Dent Mater 13:258-269, July, 1997

Comparison of surface roughness of

oral hard materials to the threshold surface
roughness for bacterial plaque retention:
A review of the literature
C u r d M. L. B o l l e n l , 2, P a u l L a m b r e c h t s 3, M a r c Q u i r y n e n 1,2

1Department of Periodontology, School of Dentistry, Oral Pathology and Maxillo-facial Surgery,

Catholic University of Leuven, Leuven, BELGIUM
~Research Group for Microbial Adhesion, Leuven, BELGIUM
3BIOMAT, Department of Operative Dentistry and Dental Materials, School of Dentistry,
Oral Pathology and Maxillo-Facial Surgery, Catholic University of Leuven, Leuven, BELGIUM

ABSTRACT
Objectives. The roughness of intraoral hard surfaces can influence
bacterial plague retention, The present review evaluates the initial
surface roughness of several intraoral hard materials, as well as changes
in this surface roughness as a consequence of different treatment
modalities.
Methods. Articles found through Medtine searches were included in this
review if they met the following criteria: 1) stated threshold surface
roughness values and reputed change in surface roughness due to
different manipulation techniques; or 2) included standardized surface
conditions that could be compared to the treated surface.
Results. Recently, some in vivo studies suggested a threshold surface
roughness for bacterial retention (R, = 0.2 pro) below which no further
reduction in bacterial accumulation could be expected. An increase in
surface roughness above this threshold roughness, however, resulted in
a simultaneous increase in plaque accumulation, thereby increasing the
risk for both caries and periodontal inflammation. The initial surface
roughness of different dental materials (e.g., teeth, abutments, gold,
amalgam, acrylic resin, resin composite, glass ionomer or compomer
and ceramics) and the effect of different treatment modalities (e.g.,
polishing, scaling, brushing, condensing, glazing or finishing) on this
initial surface roughness were analyzed and compared to the threshold
surface roughness of 0.2 pro. The microbiological effects of these
treatment modalities, if reported, are also discussed and compared to
recent in vivo data.
Significance. Based on this review, the range in surface roughness of
different intraoral hard surfaces was found to be wide, and the impact of
dental treatments on the surface roughness is material-dependent. Some
clinical techniques result in a very smooth surface (compressing of
composites against matrices), whereas others made the surface rather
rough (application of hand instruments on gold). These findings
indicated that every dental material needs its own treatment modality in
order to obtain and maintain a surface as smooth as possible.
INTRODUCTION
The oral cavity is constantly c o n t a m i n a t e d by m a n y
diverse microbial species. Most of these microorganisms,
especially those which are responsible for caries (e.g.,
Streptococcus mutans a n d Lactobacillus spp.) a n d
periodontitis (e.g.,Actinobacillus actinomycetemcomitans
and Porphyromonas gingivalis), can only survive in the
mouth when they adhere to non-shedding surfaces. The
surface roughness of intraoral hard surfaces is of clinical
importance in the process of bacterial retention. Changes
in this variable might, therefore, facilitate the prevention
of caries and periodontitis. The surface free energy can
also play a role in bacterial adhesion and retention;
however, several studies (e.g., Q u i r y n e n et al., 1990;
Quirynen and BoUen, 1995) suggested that the influence
of the surface roughness overrules the influence of the
surface free energy.
Studies by Quirynen et al. (1990) showed t h a t an
increase in the surface roughness of resin strips above an
R a value of 2 pm resulted in a dramatic increase in the
bacterial colonization of these surfaces in comparison to
smooth strips (R, = 0.12 ~ra), whereas a change in the
surface free energy had almost no impact. Recent studies
on abutments of intraoral two-stage implants (Quirynen
et al., 1996; Bollen et al., 1996) indicated that an increase
in surface roughness (up to 0.8 pm) of these intraoral hard
surfaces had a significant effect on the in vivo rate of plaque
formation (supra- and subgingivally) only if the initial
surface had a minimum R~ value of 0.2 p m (see profile
images, Fig. 1). Therefore, a "threshold R a" was suggested,
which can be located at an R, score of 0.2 pm.
This R~ score is supported by the theory of bacterial
adhesion and retention. Physically, bacterial adhesion and

