Comparative evaluation of probiotic solutions on surface roughness and microhardness of different restorative materials and enamel

This research study aimed to investigate the impact of probiotic mouthwash and kefir on the surface characteristics, specifically surface roughness and microhardness, of different restorative materials, as well as permanent and deciduous tooth enamels. Thirty disc-shaped specimens were prepared from composite resin (G-ænial Posterior (GP)), polyacid-modified composite resin (compomer) (Dyract-XP (DXP)), and resin-modified glass ionomer cement (Ionoseal (IS)). Additionally, thirty specimens of enamel were obtained from permanent teeth (PT) and thirty from deciduous teeth (DT) by embedding buccal and lingual sections, acquired through vertical sectioning of 15 permanent and 15 deciduous human tooth crowns in the mesiodistal orientation within acrylic resin blocks. The specimens were then categorized into three distinct groups and immersed for 14 days in one of the following solutions: distilled water, kefir or probiotic mouthwash. The mean surface roughness values of all specimens were assessed using an atomic force microscope, while the mean surface microhardness was measured using a Vickers hardness measuring instrument. The results revealed a statistically significant difference in mean surface roughness among the various restorative materials (p < 0.001). Among the restorative materials, the IS material exhibited notably higher mean surface roughness values than other restorative materials and tooth enamel, while no significant differences were observed between the PT and DT groups. Importantly, the main effect of the solutions under investigation was not statistically significant (p = 0.208). No significant difference was found between the surface roughness values of specimens subjected to the different solutions. When evaluating the effects of materials and solutions on microhardness, the main effects of material and solution variables and the influence of material-solution interactions were statistically significant (p < 0.001). Taken together, these results indicate that consistent use of kefir or probiotic mouthwashes may impact the surface properties of various restorative materials and tooth enamel.

Atomic force microscopy; Microhardness; Probiotic mouthwash; Surface roughness

[1] Soliman HAN, Elkholany NR, Hamama HH, EL-Sharkawy FM, Mahmoud SH, Comisi JC. Effect of different polishing systems on the surface roughness and gloss of novel nanohybrid resin composites. European Journal of Dentistry. 2021; 15: 259–265.

[2] Siokis V, Michailidis T, Kotsanos N. Tooth-coloured materials for class II restorations in primary molars: systematic review and meta-analysis. European Archives of Paediatric Dentistry. 2021; 22: 1003–1013.

[3] Pires CW, Pedrotti D, Lenzi TL, Soares FZM, Ziegelmann PK, Rocha RDO. Is there a best conventional material for restoring posterior primary teeth? A network meta-analysis. Brazilian Oral Research. 2018; 32: e10.

[4] Rodrigues JA, Casagrande L, Araújo FB, Lenzi TL, Mariath AAS. Restorative materials in pediatric dentistry. Pediatric Restorative Dentistry. 2019; 83: 161–167.

[5] Casagrande L, Dalpian DM, Ardenghi TM, Zanatta FB, Balbinot CE, Garcia-Godoy F, et al. Randomized clinical trial of adhesive restorations in primary molars. 18-month results. American Journal of Dentistry. 2013; 26: 351–355.

[6] Raj D, Ganapathy D. Childrens preference toward color of compomer fillings. Drug Invention Today. 2019; 12: 1958–1961.

[7] Ghilotti J, Mayorga P, Sanz JL, Forner L, Llena C. Remineralizing ability of resin modified glass ionomers (RMGICs): a systematic review. Journal of Functional Biomaterials. 2023; 14: 421.

[8] Ozan G, Eren MM, Gürcan AT, Bilmez ZY, Yücel YY. A comparison of surface roughness values of various restorative materials immersed in pedodontic pre-and probiotics. Biointerface Research in Applied Chemistry. 2021; 11: 14389–14402.

[9] Mert Eren M, Ozan G, Yildirim Bilmez Z, Gurcan AT, Yücel YY. Comparison of restorative materials and surface alterations after pre biotic and probiotic beverages: a nanoindentation and SEM study. Microscopy Research and Technique. 2022; 85: 499–509.

[10] de Fátima Alves da Costa G, Melo AMDS, de Assunção IV, Borges BCD. Impact of additional polishing method on physical, micromorphological, and microtopographical properties of conventional composites and bulk fill. Microscopy Research and Technique. 2020; 83: 211–222.

