|Year : 2019 | Volume
| Issue : 3 | Page : 130-132
Evaluation of different polishing agents on root surface topography of human extracted teeth
Priya Kaushal, Mukesh Kumar, Rajan Gupta, Parveen Dahiya, Vrishti Bansal, Sunita R Melwani
Department of Periodontics, Himachal Institute of Dental Sciences, Paonta Sahib, Himachal Pradesh, India
|Date of Web Publication||3-Jul-2019|
Department of Periodontics, Himachal Institute of Dental Sciences, Paonta Sahib, Himachal Pradesh
Source of Support: None, Conflict of Interest: None
Context: Polishing is an important step in oral prophylaxis procedure, which retards further accumulation of plaque on the root surface. Aim: The present in vitro study was to evaluate the efficacy of Sodium Bicarbonate Prophy Powder and Glycine Prophy Powder to produce minimum roughness on the root surface of cementum and dentin. Methods: Forty-five samples were collected and stored in saline. Scaling and root planing of each sample were done. Each sample was mounted on acrylic block so as to leave one surface of the root exposed. A tentative area on the proximal side of root 4 mm apically from cementoenamel junction was demarcated. Forty-five specimens were randomly divided into three groups – Group 1: Control group, Group 2: Polished with Sodium Bicarbonate Prophy Powder, and Group 3: Polished with Glycine Prophy Powder. All the samples were analyzed under surface roughness tester, and average roughness values were calculated. Statistical Analysis Used: The values obtained were statistically analyzed using the NPAR test. Results: The study revealed that average roughness is significantly less after using Glycine Prophy Powder than Sodium Bicarbonate Prophy Powder. Conclusion: Glycine Prophy Powder is a more efficient polishing powder in producing less roughness on the root surface as compared to Sodium Bicarbonate Prophy Powder.
Keywords: Glycine, sodium bicarbonate, surface roughness tester, tooth polishing
|How to cite this article:|
Kaushal P, Kumar M, Gupta R, Dahiya P, Bansal V, Melwani SR. Evaluation of different polishing agents on root surface topography of human extracted teeth. Indian J Dent Sci 2019;11:130-2
|How to cite this URL:|
Kaushal P, Kumar M, Gupta R, Dahiya P, Bansal V, Melwani SR. Evaluation of different polishing agents on root surface topography of human extracted teeth. Indian J Dent Sci [serial online] 2019 [cited 2019 Dec 5];11:130-2. Available from: http://www.ijds.in/text.asp?2019/11/3/130/261948
| Introduction|| |
Periodontal disease is associated with the presence of bacterial biofilm and calculus on the root surfaces. It may result in the exposure of the root surface to the pathogenomic biofilm leading to the alterations on the root surfaces of the teeth. Therefore, control of the oral biofilm and removal of bacterial plaque are essential in the prevention and treatment of periodontal disease. Scaling and root planing form the mainstay of periodontal treatment. The traditional modalities for plaque and calculus removal include the use of hand instruments or ultrasonic devices or a combination of both. These have proven to successfully treat almost all the cases of periodontal diseases, and the results can be sustained over a long period of time with regular maintenance visits. However, these procedures repeatedly cause severe, substantial, and irreversible root damage. To overcome this, air polishing method was introduced to overcome this damage.
Therefore, the use of other more effective treatment modalities in removing plaque with minimal abrasion to root surface is preferable. The most common method used for tooth polishing is a rotating rubber cup and pumice. This method is often disappointing when attempting to remove very adherent stains and can be time-consuming and can cause fatigue to the dentist. To meet the demands for more efficient and time-saving tooth polishing, an alternative procedure has been introduced.
The use of an air-abrasive technology is a good alternative to rubber cups and bristle brush for the removal of plaque and diseased cementum. The air-abrasive technology uses an abrasive powder introduced into a stream of compressed air to clean or polish a surface by removing deposits attached to it or smoothening its texture. Air polishing was first introduced in the dental profession during the late 1970s. The first air polishing device, the Prophy-Jet Marck IV™, was marketed by Dentron, Incorporated (Corpus Christi, Texas).
Different types of polishing agents such as sodium bicarbonate, calcium sodium phosphosilicate powder, calcium carbonate powder, aluminum trihydroxide, and Clinpro™ Glycine Prophy Powder are being used for long time in the field of periodontology. The purpose of the present in vitro study was to evaluate the abrasiveness and safety of two air polishing agents, that is, Sodium Bicarbonate Prophy Powder and Glycine Prophy Powder on the root surfaces.
| Methods|| |
Forty-five single-rooted teeth were taken and treated with ultrasonic instrument and thoroughly planed with 1–2, 3–4 Gracey curettes to remove all the altered cementum and stored in normal saline till further study.
Preparation of acrylic block
The acrylic block was prepared, and each sample was mounted in the acrylic block so as to leave one surface of the root exposed.
Preparation of experimental site
A tentative area on the root surface of the proximal side up to 4 mm apically from the cementoenamel junction was properly demarcated with the help of an indentation made by diamond straight fissure bur. All the proceedings of polishing were conducted in this area of the proximal side.
Grouping of teeth
All 45 specimens were randomly divided into three groups. Method of randomization used was Lottery method.
- Group 1: 15 specimens were not polished
- Group 2: 15 specimens were polished with Sodium Bicarbonate Prophy Powder
- Group 3: 15 specimens were polished with Glycine Prophy Powder.
