The effect of toothbrushing
on a h y b r i d c o m p o s i t e r e s i n
G a r y R. G o l d s t e i n , D D S , a a n d T o d d L e r n e r , D D S
New York University, David B. Kriser Dental Center, New York, N.Y. This study o b s e r v e d the effect of various t o o t h p a s t e s on a hybrid c o m p o s i t e r e s i n to d e t e r m i n e the difference in surface r o u g h n e s s as m e a s u r e d by a profilometer. S l u r r i e s (100 gm d e n t i f r i c e / 1 0 0 gm H20) of eight t o o t h p a s t e s w e r e t e s t e d by b r u s h i n g c o m p o s i t e r e s i n s a m p l e s 20,000 t i m e s and recording c h a n g e s in surface s m o o t h n e s s w i t h a p r o f l e meter. The surface t o p o g r a p h y of a hybrid c o m p o s i t e r e s i n w a s altered by routine toothbrushing; the effect of Colgate t o o t h p a s t e w a s a s t a t i s t i c a l l y s m o o t h e r surface than found w i t h the other dentifrices; and the surface t o p o g r a p h y of acrylic resin w a s altered l e s s by Colgate, Crest, Viadent, and S u p e r s m i l e t h a n the more a b r a s i v e Shane, S e n s o d y n e , R e m b r a n d t , and Topol dentifrices. (J PROSTHET DENT 1991;66:498-500.)
T h e attraction of dental plaque to roughened restorations is of serious concern. Careful polishing and finishing of composite resin restorations can be compromised by subsequent home care. Toothbrushing affects the surface of conventional and microfilled composite resinJ -3 Average losses in the 0.035 mm range after 240,000 strokes (estimated to be 15 years of simulated brushing) have been reported. 3 Although this minimal weight loss is of doubtful clinical significance, the major problem is the resultant surface roughness. This study Observed the effect of various toothpastes on a hybrid composite resin to determine whether commercially available products produced a difference in surface roughness of the restorative resin. MATERIAL
AND
METHODS
Acrylic resin blocks, 3 mm thick, were cured and milled to 82 by 26 mm with a hole 10 mm in diameter prepared in the center. A hybrid composite resin (Herculite-Kerr Mfg. Co., Romulus, Mich.) was compressed between two glass slabs into the prepared hole, cured with a visible light-curing unit (Elipar Visio ESPE Premier Mfg., Norristown, Pa.), and placed in a 37 ° C water bath for 1 week. In a pretest, 24 samples were divided into four groups, placed in a Tooth Brush Wear Tester (Block Drug Co. Inc,, Jersey City, N.J.) instrument, and subjected to 10,000 brushing strokes in 100 cc of deionized water with different toothbrushes (Sensodyne Gentle, Block Drug Co.; Pycopay Natural Soft, Block Drug Co.; Pycopay Softex 4, Block Drug Co.; or Sensodyne Search, Block Drug Co.) to deter-
Presented at the American Association of Dental Research meeting, San Francisco, Calif. *Professor and Director of Research, Department of Prosthodontics and Occlusion. 10/1/28258
498
Table I. Products used in study Product
Manufacturer
Crest regular flavor Rembrandt fluoride Supersmile Colgate Winterfresh gel Topol Smokers polish Shane fluoride Viadent fluoride Sensodyne
Proctor and Gamble, Cincinnati, Ohio Den-Mat Corp., Santa Maria, Calif. Robell Research, New York, N.YI Colgate-Palmolive Co., New York, N.Y. Jeffrey Martin Co., Union, N.J. Jerome Milton Inc., Chicago, Ill. Viadent Inc., Fort Collins, Colo. Dentco Inc., Jersey City, N.J.