258 Bollen et aL/Surface roughness of oral hard materials: A review

 MATERIALS AND METHODS

ROUGH
The articles included in this review were selected using a
(R, - 0 8[ p.rn) lJ . ,, Medline search (U.S. National Library of Medicine). The
inclusion criterion was the presence of data on surface
roughness. The following i n t r a o r a l m a t e r i a l s were
studied: natural teeth (9 studies), impl.ant abutments
(5 studies), amalgam (8 studies), gold (6 studies), resin
composites (17 studies), acrylic resin (7 studies), glass
ionomers and compomers (3 studies), a n d ceramics
(4 studies). If microbiological changes in relation to the
0.8 p m q r J roughness were available, they were included.
ST RESULTS
(R, = 0.21 ,~rn)
Tooth: E n a m e l a n d d e n t i n / cementum. T h e mean R a
values, before and after professional therapies, are depicted
-1.2 prn J
in Table 1. Von Mierau et al. (1982) measured the surface
roughness in vivo of crowns of natural teeth in 16 patients
Fig. 1. Profile images of 2 test abutments over the same assessment length (ROUGH using a specially designed roughness probe. They reported
= roughened standard abutment, ST -- standard abutment). The length of the that roughness depended on the tooth type (canines were
profiles is 0.12 pm. The surface roughness (R: arithmetic mean of the departures the roughest) and on the location in the oral cavity (teeth
of the profile from the mean line) was measured with the Talysurf (Taylor-Hobson, in the upper jaw were rougher). All Ra values were above
Leicester, England).
3.5 ~m.
The effect of scaling on roots was examined by Rosenberg
retention occur in four phases: transport of the bacterium and Ash (1974). Fifty-eight teeth were divided into three
toward the surface, initial bacterial adhesion, attachment groups before extraction: 20 teeth were scaled by curettes,
by specific interactions, and finally, colonization of the 20 teeth were scaled by cavitron and the remaining 18
surfaces (Quirynen and Bollen, 1995). Initial bacterial teeth served as controls. The initial surface roughness of
adhesion and retention are physico-chemically possible 18.30 ~m decreased after curette scaling (to 9.51 ~m),
because a bacterium and a surface interact with each other whereas the cavitron scaling had no significant effect on
from a certain distance (approximately 50 nm) through a the tooth roughness (17.21 pm). In an earlier study, Green
combination of van der Waal's attractive forces and and Rami]ord (1966) found almost t h e same results
electrostatic repulsive forces. Lekness and Lie (1991) reported that the scaling of roots
Preferential retention occurs on rough surfaces since followed by polishing with chalk and pumice could decrease
bacteria on such surfaces are more protected against shear the surface roughness to nearly 1.3 ~m, which is still high
forces and can, thereby, have the necessary time to reach compared to the 0.2 pm threshold roughness.
direct contact or to bridge the distance. Initial colonization Oral hygiene implements have almost no influence on
of enamel surfaces was indeed shown to start from surface the initial roughness of crowns. Smith et al. (1986), as
irregularities (e.g., pits, grooves or abrasion defects) where well as Slop a n d A r e n d s (1987), s h o w e d t h a t t h e
bacteria are strongly protected (Nyvad and Fejerskov, application of floss or toothbrushes did not change the R~
1987). At these locations, the attachment may be more value, whereas the use of wooden toothpicks resulted in
s t r o n g l y e s t a b l i s h e d ( Q u i r y n e n a n d Bollen, 1995). an increase in the surface roughness. The difference of
Furthermore, several studies stated that proliferation of the latter roughness values from the R~ values reported
the initially adhering microorganisms accounts for the by Von Mierau et al. (1982) can be explained by the
major part of the microbial mass increase during early different device that was used to measure the surface
plaque formation (Brecx et al., 1983) which may explain roughness. Whereas Slop and Arends (1987) and Smith
the importance of surface roughness in initial plaque et al. (1986) used a computer- guided profilometer on
formation. extracted teeth, Von Mierau et al. (1982) had to use a
Subgingivally, the impact of surface roughness is much manual probe for measuring the surface roughness on teeth~
smaller. The pocket by itself offers a shelter, which limits in the oral cavity.
t h e p o s s i b l e i m p a c t of s u r f a c e r o u g h n e s s on t h e Polishing teeth has different effects on roughness,
subgingival plaque composition. Moreover, different means depending on the paste used. A recent study (Lutz et al.,
are available in this environment for bacterial survival: 1995) showed that polishing dentin (with an initial R of
adhesion to root cementum, adhesion to the desquamat- 0.03 pm) with different materials resulted in an increase
ing pocket epithelium, immersion in the crevicular fluid, in roughness up to 0.131 ~m (pumice). Only the application
invasion of the soft tissue and invasion of the hard tissue of CCS 40 (Clean Chemical AB, Upplands V~isby, Sweden)
via the dentin tubuli (Quirynen and Bollen, 1995). stabilized the R value at 0.03 pm. When enamel (initially
The aim of this literature review was to compare the 0.03 ~m) was polished, only pumice led to an increase in
surface roughness of different materials and the change roughness (up to 0.16 pm); none of the other materials
!n surface roughness by different manipulation techniques influenced the R value (Table 1).
m relation to the stated threshold surface roughness of No studies concerning microbiological effects and
0.2 ~m. results were available.