Securing air polishing device and acrylic block with a custom-made metal stand
The handpiece of the air polishing device was secured by a clamp to a custom-made metal stand as shown in [Figure 1]. The acrylic block was secured to the stand. The distance between the handpiece nozzle and the tooth surface was kept constant at 4 mm and at an angle of 45°. The root surface was subjected to air polishing for 5 s. After the treatment, the teeth were rinsed with water spray and dried with air spray. Each sample was then preserved into a plastic zip pouch.
|Figure 1: Securing air polishing device and acrylic block with a custom-made metal stand|
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Preparation of samples for surface roughness tester study
To evaluate the surface topography of each group, they were subjected to surface roughness tester study. These samples were mounted on surface roughness tester (SurfTest SJ-301) as depicted in [Figure 2]. The machine was adjusted and calibrated to move the stylus up to 4 mm apicocoronally. With the concomitant movement of the stylus, a representative graph was obtained. The graph was then subsequently recorded and printed.
Results were statistically analyzed by the NPAR Test.
| Results|| |
The comparison was made between the mean average roughness values of sodium bicarbonate test group, glycine test group, and control group [Table 1] and [Table 2]. Intergroup comparison between sodium bicarbonate test group and glycine test group was also carried out [Table 3].
|Table 1: Comparison of mean average roughness of sodium bicarbonate test group versus control group|
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|Table 2: Comparison of mean average roughness of glycine test group versus control group|
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|Table 3: Comparison of mean average roughness of glycine test group versus sodium bicarbonate test group|
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| Discussion|| |
The roughness on the root surface after scaling will favor constant plaque accumulation, especially on proximal sites, that enhances the development of gingival inflammation. Instruments used to mechanically prepare root surfaces should not excessively damage or remove unacceptable amounts of tooth substance. A smooth root surface should be the goal of successful root planing.
For removing stain and plaque, various methods are used, including scaling (sonic and ultrasonic) and root planing, polishing with rubber cups, and polishing pastes. Air polishing devices are increasingly used for easy, rapid, and complete supragingival stain and plaque removal.
The mean scores of average roughness of control group and sodium bicarbonate test group were found to be 4.81 ± 0.58 and 3.60 ± 0.26, respectively. This difference was statistically highly significant (P ≤ 0.001) because sodium bicarbonate air polishing does not lead to clinically significant surface alterations or substance loss as compared to the control group. Our findings were similar with the study done by Petersilka 2011.
Similarly, the difference in the mean score of glycine test group (1.71 ± 0.39) and control group (4.81 ± 0.58) was statistically highly significant (P ≤ 0.001). This may be attributed to the less chiseled shape of powder crystals.
On intergroup analysis, the difference between the mean score of glycine (1.71 ± 0.39) and sodium bicarbonate (3.60 ± 0.26) was highly significant (P ≤ 0.001). It may be due to the difference in particle size, as mean particle size of sodium bicarbonate powder is up to 250 μm and the mean particle size of glycine polishing powder is 63 μm or less. Thus, the glycine polishing powder is approximately four times smaller than sodium bicarbonate polishing powder, thereby causing less surface alterations on the root surface.,,
| Conclusion|| |
The Glycine Prophy Powder shows a better effect on the soft tissues and produces less gingival erosions than Sodium Bicarbonate Prophy Powder. Two air polishing powders were compared in terms of their effects on human root surfaces. However, remarkable and significant differences were observed with the use of Glycine Prophy Powder as compared to Sodium Bicarbonate Prophy Powder. Although Glycine Prophy Powder is considered to be an antioxidant, it decreases the formation of free radicals by inhibiting the activation of macrophages.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Van der Weijden GA, Timmerman MF. A systematic review on the clinical efficacy of subgingival debridement in the treatment of chronic periodontitis. J Clin Periodontol 2002;29 Suppl 3:55-71.
Wennström JL, Dahlén G, Ramberg P. Subgingival debridement of periodontal pockets by air polishing in comparison with ultrasonic instrumentation during maintenance therapy. J Clin Periodontol 2011;38:820-7.
Agger MS, Hörsted-Bindslev P, Hovgaard O. Abrasiveness of an air-powder polishing system on root surfaces in vitro
. Quintessence Int 2001;32:407-11.
Berkstein S, Reiff RL, McKinney JF, Killoy WJ. Supragingival root surface removal during maintenance procedures utilizing an air-powder abrasive system or hand scaling. An in vitro
study. J Periodontol 1987;58:327-30.
Moëne R, Décaillet F, Andersen E, Mombelli A. Subgingival plaque removal using a new air-polishing device. J Periodontol 2010;81:79-88.
Graumann SJ, Sensat ML, Stoltenberg JL. Air polishing: A review of current literature. J Dent Hyg 2013;87:173-80.
Arabaci T, Ciçek Y, Ozgöz M, Canakçi V, Canakçi CF, Eltas A, et al.
The comparison of the effects of three types of piezoelectric ultrasonic tips and air polishing system on the filling materials: An in vitro
study. Int J Dent Hyg 2007;5:205-10.
Petersilka GJ. Subgingival air-polishing in the treatment of periodontal biofilm infections. Periodontol 2000 2011;55:124-42.
Gerbo LR, Barnes CM, Leinfelder KF. Applications of the air-powder polisher in clinical orthodontics. Am J Orthod Dentofacial Orthop 1993;103:71-3.
Petersilka G, Faggion CM Jr., Stratmann U, Gerss J, Ehmke B, Haeberlein I, et al.
Effect of glycine powder air-polishing on the gingiva. J Clin Periodontol 2008;35:324-32.
Pelka M, Trautmann S, Petschelt A, Lohbauer U. Influence of air-polishing devices and abrasives on root dentin-an in vitro
confocal laser scanning microscope study. Quintessence Int 2010;41:e141-8.
Bühler J, Schmidli F, Weiger R, Walter C. Analysis of the effects of air polishing powders containing sodium bicarbonate and glycine on human teeth. Clin Oral Investig 2015;19:877-85.
[Figure 1], [Figure 2]
[Table 1], [Table 2], [Table 3]