Table IL Results of toothbrushing composite resin with deionized water
Group
Count
Pretest mean (~m)
Sensodyne Gentle Pycopay Natural-Soft Pycopay Softex 4 Sensodyne Search
6 6 6 6
0.89 1.00 1.40 0.94
Mean (~m)
1.75 0.65 1.20 1.10
Table IIL Results of brushing composite resin Group
Cases
pH
Mean (~m)
SD
Colgate Shane Viadent Sensodyne Supersmile Crest Rembrandt Topol
36 36 36 36 30 30 36 36
6.8 7,1 5.8 7.2 8.7 7.1 7.1 6.7
4.94 14.36 14.91 17.50 23.80 31.43 33.03 34.58
2.70 13.03 6.52 8.49 17.56 33.40 32.09 36.92
OCTOBER1991 VOLUME66 NUMBER4
TOOTHBRUSHING COMPOSITE RESIN
Table IV. ANOVA by paste (composite resin) Source
DF
Between groups Within groups Total
7 268 275
Sum of squares
27901.8587 135271.8333 163173.6920
mine whether the type of brush affected the surface topography of the composite resin. The toothpastes (Table I) (100 gm of toothpaste in 100 gm of water) were mixed cold for 15 minutes in a Corning hot plate stirrer (PC351, Corning, N.Y.) set to stir only. Readings for pH were made for all slurries with a Beckman Zeromatic SS-3 pH meter (Beckman Instruments Inc., Fullerton, Calif.). The 48 composite resin samples were subjected to 20,000 brushing strokes in the toothpaste slurry with Pycopay Softex brushes in the Tooth Brush Wear Tester instrument, rinsed in tap water, air dried, and evaluated for surface roughness on a profilometer (Mitotoyo Surftest-4, Tokyo, Japan) at a transverse length of 1.5 mm. Six representative readings were made on each sample of composite resin and mounting acrylic resin. The mounting heads were removed and weighed. RESULTS The results of the preliminary test on different toothbrushes are listed in Table II. After 10,000 strokes in the deionized water, no significant differences in surface roughness were found among the four groups, and no significant difference was found between pretest means and posttest means. Table III lists the results of brushing with toothpaste on the composite resin. A one-way analysis of variance (ANOVA) on the effect of the paste showed a significant difference at the 0.01 level (Table IV). A Scheffe test and a Duncan test looking for difference between groups or subsets of groups at the 0.01 level showed results for Colgate to be different from those for the other toothpastes. The weight of the holding heads are listed in Table V. ANOVA on the effect of head position showed no significance at the 0.01 level. Table VI lists the results of brushing with the toothpaste on the acrylic resin blocks. ANOVA showed a significant difference at the 0.01 level (Table VII). A Scheffe test and a Duncan test, also done at the 0.01 level, showed that results for Shane, Sensodyne, Rembrandt, and Topol were different from those of the other products tested. DISCUSSION
Composite resin exhibited good wear resistance. Brushing with deionized water had no effect on the surface of the material. The weights of the toothbrush holding heads were
THE JOURNAL OF PROSTHETIC DENTISTRY
Mean squares (~m)
F Ratio
3985.9798 504.7456
F Prob
7.8970
0.0O00
Table V. Weight of toothbrush-holding heads Head position
W e i g h t in g r a m s
1 2 3 4 5 6
286.6 283.8 281.2 283.9 286.5 282.3
Table VI. Results of brushing acrylic resin Group
Cases
Colgate Crest Viadent Supersmile Shane Sensodyne Rembrandt Topoi
36 30 36 30 36 36 36 36
Mean (#m)
57.88 60.10 88.30 117.53 143.00 167.80 185.00 226.22
SD
72.60 81.03 58.41 130.33 131.01 196.57 115.39 160.69
slightly different (Table V), but did not vary enough to register any difference in the profilometer readings. The number of strokes needed to simulate 1 year's brushing is controversial and arbitrary. Ranges from 43201 to 16,0003 have been reported. Because Kanter et al. 1 demonstrated that there was a decrease in wear rate with an increase in brushing time, the assignment of 10,000 strokes per year and the use of a 2-year simulated study (20,000 strokes) was considered acceptable for this study. The addition of a dentifrice caused surface deterioration in all of the samples. Twenty thousand brushing strokes were produced in 116 minutes at 172 rpm. The Sensodyne and Rembrandt products exhibited severe sludging, whereas Topol, Viadent, Supersmile, and Crest products exhibited slight sludging during the experiment. A comparison of the effect of the toothbrushing on the acrylic resin and the composite resin shows that Colgate toothpaste gave a smoother surface for both the acrylic resin and the composite resin, although only the data for the composite resin were statistically significant (Table VIII). Rembrandt and Topol toothpastes gave a rougher
499
GOLDSTEIN AND LERNER
Table VII. Analysis of variance by paste (acrylic resin) Sum of s q u a r e s Source
DF
(/~m)
Mean squares
F Ratio
F Prob
Between groups Within groups Total
7 268 275
898976.9626 4310195.222 5209172.185
128425.2804 16082.8180
7.9852
0.0000
Table VIII. Comparison effect of toothpaste on acrylic and composite resins Acrylic
Colgate Crest Viadent Supersmile Shane Sensodyne Rembrandt Topol
Composite
Colgate Shane Viadent Sensodyne Supersmile Crest Rembrandt Topol
Spaces separate groups significantly different from one another.