[11] Mara da Silva T, Barbosa Dantas DC, Franco TT, Franco LT, Rocha Lima Huhtala MF. Surface degradation of composite resins under staining and brushing challenges. Journal of Dental Sciences. 2019; 14: 87–92.

[12] Ruivo MA, Pacheco RR, Sebold M, Giannini M. Surface roughness and filler particles characterization of resin‐based composites. Microscopy Research and Technique. 2019; 82: 1756–1767.

[13] Lai G, Zhao L, Wang J, Kunzelmann K. Surface properties and color stability of dental flowable composites influenced by simulated toothbrushing. Dental Materials Journal. 2018; 37: 717–724.

[14] Koc Vural U, Bagdatli Z, Yilmaz AE, Yalçın Çakır F, Altundaşar E, Gurgan S. Effects of charcoal-based whitening toothpastes on human enamel in terms of color, surface roughness, and microhardness: an in vitro study. Clinical Oral Investigations. 2021; 25: 5977–5985.

[15] Schrezenmeir J, de Vrese M. Probiotics, prebiotics, and synbiotics—approaching a definition. The American Journal of Clinical Nutrition. 2001; 73: 361S–364S.

[16] Young RJ, Huffman S. Probiotic use in children. Journal of Pediatric Health Care. 2003; 17: 277–283.

[17] Krupa N, Thippeswamy H, Chandrashekar B. Antimicrobial efficacy of Xylitol, Probiotic and Chlorhexidine mouth rinses among children and elderly population at high risk for dental caries—a randomized controlled trial. Journal of Preventive Medicine and Hygiene. 2022; 63: E282.

[18] Kurinji Amalavathy R, Sahoo HS, Shivanna S, Lingaraj J, Aravinthan S. Staining effect of various beverages on and surface nano-hardness of a resin coated and a non-coated fluoride releasing tooth-coloured restorative material: an in-vitro study. Heliyon. 2020; 6: e04345.

[19] ARMORAL. Armoral Probiotic Oral Care. 2019. Available at: https://www.armoral.com.tr/ (Accessed: 28 November 2023).

[20] Szajewska H. What are the indications for using probiotics in children? Archives of Disease in Childhood. 2016; 101: 398–403.

[21] Gurdogan Guler EB, Bayrak GD, Unsal M, Selvi Kuvvetli S. Effect of pediatric multivitamin syrups and effervescent tablets on the surface microhardness and roughness of restorative materials: an in vitro study. Journal of Dental Sciences. 2021; 16: 311–317.

[22] Guler S, Unal M. The evaluation of color and surface roughness changes in resin based restorative materials with different contents after waiting in various liquids: an SEM and AFM study. Microscopy Research and Technique. 2018; 81: 1422–1433.

[23] Kazak M, Koymen SS, Yurdan R, Tekdemir K, Donmez N. Effect of thermal aging procedure on the microhardness and surface roughness of fluoride containing materials. Annals of Medical Research. 2020; 27: 888–894.

[24] Erturk-Avunduk AT, Cengiz-Yanardag E, Karakaya I. The effect of bleaching applications on stained bulk-fill resin composites. BMC Oral Health. 2022; 22: 392.

[25] Mei L, Guan G. Profilometry and atomic force microscopy for surface characterization. Nano TransMed. 2023; 2: e9130017.

[26] Colombo M, Poggio C, Lasagna A, Chiesa M, Scribante A. Vickers micro-hardness of new restorative CAD/CAM dental materials: evaluation and comparison after exposure to acidic drink. Materials. 2019; 12: 1246.

[27] Bilge K, Kılıç V. Effects of different remineralizing agents on color stability and surface characteristics of the teeth following vital bleaching. Microscopy Research and Technique. 2021; 84: 2206–2218.

[28] Heintze SD, Loguercio AD, Hanzen TA, Reis A, Rousson V. Clinical efficacy of resin-based direct posterior restorations and glass-ionomer restorations—an updated meta-analysis of clinical outcome parameters. Dental Materials. 2022; 38: e109–e135.

[29] Francois P, Fouquet V, Attal JP, Dursun E. Commercially available fluoride-releasing restorative materials: a review and a proposal for classification. Materials. 2020; 13: 2313.

[30] Rajeev G, Lewis A, N S. A time based objective evaluation of the erosive effects of various beverages on enamel and cementum of deciduous and permanent teeth. Journal of Clinical and Experimental Dentistry. 2020; 12: e1–e8.