Dental Materials~July 1997 259


Green and Ramfjord, 1966 Scaling (sickles)
Scaling (curettes)
Scaling (files & curettes)
Scaling (hoes)
ScalinQ (files)
" " " "~ " "" ": ""~
Heath and Wilson, 1976 Brushing (Enamel)
Polishing (rubber cup)
Finishing (white stone)
Polishing (prophylactic paste)
Polishing (Zr discs)
Lekness and Lie, 1991 Scaling
+ Polishing (pumice)
+ Polishing (chalk)
Scaling
+ Polishing (air powder)
+ Polishing (chalk)
Lutz et aL, 1995 0.03 Polishing(CCS 40) (Dentin)
Polishing (Ddtartrine Z)
Polishing (Zircate)
Polishing (Cleanic)
Polishing (CCS 250)
Polishing (Nupro Coarse)
Polishing (pumice)
0.03 Polishing(CCS 40) (Enamel)
Polishing (Cleanic)
Polishing (Ddtartrine Z)
Polishing (COS 250)
Polishing (Nupro Coarse)
Polishing (Zircate)
Polishing (pumice)
Artificial abutment on top of implants. The R, values of that 0.2 Inn is the threshold surface roughness below which
abutments in different studies are shown in Table 2. There no impact on the bacterial retention could be expected.
is a highly significant similarity between oral implants and
teeth, indicated by the presence of crevicular fluid, the after different treatment modalities, are depicted in
similarity in pocket epithelium or a comparable reaction Table 3.
toward plaque (Aspe et al., 1989; Sanz et al., 1991).
Recently, Adonogianaki et al. (1995) even proved that the Smales (1981) found that the amalgams had a two-fold
260 Bollen et aL/Surface roughness of oral hard matenals: A review
inflammatory and immune events in
the peri-implant mucosa and the gin-
giva around natural teeth are similar.
Therefore, the observations made of
artificial abutments can be extrapo-
9.12 + 2.67 lated to the root surfaces of natural
10.05 + 2.29 teeth.
10.54 + 2.45 When six commercially available
12.89 + 2.16
systems were compared, only the Steri-
~ 13.95 ± 3.69
"~" " ~i. ~- Oss (Denar Corp.,Anaheim, CA, USA)
"
and the IMZ abutments (AG Sparte
0.10" Medizin Technik, Mannheim,
0.50* Germany) seemed to have an Ra value
0.50* below 0.2 pm (Quirynen et al., 1994).
0.80* Recently it was shown that electro-
0.80* and mechano-polishing of standard
Brtmemark abutments (Nobelbiocare,
GStenborg, Sweden) also led to a
surface roughness of less than 0.2 pm
(0.13 pin and 0.11 Inn, respectively)
( Q u i r y n e n et al., 1996). Ceka
(Alphadent, La C h a u x - d e fonds,
Switzerland) and Prozyr abutments
(FBC Int. NV, Dessel, Belgium) even
had Ra values below 0.1 llm (0.05 pin
and 0.06 llm, respectively) (Bollen
et al., 1996) (Table 2).
Considering t h e t r e a t m e n t of
artifical a b u t m e n t s , special care
should be taken when titanium instru-
ments (Speelman et al., 1992), air
1.54 ± 0.29 powder abrasive systems (Eliades
126 ± 0.19 et al., 1991) or prophylactic agents,
1.10 ± 0.22 such as fluoride gels or gels contain-
1.68 ± 0.40 ing hydrofluoric acid (PrSbster et al.,
1.41 ± 0.32 1992), are used. These products lead
1.19 ± 0.26 to a t r e m e n d o u s i n c r e a s e in the
initial s u r f a c e r o u g h n e s s of t h e
abutments.
0.03* Microbiology. When roughened
0.08" (Ra = 0.81 pro) abutments were com-
0.11" pared to smooth ones (Ra = 0.35 pin)
0.15" (Quirynen et al., 1993), it was shown
0.23* that the rough abutments harbored 20
0 25* times more bacteria subgingivally,
0.31" with a dearly higher proportion of
0.03* spirochetes and motile organisms,
0.03* which can be considered pathogenic
0.05*
(Theilade et al., 1966). w h e n the Ra
0.06'
0.06* value was decreased below 0.2 pm, no
0,08* significant further changes in the
0.16" total amount nor in the pathogenicity
of the adhering-bacteria could be
detected (Quirynenetal., 1996; Bollen
et al., 1996). Therefore, it was stated
Amalgam. The mean roughness values, before and
When different brands of amalgam were compared,
 the surface roughness of gold are
summarized in Table 4. Roulet
and R o u l e t - M e h r e n s (1982)
showed that polishing of gold with
different pastes did not have any
effect on the surface roughness.
Some pastes (Silperpolish and
Clean-polish) even smoothed the
gold surface from 0.04 tim to
a l m o s t 0.02 Bm. Nupro red
( J o h n s o n & Johnson, E a s t
Windsor, NJ, USA) and Nupro
green" (Johnson & J o h n s o n )
seemed to have an adverse effect
on the Ra value, but the roughness
still remained below 0.2 Bm.
Heath and Wilson (1976), in
contrast, showed that polishing of