surface to both the acrylic resin and the composite resin; data for the acrylic resin were statistically significant. There is also a concern over the unusually low pH of Viadent toothpaste and its long-term effect on enamel as well as composite resin. CONCLUSIONS
fect of Colgate toothpaste is a statistically significant smoother surface than found with the other dentifrices. 2. The surface topography of acrylic resin will be altered by toothbrushing, with Colgate, Crest, Viadent, and Supersmile products less abrasive than Shane, Sensodyne, Rembrandt, and Topol products. We thank Dr. Gene Hittleman for his assistance with the statistics and the Block Drug Co. for material support for the project. REFERENCES 1. Kanter J, Koski RE, Martin D. The relationship of weight loss to surface roughness of composite resins from simulated toothbrushing. J PROSTHET DENT 1982;47:505-13. 2. Ehrnford L. Surface microstructure of composite resins after toothbrush-dentifrice abrasion. Acta Odontol Scand 1983;41:241-5. 3. Aker JR. New composite resins: comparison of their resistance to toothbrush abrasion and characteristics of abraded surfaces. J Am Dent Assec 1982;105:633-5.
Reprint requests to: DR. GARYR. GOLDSTEIN DAVIDB. KRISERDENTALCENTER NEW YORKUNIVERSITY 345 EAST 24TH ST. NEW YORK, NY 10010
1. The surface topography of a hybrid composite resin will be altered by routine toothbrushing, although the ef-
500
OCTOBER 1991
VOLUME66 NUMBER 4
on a h y b r i d c o m p o s i t e r e s i n
G a r y R. G o l d s t e i n , D D S , a a n d T o d d L e r n e r , D D S
New York University, David B. Kriser Dental Center, New York, N.Y. This study o b s e r v e d the effect of various t o o t h p a s t e s on a hybrid c o m p o s i t e r e s i n to d e t e r m i n e the difference in surface r o u g h n e s s as m e a s u r e d by a profilometer. S l u r r i e s (100 gm d e n t i f r i c e / 1 0 0 gm H20) of eight t o o t h p a s t e s w e r e t e s t e d by b r u s h i n g c o m p o s i t e r e s i n s a m p l e s 20,000 t i m e s and recording c h a n g e s in surface s m o o t h n e s s w i t h a p r o f l e meter. The surface t o p o g r a p h y of a hybrid c o m p o s i t e r e s i n w a s altered by routine toothbrushing; the effect of Colgate t o o t h p a s t e w a s a s t a t i s t i c a l l y s m o o t h e r surface than found w i t h the other dentifrices; and the surface t o p o g r a p h y of acrylic resin w a s altered l e s s by Colgate, Crest, Viadent, and S u p e r s m i l e t h a n the more a b r a s i v e Shane, S e n s o d y n e , R e m b r a n d t , and Topol dentifrices. (J PROSTHET DENT 1991;66:498-500.)