[31] Teutle-Coyotecatl B, Contreras-Bulnes R, Rodríguez-Vilchis LE, Scougall-Vilchis RJ, Velazquez-Enriquez U, Almaguer-Flores A, et al. Effect of surface roughness of deciduous and permanent tooth enamel on bacterial adhesion. Microorganisms. 2022; 10: 1701.

[32] Irwin N, Currie MJ, Davis D. Probiotic supplementation in healthy pre‐school‐aged children: what, why, how and when? Journal of Paediatrics and Child Health. 2023; 59: 58–63.

[33] Hojsak I. Probiotics in children: what is the evidence? Pediatric Gastroenterology, Hepatology & Nutrition. 2017; 20: 139.

[34] Lundelin K, Poussa T, Salminen S, Isolauri E. Long‐term safety and efficacy of perinatal probiotic intervention: evidence from a follow‐up study of four randomized, double‐blind, placebo‐controlled trials. Pediatric Allergy and Immunology. 2017; 28: 170–175.

[35] O’Connor LE, Gahche JJ, Herrick KA, Davis CD, Potischman N, Vargas AJ. Nonfood prebiotic, probiotic, and synbiotic use has increased in US adults and children from 1999 to 2018. Gastroenterology. 2021; 161: 476–486.e3.

[36] Ciprandi G, Tosca MA. Probiotics in children with asthma. Children. 2022; 9: 978.

[37] Devlukia S, Hammond L, Malik K. Is surface roughness of direct resin composite restorations material and polisher‐dependent? A systematic review. Journal of Esthetic and Restorative Dentistry. 2023; 35: 947–967.

[38] Gaviria-Martinez A, Castro-Ramirez L, Ladera-Castañeda M, Cervantes-Ganoza L, Cachay-Criado H, Alvino-Vales M, et al. Surface roughness and oxygen inhibited layer control in bulk-fill and conventional nanohybrid resin composites with and without polishing: in vitro study. BMC Oral Health. 2022; 22: 258.

[39] Haghgoo R, Haghgou H, Asdollah F. Comparison of the microhardness of primary and permanent teeth after immersion in two types of carbonated beverages. Journal of International Society of Preventive and Community Dentistry. 2016; 6: 344.

[40] Lussi A, Kohler N, Zero D, Schaffner M, Megert B. A comparison of the erosive potential of different beverages in primary and permanent teeth using an in vitro model. European Journal of Oral Sciences. 2000; 108: 110–114.

[41] Escamilla-Gómez G, Sánchez-Vargas O, Escobar-García DM, Pozos-Guillén A, Zavala-Alonso NV, Gutiérrez-Sánchez M, et al. Surface degradation and biofilm formation on hybrid and nanohybrid composites after immersion in different liquids. Journal of Oral Science. 2022; 64: 263–270.

[42] Villalta P, Lu H, Okte Z, Garcia-Godoy F, Powers JM. Effects of staining and bleaching on color change of dental composite resins. The Journal of Prosthetic Dentistry. 2006; 95: 137–142.

[43] Shamszadeh S, Sheikh-Al-Eslamian SM, Hasani E, Abrandabadi AN, Panahandeh N. Color stability of the bulk-fill composite resins with different thickness in response to coffee/water immersion. International Journal of Dentistry. 2016; 2016: 7186140.

[44] Aly AAM, Erfan D, Abou El Fadl RK. Comparative evaluation of the effects of human breast milk and plain and probiotic-containing infant formulas on enamel mineral content in primary teeth: an in vitro study. European Archives of Paediatric Dentistry. 2020; 21: 75–84.

[45] Saha S, Chopra A, Kamath SU, Kashyap NN. Can acid produced from probiotic bacteria alter the surface roughness, microhardness, and elemental composition of enamel? An in vitro study. Odontology. 2023; 111: 929–941.

[46] Ferrer MD, López-López A, Nicolescu T, Salavert A, Méndez I, Cuñé J, et al. A pilot study to assess oral colonization and pH buffering by the probiotic Streptococcus dentisani under different dosing regimes. Odontology. 2020; 108: 180–187.

