Anja Liebermann, Annett Kieschnick, Bogna Stawarczyk
Prophylactic pastes: Effects on discoloration, surface gloss and surface properties of a CAD/CAM composite
Professional teeth cleanings are usually carried out - usually every six months - using various prophylactic pastes to polish the surface. Since patients are often treated intraorally with a wide variety of materials (e.g. composites, ceramics, alloys), the respective prophylactic pastes must be suitable for different filling and restorative materials. Especially with the relatively new CAD/CAM materials, there is currently no recommendation from the manufacturer for preferred prophylactic pastes. The pastes sometimes differ greatly in the composition, size and geometry of the polishing fillers. But what influence do these differences have on application, especially for materials with lower surface hardness?
Objective
The aim was to investigate the reduction of discoloration and the changes in surface properties after 14 days of storage of a CAD/CAM composite in red wine by polishing with nine different prophylactic pastes.
material and methods
Rectangular test specimens (N=172) were made from GC Cerasmart (GC Europe) and polished to a high shine (P4000). The test specimens were polished according to various polishing protocols with related prophylactic pastes (22 in total) in descending order:
- Cleanic (Kerr),
- CleanJoy (Voco),
- Clean Polish/Super Polish (Kerr),
- Clinpro Prophy Paste (3M),
- Détartrine (Septodont),
- Nupro (Dentsply Sirona),
- Prophy paste CCS (Directa),
- Proxy (Ivoclar Vivadent),
- Circate Prophy Paste (Dentsply Sirona).
Surface properties ( roughness values (RV): Ra, Rz, Rv, Rv, surface free energy (SFE), surface gloss (G), and discoloration (ΔE)) were analyzed before and after storage and subsequent polishing. The data were examined using the Kolmogorov-Smirnov test, three-way ANOVA, followed by Tukey B post-hoc, Mann-Whitney U, and Kruskal-Wallis H tests (α < 0.05).
Results
Within the roughness values, Cleanic, followed by Prophy-Paste CCS and Clinpro Prophy Paste, showed the highest values; Clean Polish/Super Polish, Détartrine and Proxyt presented the lowest values.
Lowest free surface energy was measured for Détartrine, followed by Clean Polish/Super Polish; the highest for Prophy-Paste CCS followed by Nupro, Clinpro Prophy Paste and Proxyt.
Within the surface gloss category, the lowest values were observed for Cleanic and Nupro, followed by Prophy-Paste CCS, Zircate Prophy Paste and CleanJoy; the highest was presented by Clean Polish/Super Polish followed by Proxyt.
Polishing showed a positive influence on the surface free energy for all prophylactic pastes except for Circate Prophy Paste and Cleanic. The surface gloss was increased after polishing and the roughness values were decreased, except for Clean Polish/Super Polish, with no significant change in gloss.
Conclusions
In the study, all prophylactic pastes influenced the free surface energy, the surface gloss and the roughness values. The choice of prophylactic paste for professional tooth cleaning consequently influenced the surface properties of CAD/CAM composites.
Clinical Relevance
The correct selection of prophylactic pastes is crucial for the clinical outcome of the surface properties of resin-based prosthetic restorations. Not every polishing paste results in consistent surface quality.
The details can be found in this publication: Liebermann A, Spintzyk S, Reymus M, Schweizer E, Stawarczyk B. Nine prophylactic polishing pastes: impact on discoloration, gloss, and surface properties of a CAD/CAM resin composite. Clin Oral Investig 2019;23:327-335. doi: 10.1007/s00784-018-2440-z. Epub 2018 Apr 16.