014 Tungsten carbide burs 16 blades (Q finishing instruments) 30 blades - trasversal cut (UF) SE6-10 SE6-20 Tungsten carbide burs 20 blades 10 blades 62 Abrasive Manufacturers Ultrafine diamonds Komet Gebr. Brasseler GmbH & Co., Germany Ultrafine diamonds SS White Burs, Inc. Lakewood, New Jersey Tungsten carbides Komet Gebr. Brasseler GmbH & Co., Germany Tungsten carbides SS White Burs, Inc. Lakewood, New Jersey Annali di Stomatologia 2006; LV (2-4): 61-65 Effect of various finishing and polishing systems on surface roughness of composite resin: a profilometric study – group 4: two tungsten carbide burs (SS White Burs, Inc. Lakewood). Table I shows the finishing systems investigated. Polishing procedures: – group 5: three polisher interspersed with diamond grit (Komet, Gebr. Brasseler GmbH & Co., Germany); – group 6: resin reinforced by zircon-rich glass fiber Whitech points (Isasan, Rovello Porro, Italy); – group 7: PoGo polishing discs (Dentsply-DeTrey GmbH, Germany); – group 8: Enamel Plus Shiny polishing paste (Micerium, Avegno, Italy). Table II shows the polishing systems investigated. Group 9 is control group (no finishing/polishing procedures). All specimen preparation/finishing/polishing procedures were performed by the same investigator, in order to reduce variability. Finishing/polishing sequences are given in tables III and IV. After all specimens were finished/polished, they were thoroughly rinsed with water and allowed to dry for 24h before the average surface roughness (Ra) was measured (Kaplan, 1996; Damiani, 2003). A profilometer (Perth-O-Meter, Perthen GmbH, Goettingen, Germany) was used to measure the surface roughness of specimens. Three measurements in different directions were recorded for specimens in each group; all readings were taken at the centre of each specimen, giving a total evaluation length of 1 mm. The mean Ra value was determined for each specimen and an overall Ra was determined for the total sample group. Table II - Polishing systems investigated. Polishing systems (Manufacturers’ code) Type Abrasive Manufacturers Polisher interspersed 9400 204 030 9401 204 030 9402 204 030 Pre-polishing Polishing High-shine polishing Diamond grit Komet Gebr. Brasseler GmbH & Co., Germany Whitech Composite points Zircon-rich glass fiber Isasan Carbotech, Rovello Porro, Italy PoGo Polishing Disc Diamond micro-polisher Diamond powder Dentsply-DeTrey GmbH, Germany Enamel Plus Shiny Micerium S.p.A., Avegno, Italy - Shiny A Diamond paste 3 microns + Hair Goat Brushes Diamond powder - Shiny B Diamond paste 1 micron + Hair Goat Brushes Diamond powder - Shiny C Aluminium oxide paste + Felt discs Aluminium oxide powder Table III - Finishing systems sequences. Group Finishing systems Strokes Handpiece speed (Manufacturers’ recommended) Usage (Manufacturers’ recommended) 1 8852.314.014 852EF.314.014 852UF.314.014 6 20000 rpm 20000 rpm 20000 rpm wet wet wet 2 806.314.167.504.016 806.314.167.514.016 806.314.167.494.016 6 20000 rpm 20000 rpm 20000 rpm wet wet wet 3 H134UF.314.014 H134Q.314.014 6 20000 rpm 20000 rpm wet wet 4 SE6-10 SE6-20 6 20000 rpm 20000 rpm wet wet Annali di Stomatologia 2006; LV (2-4): 61-65 63 C. Poggio et al. Table IV - Polishing systems sequences. Group Polishing systems Strokes Handpiece speed (Manufacturers’ recommended) Usage (Manufacturers’ recommended) 5 9400 204 030 59401 204 030 9402 204 030 12 light intermittent strokes 6000 rpm wet 6 Whitech 12 light intermittent strokes 10000 rpm wet 7 PoGo 12 light intermittent strokes 12000 rpm dry 8 Shiny A Shiny B Shiny C 6000 rpm 12000 rpm 12000 rpm dry wet dry 12 light intermittent strokes Statistical analysis was performed using a computer software (Stata 7.0, Stata Corp., Station College, TX, USA). Descriptive statistics including the mean, standard deviation, median, minimum and maximum values were calculated for each of the 9 groups. ANOVA test was applied to determine significant differences in surface roughness values among the different finishing/polishing techniques. Post-hoc Scheffè test was used. Significance for statistical tests was predetermined at P<0.05. Results The null hypothesis of the study was rejected. The results of present investigation showed significant differences in roughness