[47] Angarita-Díaz MP, Forero-Escobar D, Cerón-Bastidas XA, Cisneros-Hidalgo CA, Dávila-Narvaez F, Bedoya-Correa CM, et al. Effects of a functional food supplemented with probiotics on biological factors related to dental caries in children: a pilot study. European Archives of Paediatric Dentistry. 2020; 21: 161–169.

[48] Kılıç V, Gök A. Effect of different polishing systems on the surface roughness of various bulk‐fill and nano‐filled resin‐based composites: an atomic force microscopy and scanning electron microscopy study. Microscopy Research and Technique. 2021; 84: 2058–2067.

[49] Karatas O, Gul P, Gündoğdu M, Iskenderoglu DT. An evaluation of surface roughness after staining of different composite resins using atomic force microscopy and a profilometer. Microscopy Research and Technique. 2020; 83: 1251–1259.

[50] Dinçkal Yanıkoğlu N, Sakarya RE. Test methods used in the evaluation of the structure features of the restorative materials: a literature review. Journal of Materials Research and Technology. 2020; 9: 9720–9734.

[51] Yılmaz C, Kanık Ö. Investigation of surface roughness values of various restorative materials after brushing with blue covarine containing whitening toothpaste by two different methods: AFM and profilometer. Microscopy Research and Technique. 2022; 85: 521–532.

[52] Kakaboura A, Fragouli M, Rahiotis C, Silikas N. Evaluation of surface characteristics of dental composites using profilometry, scanning electron, atomic force microscopy and gloss-meter. Journal of Materials Science: Materials in Medicine. 2007; 18: 155–163.

[53] Ünal M, Candan M, İpek İ, Küçükoflaz M, Özer A. Evaluation of the microhardness of different resin‐based dental restorative materials treated with gastric acid: scanning electron microscopy-energy dispersive X‐ray spectroscopy analysis. Microscopy Research and Technique. 2021; 84: 2140–2148.

[54] Saati K, Khansari S, Mahdisiar F, Valizadeh S. Evaluation of microhardness of two bulk-fill composite resins compared to a conventional composite resin on surface and in different depths. Journal of Dentistry. 2022; 23: 58.

[55] Ozkanoglu S, G Akin E. Evaluation of the effect of various beverages on the color stability and microhardness of restorative materials. Nigerian Journal of Clinical Practice. 2020; 23: 322.

[56] Karatas O, Gul P, Akgul N, CELİK N, Gundogdu M, Duymus Z, et al. Effect of staining and bleaching on the microhardness, surface roughness and color of different composite resins. Dental and Medical Problems. 2021; 58: 369–376.

[57] Souza RO, Özcan M, Mesquita AM, De Melo RM, Galhano GÁP, Bottino MA, et al. Effect of different polymerization devices on the degree of conversion and the physical properties of an indirect resin composite. Acta Odontológica Latinoamericana. 2010; 23: 129–135.

[58] Demirel F, Saygılı G, Şahmalı S. Comparative mechanical property characterization of three indirect composite resin materials compared with two direct composites. Polymers for Advanced Technologies. 2003; 14: 380–386.

[59] Yesilyurt C, Yoldas O, Altintas Sh, Kusgoz A. Effects of food-simulating liquids on the mechanical properties of a silorane-based dental composite. Dental Materials Journal. 2009; 28: 362–367.

[60] Nagdev P, Kumar NN, Moyin S, Lahiri B. Evaluation of the impact of acidic drink on the microhardness of different esthetic restorative materials: an in vitro study. The Journal of Contemporary Dental Practice. 2020; 21: 233–237.

[61] Altwaim B, Salama F, Alogayyel S. Effect of probiotic mouthrinses on surface microhardness of esthetic restorative materials. The Journal of Contemporary Dental Practice. 2020; 21: 543–548.

[62] Üstün‐Aytekin Ö, Çoban I, Aktaş B. Nutritional value, sensory properties, and antioxidant activity of a traditional kefir produced with Arthrospira platensis. Journal of Food Processing and Preservation. 2022; 46: e16380.

[63] Devlin H, Bassiouny Ma, Boston D. Hardness of enamel exposed to Coca‐Cola® and artificial saliva. Journal of Oral Rehabilitation. 2006; 33: 26–30.

[64] Al Ghwainem A. Impact of various remineralizing agents on artificial white spot lesion on primary teeth—a comparative study. Journal of Pharmacy & Bioallied Sciences. 2023; 15: S426–S429.