T h e attraction of dental plaque to roughened restorations is of serious concern. Careful polishing and finishing of composite resin restorations can be compromised by subsequent home care. Toothbrushing affects the surface of conventional and microfilled composite resinJ -3 Average losses in the 0.035 mm range after 240,000 strokes (estimated to be 15 years of simulated brushing) have been reported. 3 Although this minimal weight loss is of doubtful clinical significance, the major problem is the resultant surface roughness. This study Observed the effect of various toothpastes on a hybrid composite resin to determine whether commercially available products produced a difference in surface roughness of the restorative resin. MATERIAL
AND
METHODS
Acrylic resin blocks, 3 mm thick, were cured and milled to 82 by 26 mm with a hole 10 mm in diameter prepared in the center. A hybrid composite resin (Herculite-Kerr Mfg. Co., Romulus, Mich.) was compressed between two glass slabs into the prepared hole, cured with a visible light-curing unit (Elipar Visio ESPE Premier Mfg., Norristown, Pa.), and placed in a 37 ° C water bath for 1 week. In a pretest, 24 samples were divided into four groups, placed in a Tooth Brush Wear Tester (Block Drug Co. Inc,, Jersey City, N.J.) instrument, and subjected to 10,000 brushing strokes in 100 cc of deionized water with different toothbrushes (Sensodyne Gentle, Block Drug Co.; Pycopay Natural Soft, Block Drug Co.; Pycopay Softex 4, Block Drug Co.; or Sensodyne Search, Block Drug Co.) to deter-
Presented at the American Association of Dental Research meeting, San Francisco, Calif. *Professor and Director of Research, Department of Prosthodontics and Occlusion. 10/1/28258
498
Table I. Products used in study Product
Manufacturer
Crest regular flavor Rembrandt fluoride Supersmile Colgate Winterfresh gel Topol Smokers polish Shane fluoride Viadent fluoride Sensodyne
Proctor and Gamble, Cincinnati, Ohio Den-Mat Corp., Santa Maria, Calif. Robell Research, New York, N.YI Colgate-Palmolive Co., New York, N.Y. Jeffrey Martin Co., Union, N.J. Jerome Milton Inc., Chicago, Ill. Viadent Inc., Fort Collins, Colo. Dentco Inc., Jersey City, N.J.
Table IL Results of toothbrushing composite resin with deionized water
Group
Count
Pretest mean (~m)
Sensodyne Gentle Pycopay Natural-Soft Pycopay Softex 4 Sensodyne Search
6 6 6 6
0.89 1.00 1.40 0.94
Mean (~m)
1.75 0.65 1.20 1.10
Table IIL Results of brushing composite resin Group
Cases
pH
Mean (~m)
SD
Colgate Shane Viadent Sensodyne Supersmile Crest Rembrandt Topol
36 36 36 36 30 30 36 36
6.8 7,1 5.8 7.2 8.7 7.1 7.1 6.7
4.94 14.36 14.91 17.50 23.80 31.43 33.03 34.58
2.70 13.03 6.52 8.49 17.56 33.40 32.09 36.92
OCTOBER1991 VOLUME66 NUMBER4
TOOTHBRUSHING COMPOSITE RESIN
Table IV. ANOVA by paste (composite resin) Source
DF
Between groups Within groups Total
7 268 275
Sum of squares
27901.8587 135271.8333 163173.6920
mine whether the type of brush affected the surface topography of the composite resin. The toothpastes (Table I) (100 gm of toothpaste in 100 gm of water) were mixed cold for 15 minutes in a Corning hot plate stirrer (PC351, Corning, N.Y.) set to stir only. Readings for pH were made for all slurries with a Beckman Zeromatic SS-3 pH meter (Beckman Instruments Inc., Fullerton, Calif.). The 48 composite resin samples were subjected to 20,000 brushing strokes in the toothpaste slurry with Pycopay Softex brushes in the Tooth Brush Wear Tester instrument, rinsed in tap water, air dried, and evaluated for surface roughness on a profilometer (Mitotoyo Surftest-4, Tokyo, Japan) at a transverse length of 1.5 mm. Six representative readings were made on each sample of composite resin and mounting acrylic resin. The mounting heads were removed and weighed. RESULTS The results of the preliminary test on different toothbrushes are listed in Table II. After 10,000 strokes in the deionized water, no significant differences in surface roughness were found among the four groups, and no significant difference was found between pretest means and posttest means. Table III lists the results of brushing with toothpaste on the composite resin. A one-way analysis of variance (ANOVA) on the effect of the paste showed a significant difference at the 0.01 level (Table IV). A Scheffe test and a Duncan test looking for difference between groups or subsets of groups at the 0.01 level showed results for Colgate to be different from those for the other toothpastes. The weight of the holding heads are listed in Table V. ANOVA on the effect of head position showed no significance at the 0.01 level. Table VI lists the results of brushing with the toothpaste on the acrylic resin blocks. ANOVA showed a significant difference at the 0.01 level (Table VII). A Scheffe test and a Duncan test, also done at the 0.01 level, showed that results for Shane, Sensodyne, Rembrandt, and Topol were different from those of the other products tested. DISCUSSION