initially smooth gold surfaces with
rubber cups, zirconium discs or a
prophylactic paste (Kemdent
Brand, Associated D e n t a l
Products, London, England, UK)
higher R, value than the threshold surface roughness, increased the surface roughness clearly above the
ranging from 0.43 ± 0.03 tim for Sybraloy (Sybron/Kerr, threshold R, value. Brushing had no effect on gold. The
Romulus, MI, USA) to 0.49 ± 0.04 tun for Indiloy (Shofu latter findings were confirmed by Johannsen et al. (1989;
Inc., Tokyo, Japan). 1992) who also r e p o r t e d t h a t b r u s h i n g gold with
Moreover, the finishing procedures were also found to toothpastes such as Clindomyn or Colgate did not have a
have a dramatic impact on the surface roughness. A study severe effect on the roughness. The application of scalers
by Roulet and Roulet-Mehrens (1982) showed that, when and other oral hygiene instruments on gold increased the
initially smooth amalgam (0.05 tim) was polished with R a value from 3 tim (use of curettes) to 20 tim (use of
different materials, the surface roughness remained cavitron) (Cutler et al., 1995) (Table 4).
below 0.2 tun. Some polishing pastes had no influence on No microbiological data were available.
the initial R, value: Fluor-O-Clean (Hawe Neos Dental, Resin composite. Many studies examined the surface
Gentilino, Switzerland), Zircate (L.D. Caulk Co., Dentsply roughness of resin composites (Table 5). When different
Int., Milford, DE, USA), Superpolish (Hawe Neos Dental) brands were studied in vitro, Willems et al. (1992) found
and Cleanpolish (Hawe Neos Dental). By contrast, that almost 30% of the 60 composites tested had an Ra
polishing of smooth amalgam (0.16 pm) with Clinomyn value below the threshold of 0.2 Bm after mechanical
and Colgate (Proctor and Gamble) toothpastes, resulted in polishing. Heliosit (Vivadent, Schaan, Liechtenstein),
a two- to three-fold increase in the surface roughness (up Certain (Johnson & Johnson) and Heliomolar (Vivadent)
to 0.56 Inn) (Johannsen et al., 1989). When initially rough were the smoothest (0.07 tim, 0.08 pm and 0.09 tim,
amalgam (R, = approximately 4.5 tim) was treated with respectively), whereas Estilux Posterior CVS (Kulzer
consecutive polishing and finishing procedures, a ten-fold Friedrichsdorf, Germany), Opalux (GC Int., Tokyo, Japan)
reduction in the surface roughness could be detected (Eide and Litefil A (Shofu Inc.) were initially the roughest
and Tveit, 1987). Davidson (1979) showed that polishing (1.48 tim, 1.50 Inn and 1.56 Inn, respectively). Smales
of amalgam with pumice and SnO 2 resulted in the (1981) detected higher in vitro values for Isopast (Vivadent)
smoothest surfaces and that the threshold roughness of (0.93 + 0.12 Inn) and Concise (3M Dental Products, St. Paul,
0.2 Inn could be reached. Other studies confirmed these MN, USA) (2.09 ± 0.08 Inn), whereas Willems et al. (19923
findings. The use of white stone (AD Trade Dist. Ltd., scored them as 0.13 tim and 1.44 tun, respectively.
London, England, UK) or Nupro-paste (Nupro-gold, Janar Possible explanations for these differences could be the
Co., Grand Rapids, MI, USA), polishing with 240-grit discs finishing procedures of the composites in the different
and tiny strips, are procedures that enormously increase studies and the different equipment used to perform the
the surface roughness (Table 3). surface roughness measurements. When finishing and
No microbiological data were available. However, one polishing procedures are considered, it is concluded that
can state that the amounts of copper (for T2-amalgam: from compressing a composite against a matrix creates a very
1.4 to 5.3%; for non T2-amalgam:from 8.6 to 29.7%) (Vrijhoef smooth surface. All studies showed R, values far below
et al., 1980) and mercury in the different amalgams have the threshold level of 0.2 tim, ranging from 0.03 tim
an antibacterial function. Nourallahi and Meryon (1989) (Restodent (Lee Pharmaceutics) (Davidson,. 1979) up to
showed t h a t when released from dental restorative 0.2 Inn (Adaptic (Johnson & Johnson, New Brunswick, NJ,
materials, copper and mercury, have an antibacterial USA) (Weitman and Eames, 1975). However, when
activity on bacterial plaque. conventional and microfilled composites were polished with
Gold. T h e results of different treatment modalities on different prophylactic pastes, an increase in surface

