Questioning the effectiveness of composite Polishing systems by crosschecking profilometer and dental microscope...

To investigate the clinical efficiency of the composite polishing systems and procedures by comparing device-based quantitative and visual inspections. Six composite polishing groups were prepared as per polishing discs (fine and super-fine, Sof-Lex), spiral wheels (prepolisher & high-shine-polisher, DiacompPlus), silicone cup (Enhance & Pogo), polishing paste (Lucida), rubber cup (Kenda), and sandpaper (1000 & 1500-grits). All were performed in three steps (3 × 30s), and paste was used for each. Surface roughness (Ra) was measured by a profilometer, and the Surface Roughness Index (SRI) was evaluated using a dental operating microscope (DOM). ANOVA, Kruskal-Wallis H, and Friedman tests were used (< 0.050). The first polishing step significantly increased Ra scores (P < 0.05) except for the paste group. The second step decreased Ra for all (P < 0.05). The best results were obtained after using polishing paste as the third step. A weak correlation was found between the SRI and Ra scores (rho = 0.287)(P < 0.001). A weak correlation in the second (rho = 0.460)(P = 0.002) and a moderate correlation in the third step were observed (rho = 0.549)(P < 0.001). Outcomes were different for profilometer Ra and DOM SRI assessments. High SRI scores for the mylar strip corresponded to the low Ra scores. Therefore, Ra measurements may be misleading without DOM confirmation. Crosschecking device-based roughness scores with visual evaluations under magnification might be recommended. Lucida paste enhanced the polishing effectiveness for all systems. Different outcomes may be obtained in vitro through the device-based and visually driven surface roughness analyses, which are important for proper composite polishing system selection clinically. The polishing system and application procedure may affect not only the surface roughness but also the surface morphology of a restoration.