Composite resin exhibited good wear resistance. Brushing with deionized water had no effect on the surface of the material. The weights of the toothbrush holding heads were
THE JOURNAL OF PROSTHETIC DENTISTRY
Mean squares (~m)
F Ratio
3985.9798 504.7456
F Prob
7.8970
0.0O00
Table V. Weight of toothbrush-holding heads Head position
W e i g h t in g r a m s
1 2 3 4 5 6
286.6 283.8 281.2 283.9 286.5 282.3
Table VI. Results of brushing acrylic resin Group
Cases
Colgate Crest Viadent Supersmile Shane Sensodyne Rembrandt Topoi
36 30 36 30 36 36 36 36
Mean (#m)
57.88 60.10 88.30 117.53 143.00 167.80 185.00 226.22
SD
72.60 81.03 58.41 130.33 131.01 196.57 115.39 160.69
slightly different (Table V), but did not vary enough to register any difference in the profilometer readings. The number of strokes needed to simulate 1 year's brushing is controversial and arbitrary. Ranges from 43201 to 16,0003 have been reported. Because Kanter et al. 1 demonstrated that there was a decrease in wear rate with an increase in brushing time, the assignment of 10,000 strokes per year and the use of a 2-year simulated study (20,000 strokes) was considered acceptable for this study. The addition of a dentifrice caused surface deterioration in all of the samples. Twenty thousand brushing strokes were produced in 116 minutes at 172 rpm. The Sensodyne and Rembrandt products exhibited severe sludging, whereas Topol, Viadent, Supersmile, and Crest products exhibited slight sludging during the experiment. A comparison of the effect of the toothbrushing on the acrylic resin and the composite resin shows that Colgate toothpaste gave a smoother surface for both the acrylic resin and the composite resin, although only the data for the composite resin were statistically significant (Table VIII). Rembrandt and Topol toothpastes gave a rougher
499
GOLDSTEIN AND LERNER
Table VII. Analysis of variance by paste (acrylic resin) Sum of s q u a r e s Source
DF
(/~m)
Mean squares
F Ratio
F Prob
Between groups Within groups Total
7 268 275
898976.9626 4310195.222 5209172.185
128425.2804 16082.8180
7.9852
0.0000
Table VIII. Comparison effect of toothpaste on acrylic and composite resins Acrylic
Colgate Crest Viadent Supersmile Shane Sensodyne Rembrandt Topol
Composite
Colgate Shane Viadent Sensodyne Supersmile Crest Rembrandt Topol
Spaces separate groups significantly different from one another.
surface to both the acrylic resin and the composite resin; data for the acrylic resin were statistically significant. There is also a concern over the unusually low pH of Viadent toothpaste and its long-term effect on enamel as well as composite resin. CONCLUSIONS
fect of Colgate toothpaste is a statistically significant smoother surface than found with the other dentifrices. 2. The surface topography of acrylic resin will be altered by toothbrushing, with Colgate, Crest, Viadent, and Supersmile products less abrasive than Shane, Sensodyne, Rembrandt, and Topol products. We thank Dr. Gene Hittleman for his assistance with the statistics and the Block Drug Co. for material support for the project. REFERENCES 1. Kanter J, Koski RE, Martin D. The relationship of weight loss to surface roughness of composite resins from simulated toothbrushing. J PROSTHET DENT 1982;47:505-13. 2. Ehrnford L. Surface microstructure of composite resins after toothbrush-dentifrice abrasion. Acta Odontol Scand 1983;41:241-5. 3. Aker JR. New composite resins: comparison of their resistance to toothbrush abrasion and characteristics of abraded surfaces. J Am Dent Assec 1982;105:633-5.
Reprint requests to: DR. GARYR. GOLDSTEIN DAVIDB. KRISERDENTALCENTER NEW YORKUNIVERSITY 345 EAST 24TH ST. NEW YORK, NY 10010
1. The surface topography of a hybrid composite resin will be altered by routine toothbrushing, although the ef-
500
OCTOBER 1991
VOLUME66 NUMBER 4
