In-vitro influence of the use of an erythritol powder through air polishing on the surface roughness and abrasiveness of various restorative materials

Adverse Effects of Ultrasonic Instrumentation and Air Polishing on Dental Restorations: A Systematic Review of Laboratory Studies

OBJECTIVE

The aim of this systematic review was to evaluate the effects of ultrasonic instrumentation and air polishing on surface roughness and marginal integrity of dental restorations, addressing their potential adverse impacts on various biomaterials.

MATERIALS AND METHODS

A search of five databases, supplemented by manual searches, identified relevant laboratory studies. Forty-two studies met the inclusion criteria, with data on surface roughness and marginal quality extracted for analysis. The RoBDEMAT tool was used to assess risk of bias.

RESULTS

Ultrasonic instrumentation significantly increased roughness, particularly in resin-modified glass ionomer cements and resin-based composites, whereas zirconia and lithium disilicate were less affected. Air polishing, especially with sodium bicarbonate and calcium carbonate powders, also increased roughness. Erythritol and glycine powders were the least abrasive. Both ultrasonic scaling and air polishing negatively impacted marginal quality. The RoBDEMAT assessments revealed shortcomings in randomization, sample size justification, and blinding.

CONCLUSIONS

Ultrasonic instrumentation and air polishing can adversely affect dental restorations, with the degree of impact varying by biomaterial and debridement method. Low-abrasive powders, such as erythritol and glycine, are recommended. Methodological refinements and clinical studies are needed to enhance the applicability of these findings to patient care.

CLINICAL SIGNIFICANCE

This review highlights the critical need to choose appropriate debridement methods to minimize iatrogenic damage to dental restorations. Low-abrasive air polishing powders, such as erythritol and glycine, are recommended for the removal of soft deposits and stains to preserve surface smoothness and marginal integrity.

Long-term effect of simulated five years professional mechanical biofilm removal on the luting gap of ceramic restorations

BACKGROUND

Achieving sufficient professional mechanical biofilm removal (PMPR) can be challenging in supportive periodontal therapy (SPT), particularly in patients with prosthetic restorations. This experimental study aimed to simulate five years of SPT with periodic PMPR near the luting gap of ceramic restorations using a rubber cup with polishing paste (RCP), air polishing with two different low-abrasive powders (LAPA-1: glycine powder, LAPA-2: erythritol powder), and non-professional mechanical cleaning (control group) to measure the extent of volume loss in the luting gap after baseline (∆V = Vbaseline-V1-5; in µm3).

METHODS

Two operators randomly performed PMPR ten times for thirty seconds on one of four sides of 30 crown replicas fixed with glass-ionomer cement (CGIZ: n = 15) or adhesive bonding (CAB: n = 15). The replicas were separated in a template during PMPR, and afterward, cleaned for five seconds per side with a sonic brush under flowing water. The artificial aging process between two PMPRs simulated a 5-year SPT with two PMPRs per year. Profilometric measurements were performed at baseline and after each second PMPR to obtain the mean change of ∆V. The statistical evaluation of the data was carried out using nonparametric tests with Bonferroni correction applied for multiple tests.

RESULTS

Ninety-six out of 120 sides could be included in the analysis. PMPR methods showed a loss of substance in the luting gap with a ∆V (mean(standard deviation)) of -4.35 × 106(4.8 × 106)µm3 versus 8.79 × 104(1.05 × 106)µm3 for control at V5 (p ≤ 0.001). No significant differences of ∆V1-5 values could be identified in the control (p > 0.05), whereat all PMPRs showed a significant increasing loss of substance per simulated year (p ≤ 0.001). Intergroup comparison identified LAPA-1 as having the highest significant loss of substance determined on CAB (∆V: -1.05 × 107 (7,2 × 106) µm3), followed by LAPA-2 on CAB (∆V: -6.29 × 106 (4,24 × 106) µm3), LAPA-1 on CGIZ (∆V: -4.15 × 106 (3,25 × 106) µm3), LAPA-2 on CGIZ (∆V: -3.0 × 106 (2,23 × 106) µm3), RCP on CAB (∆V: -1.86 × 106 (2,23 × 106) µm3) and CGIZ (∆V: -1.2 × 106 (1,31 × 106) µm3; p ≤ 0.001)).

CONCLUSIONS

Within study limitations, all PMPRs caused a significantly higher loss of substance in the luting gap versus control without professional intervention, with the highest values in the CAB group for LAPA-1, LAPA-2 and RCP. Similar findings were observed for CGIZ, although the loss values were lower.

Translucency and Color Stability of a Simplified Shade Nanohybrid Composite after Ultrasonic Scaling and Air-Powder Polishing

We aimed to assess the influence of professional dental prophylaxis on the translucency and color stability of a novel simplified shade nanohybrid composite material. Sixty composite disks (5 mm in diameter and 2 mm thick) of light (n = 30) and dark (n = 30) shades were prepared. The specimens were randomly divided into the following three groups (n = 10) according to the prophylaxis procedure used: ultrasonic scaling, air-powder polishing with sodium bicarbonate, and controls. The specimens were submitted to translucency and color analysis based on the CIELab system. Two measurements were performed before and after 48-h storage in coffee. Translucency values of untreated light and dark specimens were 9.15 ± 0.38 and 5.28 ± 1.10, respectively. Air-powder polishing decreased the translucency of the light composite specimens. Storage in coffee resulted in color changes (∆E) ranging between 2.69 and 12.05 and a mean translucency decrease ranging between -0.88 and -6.91. The samples in the light group tended to exhibit greater staining; the treatment method had no effect on ∆E. It can be concluded that light-shade composite restorations are more prone to translucency and color changes resulting from air-powder polishing and contact with staining media. However, further research using other composites and powders is required.