Dental Materials~July 1997 261

 Heath and Wilson, 1976 Brushing with dentifrice 0.30*
Polishing (pumice) 0.50*
Polishing (rubber cup) 0.50*
Polishing (prophylactic paste) 0.60*
Polishing (Zr Silicat discs) 1.00"

+ Finishing bur 1.40"

+ Polishing (pumice) 0.40*
+ Polishing (chalk) 0.35*
+ Polishing (Sn02) 0.30*
4.20 Green stone 1.70"
+ Finishing bur 1.40*
+ Coarse polisher 0.50*
+ Fine polisher 0.20*
+ Polishing (pumice) 0.50*
+ Polishing (chalk) 0.40*
+ Polishing (SnO~) 0.40*
5.00 Medium sandpaper 1.40"
+ Fine sandpaper 0.80*
Polishing (fine white disc) 0.40*
+ Polishing (pumice) 0.45*
+ Polishing (chalk) ~ 0.40*
+ Polishin~L(Sp..O~" ~ 0.40*
~ ~ ~ ~ ~ ~ ~ : , ~ i ~ ; £ m ~ ; i ; 2 ~ ~ ~ ~
. ~ :. :.:~" .::. • .,~i~..~:~:~?~:,:~::~i~i~ . . ~ iii~ ~

roughness was detected, even up to 4 times (Roulet and decreased the surface roughness below the threshold R,
Roulet-Mehrens, 1982). Chung (1994) saw the opposite (0.18 pm and 0.14 Inn, respectively).
result: polishing Herculite (Kerr Mfg. Co., Romulus, MI, In studies where, unfortunately,no initial roughness was
USA) (0.35 ± 0.07 pm) and Heliomolar (0.52 ± 0.17 llm) mentioned, it can be concluded that only the polishing of

