Investigation of the Effects of Different Polishing Methods on Tooth Surfaces in Smokers: An In Vitro Study

Introduction. This in vitro study aimed to compare the enamel and root surfaces of teeth between smokers and non-smokers after scaling with hand instruments and to evaluate surface characteristics of smokers’ teeth after applying different polishing methods. Methods. This study analyzed periodontally affected teeth extracted from heavy smokers and non-smokers, dividing them into six groups: Group 1: scaling with hand instruments (HI); Group 2: HI followed by polishing with paste (Nupro prophy paste); Group 3: HI followed by polishing with pumice (Imipomza); Group 4: HI followed by air polishing using sodium bicarbonate (Air Flow Classic powder); Group 5: HI followed by air polishing using erythritol (Air Flow Plus powder); and Group 6: HI performed on teeth from non-smokers. Following each experiment, the surface roughness of the crown (RaC) and root (RaR) was measured. The samples were analyzed using a scanning electron microscope (SEM) combined with energy-dispersive X-ray analysis. Results. A total of 60 samples were analyzed, with 10 samples allocated to each group. The samples in Group 1 exhibited erosion areas with exposed enamel rod ends on the crown surfaces, while the root surfaces displayed resorption craters with exposed dentinal tubules. In the SEM analysis of the polishing methods, Group 2 displayed a relatively smooth surface characterized by the presence of deposits. Group 3 exhibited a distinctly irregular and rough surface, with exposed enamel rods and dentinal tubules. The air polishing groups displayed scratches on the enamel surfaces, whereas the root surfaces displayed a smooth texture with minimal debris. Significant differences were observed among the groups in terms of RaC and RaR (p = 0.016). The lowest mean RaC value was recorded in Group 6 (0.77 ± 0.11µm), while the highest was in Group 3 (1.36 ± 0.34 µm) (p = 0.005). Group 2 exhibited the lowest RaR value among all groups (0.89 ± 0.26 µm). Group 1 exhibited lower calcium levels on the enamel surface compared to Group 6 (p = 0.021). Conclusions. This study revealed that, following scaling, smokers’ teeth exhibited lower elemental levels, greater surface roughness, and areas of erosion and resorption compared to those of non-smokers. After smokers’ teeth were polished, the polishing paste group demonstrated the least surface roughness, while the air polishing groups showed higher mineral levels and a few debris particles.