values among the different methods. The results of the ANOVA test indicated the presence of significant differences among the roughness values of the various groups (P<0.05). Post-hoc Scheffè test showed that group 9 (control group) showed the lowest roughness values (P=0.000). Among four finishing procedures, groups 1 and 2 showed no significant difference in roughness values between them (P>0.05), and both showed significantly higher roughness values than groups 3 and 4 (P<0.02). No significant differences were found between groups 3 and 4 (P>0.05) (Fig. 1). Among four polishing procedures, Scheffè test showed no significant differences between groups 5 and 6 (P>0.05), that both showed significantly higher roughness values than groups 7 and 8 (P<0.05). No significant difference were found among groups 7 and 8 (P>0.05) (Fig. 2). Discussion The effectiveness of finishing/polishing procedures on composite surface is an important goal to be achieved in the restorative process. Resin composite restoration can 64 Figure 1 - Mean and standard deviation of surface roughness after finishing procedures in groups 1, 2, 3, 4 and 9. Figure 2 - Mean and standard deviation of surface roughness after polishing procedures in groups 5, 6, 7, 8 and 9. be imperceptible only if its surface closely resembles the enamel surface. It is well-known that the smoothest obtainable surface is achieved by curing the material in direct contact with a Mylar strip (Damiani, 2003; Reis, 2003). However, removal of excess material or recountouring of restorations is often necessary. It’s clinically important to determine the finishing technique that results the smoothest surface with minimum time and instruments (Türkün, 2004). Annali di Stomatologia 2006; LV (2-4): 61-65 Effect of various finishing and polishing systems on surface roughness of composite resin: a profilometric study Reis et al. (2003) compared six finishing and polishing agents on surface roughness of two packable composites and concluded that each packable composite requires specific finishing/polishing devices, depending on the size and amount of filler. Yap et al. (2004) compared the smoothness of composite and compomer restoratives. They stated that the effect of finishing/polishing systems on surface roughness was material dependent. In our experimentation, we used a nano-ceramic composite resin in order to focus attention on different finishing/ polishing procedures. This class of new restorative materials should provide great polishing capability and smoother surfaces than micro-hybrid composites. Among the finishing methods investigated, in previous studies (Roeder, 2000; Rüstü, 2005; Damen, 2006) it was found that carbide burs provide a smoother surface than diamond burs. This data were confirmed in our study. Carbide burs provided great cut efficiency and better finishing degree. Clinicians can also appreciate faster finishing procedure (only two steps). As for polishing methods, the final glossy surface depends on the flexibility of the backing material in which the abrasive is embedded, the hardness of the abrasive, the geometry of the instruments (Filho, 2003). In literature we found controversial results. Marigo et al. (2001) suggested that multi-step systems provided a considerable smoother surface. On the contrary, Yap et al. (2004), Turkun et al. (2004) and Duvia et al. (2006), demonstrated that surface finish obtained with PoGo (one step) was comparable or superior to that of two and multi-step polishing systems. In this study, significant difference in surface smoothness was shown between finished/polished materials. The smoothest surfaces were produced by the Mylar strip; this finding was in agreement with previous studies on composite resins (Hondrum, 1997; Yap et al., 2004). Conclusions This study demonstrated that the finishing technique with tungsten carbide burs produced an excellent surface smoothness; diamond burs gave higher roughness values. The polishing technique with polisher interspersed with diamond grit and resin reinforced by zircon-rich glass fiber Whitech points obtained the worst results; they gave high roughness values, probably due to high tendency to wear and rigidity. Enamel Plus Shiny system (three steps) gave