262 Bollen et aL/Surface roughness of oral hard materials: A review

 between surface roughness and plaque forma-
tion and retention might be explained by the
high R a v a l u e s of t h e e x a m i n e d surfaces
Heath and Wilson, 1976 0.08 Brushing 0.07* (ranging from 0.8 to 1.4 l~n).
Polishing (prophylactic paste) 0.30* The cytotoxicity of monomers can also have
Polishing (rubber cup) 0.50* an antibacterial effect on the flora on this
material.
Polishing (Zr discs) 0.50*
Finishing (white stone) 0.90* Acrylic resin. The results of the treatment
of acrylic resin are not clear-cut (Table 6).
Busscher et al. (1984) stated that polishing this
material leads to a surface roughness below
the threshold R,, depending on the polishing
grit (from 0.03 lxm to 0.75 ]lm). Most other
studies found an increase in the roughness
after polishing procedures: Loney et al. (1994)
recently showed that treatment of resin with
different procedures leads to a two- to five-fold
Roulet and 0.04 Polishing(Superpolish) 0.02' increase of the surface roughness. Others
Roulet-Mehrens, 1982 Polishing (Cleanpolish) 0.03*
found a 10-fold increase when No. 400 emery
Polishing (Fluor-O-Clean) 0.03* paper was used (Verran et al., 1991). Similar
Polishing (Prophyprep) 0.03*
to composites, c o m p r e s s i n g acrylic resin
Polishing (Zircate) 0.03*
against glass results in a very low R, value
Polishing (Coral II) 0.04*
(0.10 ~m; Heath and Wilson, 1976) (Table 6).
Polishing (Nupro gold) 0.04* Microbiology. Verran et al. (1991) showed
Polishing (Colgate fluor prophylax paste) 0.05*
t h a t C a n d i d a a l b i c a n s cells a d h e r e d in
Polishing (Nupro green) 0.06" significantly higher numbers to rough acrylic
Polishing (Nupro red) 0.08* than to smooth acrylic, but maximal adhesion
was achieved on acrylic surfaces roughened
with medium grit size emery paper (R~ from
0.01 to 1.20 p~n).
The roughness of a denture-fitting surface
can help to d e t e r m i n e its colonization by
different microorganisms. Repeated aggressive
brushing of dentures with abrasive cleansers
will scratch even smooth denture surfaces
(Anon, 1983; De N a v a r r e , 1975). T h e s e
findings were confirmed by Yamamuchi et al.
(1990), who showed that Streptococcus sanguis,
Bacteroides gingivalis C-101 and Candida
albicans adhered in greater amounts to the
roughest surfaces in comparison to the smooth
surfaces.
Glass ionomers and compomers. Only three
studies concerning glass ionomer and
compomer cements could be found (Table 7).
Recently, Gladys et al. (1997) summarized data
on the surface roughness of these materials.
microfilled composites with alumina discs or with rubber Hotta et al. (1995) showed that only compressing Fuji~
wheels (O'Brien et al., 1984), the polishing of Isomolar with Ionomer II (GC Int.) against glass resulted in an, Rh ~ 0.2
diamond paste or Sof-lex discs (3M Dental Products) (Van llm. All the other manipulations of these cements, such as
dijken and Ruyter, 1987), and the polishing of Herculite polishing and glazing, showed higher surface roughness
with Sof-lex discs (Tjan and Chan, 1989) resulted in values, even up to 1.5 1Jm (polishing of Chelonfil (ESPE
s u r f a c e r o u g h n e s s b e l o w 0.2 l~m. All t h e o t h e r Fabrik, Seefeld, Germany) (Table 7).
manipulations led to a value above this threshold surface No microbiological data were available. The fluoride
roughness (Table 5). included in these materials resulted in antibacterial
Microbiology. Only the study by Skjorland et al. (1982) activity, although less i m p o r t a n t t h a n the activity of
mentioned some microbiological data: it was shown that copper, mercury and zinc in other dental restorative
bacteria a d h e r e d in similar amounts to the different materials (Nourollahi and Meryon, 1989; Cimasoni, 1972).
m a t e r i a l s a n d t h a t t h e r e did not a p p e a r to be a n y The fluoride release has a specific bactericidal effect on
predilection for the bacteria (Streptococcus sanguis ATCC mutans streptococci, but only for a relatively short period
10556) to accumulate in the voids or on the filler or matrix of time (Forss et al., 1991).
surface of the composite. The absence of a relationship Ceramics. The results for this material are summarized

Dental Materials~July 1997 263


Weitman and Compressing (Mylar strip)
Eames, 1975 Polishing (AIO)
Finishing (white Arkansas stone)
Polishing (Zr paste)
Polishing (pumice)
Horton et a/., Compressing (Mylar strip)
1977 Polishing (discs)
Polishing (discs + Justi paste)
Polishing (discs + Precise paste)
Polishing (discs + 3M paste)
in Table 8. Lee et al. (1995) recently found that the use of
ultrasonic scalers or hand scalers had no influence on the
roughness of initially smooth surfaces. Both treatment
modalities kept the roughness (< 0.14 ~m) below the
threshold roughness, although when SEM photographs
w e r e s u b j e c t i v e l y e v a l u a t e d , it was
indicated that the integrity of the glazed
surface was altered in the form of deep
scratches on the ultrasonic-scaled surfaces
0.20* and numerous smaller scratches on the
0.71" hand-scaled porcelain. These scratches
0.82* could not be detected with the profilometer.
1.01" Most finishing techniques were found to
1.44" render initially rough ceramic surfaces
smoother, below the threshold R~.
When ceramics with an initial R~ value
of nearly 3.0 ~ n were subjected to finish-
ing with Sof-lex discs, or carbide burs or
polishing with ET diamonds, with Flex-
discs or two striper diamonds, the rough-
ness decreased below 0.1 l~m. Ward et al.
(1995) showed that these findings were
true for different ceramic materials, such
0.04 ± 0.01 as Ceramco II (Ceramco Inc., Burlington,
0.58 + 0.11 NJ, USA),Vinytage (3M Dental Products),
1.00 ± 0.10 Opal 58 (3M D e n t a l P r o d u c t s ) a n d
1.02 ± 0.15 Duceram (Ducera Dental, GmBh, Rosbach,
1.11 ± 0.12 Germany). Polishing with different
consecutive materials, such as tungsten,
Shofu points (Shofu Int.), diamond strips
(Premier Dental Co., Norristown, PA, USA)
or Sof-lex discs resulted in little surface
roughness, but not below the threshold
surface roughness (Whitehead et al., 1995)
(Table 8).
No microbiological data were available.
In summary, the roughness ofintraoral
hard surfaces had a major impact on the
retention of oral microorganisms. Supra-
as well as subgingivally, an increase in
surface roughness was found to result in a
faster colonization of the surfaces and a
faster maturation of the plaque, thereby
increasing the risk for caries and periodon-
tal inflammation. Therefore, the roughness
of all i n t r a o r a l h a r d s u r f a c e s should
approximate an Ra value of 0.2 ~m or
lower.
Whereas a lot of publications deal with
the supragingival aspect of surface rough-
ness, the technical difficulty of altering the
surface roughness of subgingival surfaces
without surgical intervention explains the
small number of publications concerning
this subject. Furthermore, the majority
of the articles are of relative importance
since only one roughness p a r a m e t e r is
mentioned (Ra, surface roughness). It
would have been more valid to compare
Rtm (mean of m a x i m u m peak to valley
heights of a profile over the assessment
length) or Sm (mean spacing between the
profile peaks at the mean line) values since they give a
better idea of the size of the irregularities on the surface.
The Rtm value gives an idea of the depth of the defect,
whereas the Sm value describes the width of the defect.
Bollen et al. (1996) and Quirynen et al. (1996) explained

264 Bollen et aL/Surface roughness of oral hard rnatedals: A review

 b a c t e r i a a d h e r e to t h e s u r f a c e
parallel to the long axis of the
abutments. In addition, very few
publications could be found t h a t
Roulet and 0.28 Polishing (SuperpoUsh) (Conventional) 0.45* included microbiological data
Roulet-Mehrens, Polishing (Zircate) 0.85* related to the changes in surface
1982 Polishing (Cleanpolish) 0.70* roughness. From this point of view,
Polishing (Fluor-O-Clean) 0.80* a lot of research still must be done.
Polishing (Nupro gold) 0.85* Materials w i t h an initial low
Polishing (Coral II) 1.00" surface roughness should, there-
Polishing (Prophyprep) 1.00" fore, be selected as the first choice.
Polishing (Nupro green) 1.05" Amalgams with a low Ra value are
Polishing (Colgate fluoride prophylactic paste) 1.10' Sybraloy, ANA 68 or ANA 2000.
Polishing (Nupro red) 1.15" S m o o t h gold s u r f a c e s c a n be
0.05 Polishing (Superpolish) (Microfilled) 0.08* obtained with Herodor G, Sj5dings
Polishing (Zircate) 0.11" C, Primor and Try-cast soft. The
Polishing (Fluor-O-Clean) 0.12" l a r g e r e v i e w of c o m p o s i t e s by
Polishing (Nupro gold) 0.12' Willems et al. (1992) showed t h a t
Polishing (Cleanpolish) 0.14' several products are below the
Polishing (Coral II) 0.15" threshold level, such as Heliosit,
Polishing (Colgate fluoride prophylactic paste) 0.22* Certain and Heliomolar. From the
Polishing (Prophyprep) 0.22* glass ionomer c e m e n t s (Gladys
Polishing (Nupro green) 0.24* et al., 1997) only Fuji Ionomer
Polishing (Nupro red) 0.28* s e e m s to h a v e a n a c c e p t a b l e
surface roughness. Several acrylic
resins have an appropriate initial
Ra value: Ivoclar Sr Isosit PE,
Ivoclar SR Isosit N. Of the ceramic
m a t e r i a l s , o n l y V i t a V M K 68
O'Brien et aL, Polishing (rubber wheel) (Conventional) 0.30* porcelain had a surface roughness
1984 Polishing (Silicate disc) 0.32* reaching 0.2 pm.
Polishing (Alumina disc) 0.38* As for finishing procedures, the
Polishing (12-fluted bur) 1.50" b e s t w a y to a c h i e v e a s m o o t h
Polishing (rubber wheel) (Microfilled) 0.08* amalgam surface is to polish it with
Polishing (Alumina disc) 0.14" pumice or SnO=, whereas if one
Polishing (Silicate disc) 0.45* s t a r t s w i t h an i n i t i a l l y smooth