very low roughness values, as PoGo polishing discs (one step), which obtained the smoothness surfaces comparable to that of control group (Mylar strip). As it was confirmed by quoted literature and by our study, this one-step system can be considered the most suitable polishing one, because it provides very smooth surfaces with very fast clinical procedures. References 11. Borges AB, Marsillo AL, Pagani C, Rodriguesa JR. Surface roughness of packable composite resins polished with various systems. Journal of Esthetic Restorarive Dentistry 2004; 16(1): 42-7. Annali di Stomatologia 2006; LV (2-4): 61-65 12. Chung K. Effects of finishing and polishing procedures on the surface texture of resin composites. Dental Materials 1994; 10:325-330. 13. Damen L, Putignano A, Cerutti A, Santarelli C, Rappelli G. Different evaluations of a nano-ceramic composite finished surface. Italian Journal of Operative Dentistry 2006; Vol. IV (1):69. 14. Damiani F, Sacco S, Bruno E. Confronto fra diverse metodiche di rifinitura e lucidatura delle resine composite: Doctor Os 2003; 14(6):593-597. 15. Duvia G, Gandolfo R, Damiani F, Bruno E. AFM analysis of six finishing and polishing techniques. Italian Journal of Operative Dentistry 2006; Vol. IV (1):73. 16. Filho HN, D’Azevedo MT, Nagem HD, Marsola FP. Surface roughness of composite resins after finishing and polishing. Brazilian Dental Journal 2003:14(1). 17. Hoelscher DC, Neme AML, Pink FE, Hughes PJ. The effect of three finishing systems on four esthetic restorative materials. Operative Dentistry 1998; 23:36-42. 18. Hondrum SO, Fernandez R. Contouring, finishing an polishing class V restorative materials. Operative Dentistry 1997; 22(1):30-36. 19. Joniot SB, Grégoire GL, Auther AM, Roques YM. Three-dimensional optical profilometry analysis of surface states obtained after finishing sequences for three composite resins. Operative Dentistry 2000; 25:311-315. 10. Kaplan BA, Goldstein GR, Vijayaraghavan TV, Nelson IK. The effect of three polishing systems on the surface roughness of four hybrid composites. A profilometric and scanning electron microscopy study. Journal of Prosthetic Dentistry 1996; 78(1):34-38. 11. Marigo L, Rizzi M, La Torre G, Rumi G. 3-D surface profile analysis: different finishing methods for resin composites. Operative Dentistry 2001; 26:562-568. 12. Paravina RD, Roeder L, Lu H, Vogel K, Powers JM. Effect of finishing and polishing procedures on surface roughness, gloss and color of resin-based composites. Americana Dental Journal 2004; 17(4):262-6. 13. Pirani C, Gullifa A, Marchionni S, Piana G. New methods to finissh composite restorations: SEM evaluation. Italian Journal of Operative Dentistry 2004; 2(4):234-236. 14. Reis AF, Giannini M, Lovadino JR, Ambrosano GM. Effects of various finishing systems on the surface roughness and staining susceptibility of packable composite resins. Dental Materials 2003; 19:12-18. 15. Roeder LB, Tate WH, Powers JM. Effect of finishing and polishing procedures on the surface roughness of packable composites. Operative Dentistry 2000; 25:534-543. 16. Ryba TM, Dunn WJ, Murchison DF. Surface roughness of various packable composites. Operative Dentistry 2002; 27:243-247. 17. Rüstü G, Feridun H, Akin C, Özden OB, Ali KÖ. Surface roughness of new microhybrid resin-based composites. JADA 2005; 136:1106-1112. 18. Şen D, Gǒller G, Işsever H. The effect of two polishing pastes on the surface roughness of bis-acryl composite and methacrylate based resins. Journal of Prosthetic Dentistry 2002; 11:527-532. 19. Türkün LS, Türkün M. The effect of one-step polishing system on the surface roughness of three esthetic resin composite materials. Operative Dentistry 2004; 29(2):203-211. 20. ÜçtaŞli MB, Bala O, Güllü A. Surface roughness of flowable and packable composite resin materials after finishing with abrasive discs. Journal of Oral Rehabilitation 2004; 31:1197-1202. 21. Yap AUJ, Ng JJ, Yap SH, Teo CK. Surface finish of resinmodified and highly viscous glass ionomer cements produced by new one-step systems. Operative Dentistry 2004; 29:87-91. 22. Yap AUJ, Yap SH, Teo CK, Ng JJ. Finishing/polishing of composite and compomer restoratives: effectiveness of one-step systems. Operative Dentistry 2004; 29:275-279. 65