//
Polishing (12-fluted bur) 0.98* surface, most polishing pastes do
not increase the roughness very
much. Gold polishing can best be
performed with rouge. The optimal
w a y to m a k e r e s i n composites,
acrylic resin and glass ionomer
cements smooth is to compress
them against a polyester strip. Also
Vandijken and Polishing (SiC paper) (Isomolar) 0.04 + 0.0,' p o l i s h i n g w i t h a l u m i n a discs,
R~yter,1987 Polishing (Diamond paste 2.5 pm) 0.10 + 0.09 Sof-lex discs, rubber wheels or with
Polishing (Diamond paste 0.1 pm) 0.11 + 0.19 diamond pastes (from 7 to 0.1 pro)
Polishing (Diamond paste 1 pro) 0.11 + 0.05 can result in a smooth composite~
Polishing (Diamond paste 7 pm) 0.17 + 0.09 surface. Ceramics can preferably be
Polishing (Sof-lex, superfine) 0.19 + 0.06 finished w i t h Sof-lex or carbide
Polishing (Sof-lex, fine) 0.29 + 0.09 burs.
Brushing 0.30 + 0.18 ReceivedSeptember12, 1996/
Polishing (Sof-lex, medium) 0.39 + 0.13 AcceptedMarch14,1997
Polishing (Sof-lex, coarse) 1.04 + 0.3t Addresscorreslfondenceandreprintrequeststo:
(continued) CurdM.L.Bollen
Dept.of Periodontology,School of Dentistry
t h a t the Rtm value of all the artificial abutments they used OralPathologyand Maxillo-facialSurgery
was always less t h a n 1 pm, which means that vertically, CatholicUniversityofLeuven
bacteria which n o r m a l l y are several ~m in size are Capucijnenvoer7,B-3000Leuven,
protected against shear forces. The Sm values of the BEIL]IUM
abutments ranged from 26 to 6 gm, so only horizontally is Phone:++0032-16-332407
some shelter offered to the bacteria, but only if the Fax:++0032-16-332484

Dental Materials~July 1997 265


Vandijken and Polishing (SiC paper)
Ruyter,1987 Polishing (Sof-lex, superfine)
Polishing (Sof-lex, fine)
Polishing (Sof-lex, medium)
Brushing
Polishing (Sof-lex, coarse)
Polishing (Diamond paste 0.1 pro)
Polishing (Diamond paste 2.5 pm)
Polishing (Diamond paste 7 pro)
Tjan and Chan, Polishing (Luster paste)
1989 Polishing (3M Sof-lex superfine)
Polishing (3M Sof-lex fine)
Polishing (3M Sof-lex medium)
Polishing (white stone)
Polishing (coarse)
Polishing (Luster paste)
Polishing (3M Sof-lex superfine)
Polishing (3M Sof-lex fine)
Polishing (3M Sof-lex medium)
Polishing (white stone)
Polishing (coarse)
Willems et al.,
1992
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Compara-
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Dental Materials/July 1997 269