CC BY 4.0 · Eur J Dent
DOI: 10.1055/s-0043-1771450
Original Article

The Effect of Usage of Antiasthmatic Inhalers on Color Stability and Surface Roughness of Dental Restorative Materials: An In Vitro Study

1   Department of Pedodontics and Preventive Dentistry, The Oxford Dental College and Hospital, Bangalore, Karnataka, India
1   Department of Pedodontics and Preventive Dentistry, The Oxford Dental College and Hospital, Bangalore, Karnataka, India
2   Department of Pedodontics and Preventive Dentistry, Vyas Dental College and Hospital, Jodhpur, Rajasthan, India
Shabnam Gulzar
3   Pedodontics and Preventive Dentistry, District Hospital Pulwama, Pulwama, Kashmir, India
4   Special Care Dentistry Clinics, University Dental Hospital, King Saud University Medical City, Riyadh, Saudi Arabia
› Author Affiliations
Funding None.


Objectives Increased demand for esthetics by parents and children has resulted in the use of tooth-colored restorative materials. Children with chronic respiratory conditions like asthma use inhalers which have shown to affect the surface of restorative materials. Hence, the aim of the present study was to evaluate the effect of antiasthmatic inhalers on color stability and surface roughness of three restorative materials.

Materials and Methods Forty samples each of three dental restorative materials: group A: glass ionomer cement (GIC), group B: alkasite restorative material, and group C: composite resins were prepared. Each group was further divided into two subgroups of 20 samples each according to the inhaler used. All the specimens were polished using polishing discs and stored in artificial saliva in order to simulate the oral environment. The baseline color value and surface roughness of all the samples were measured using a spectrophotometer and a profilometer, respectively. Group 1 and group 2 were exposed to 0.31 mg of salbutamol sulfate and 20 mg formoterol fumarate in combination with budesonide, respectively, for every 12 hours, for a period of 15 days following which the samples were evaluated for color changes and surface roughness.

Statistical Analysis The data obtained was subjected to statistical analysis and level of significance was set at p < 0.05.

Results Exposure to both the inhalers caused a change in color and surface roughness in all three restorative materials. There was a significant change in the color of GIC and composite resin (ΔE > 3.3), following exposure to both the inhalers (p < 0.05). The change in color of alkasite restorative material was not significant. A significant increase in the surface roughness of composite resin from 0.56 ± 0.14 to 0.67 ± 0.19 was seen following 15 days' exposure to formoterol in combination with budesonide inhaler (p < 0.05).

Conclusion Following exposure, both the inhalers had an equal effect on color and surface roughness of all three restorative materials. Alkasite restorative material showed greater resistance to change in color and surface roughness when exposed to antiasthmatic inhalers, compared to GIC and composite resin. Thus, children who use inhalers and nebulizers should be advised to implement more precautionary oral hygiene measures and periodic dental visits.

Publication History

Article published online:
10 August 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

  • References

  • 1 Alzraikat H, Burrow MF, Maghaireh GA, Taha NA. Nanofilled resin composite properties and clinical performance: a review. Oper Dent 2018; 43 (04) E173-E190
  • 2 Gupta N, Jaiswal S, Nikhil V, Gupta S, Jha P, Bansal P. Comparison of fluoride ion release and alkalizing potential of a new bulk-fill alkasite. J Conserv Dent 2019; 22 (03) 296-299
  • 3 Mazumdar P, Das A, Das UK. Comparative evaluation of microleakage of three different direct restorative materials (silver amalgam, glass ionomer cement, cention N), in Class II restorations using stereomicroscope: an in vitro study. Indian J Dent Res 2019; 30 (02) 277-281
  • 4 Ahmed MA, Jouhar R, Khurshid Z. Smart monochromatic composite: a literature review. Int J Dent 2022; 2022: 2445394
  • 5 Fontes ST, Fernández MR, de Moura CM, Meireles SS. Color stability of a nanofill composite: effect of different immersion media. J Appl Oral Sci 2009; 17 (05) 388-391
  • 6 Patel SB, Gordan VV, Barrett AA, Shen C. The effect of surface finishing and storage solutions on the color stability of resin-based composites. J Am Dent Assoc 2004; 135 (05) 587-594 , quiz 654
  • 7 Llena C, Fernández S, Forner L. Color stability of nanohybrid resin-based composites, ormocers and compomers. Clin Oral Investig 2017; 21 (04) 1071-1077
  • 8 Hemalatha PN, Nagar P. A comparative evaluation of the effect of sports and fruit drinks on the surface roughness of nanofilled composite and light cure GIC-an in vitro study. Int J Clin Pediatr Dent 2018; 11 (05) 417-424
  • 9 Bennett H, Porteus J. Relation between surface roughness and specular reflectance at normal incidence. J Opt Soc Am 1961; 51 (02) 123-129
  • 10 Chung KH. Effects of finishing and polishing procedures on the surface texture of resin composites. Dent Mater 1994; 10 (05) 325-330
  • 11 Berger JC, Driscoll CF, Romberg E, Luo Q, Thompson G. Surface roughness of denture base acrylic resins after processing and after polishing. J Prosthodont 2006; 15 (03) 180-186
  • 12 Kale YJ, Nalwade AV, Dahake PT, Dadpe MV, Kendre SB. Effect of different pediatric drug formulations on color stability of composite, zirconia-reinforced glass ionomer cement, and glass ionomer cement. J Indian Soc Pedod Prev Dent 2019; 37 (02) 151-156
  • 13 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. Int J Dent 2016; 2016: 7186140
  • 14 Ayaz EA, Bagis B, Turgut S. Effect of antiasthmatic medication on the surface roughness and color stability of dental restorative materials. Med Princ Pract 2014; 23 (01) 24-28
  • 15 World Health Organization fact sheet. Accessed October 20, 2020 at: http:/www/
  • 16 Anthracopoulos MB, Pandiora A, Fouzas S, Panagiotopoulou E, Liolios E, Priftis KN. Sex-specific trends in prevalence of childhood asthma over 30 years in Patras, Greece. Acta Paediatr 2011; 100 (07) 1000-1005
  • 17 Khadadah M. The cost of asthma in Kuwait. Med Princ Pract 2013; 22 (01) 87-91
  • 18 Cavalcanti AL, De Sousa RI, Clementino MA, Vieira FF, Cavalcanti CL, Xavier AF. In vitro analysis of the cariogenic and erosive potential of paediatric antitussive liquid oral medications. Tanzan J Health Res 2012; 14 (02) 139-145
  • 19 Mittal S, Singh B, Sharma A, Mittal K, Justa A, Vaid P. Surface changes of primary tooth enamel by commonly used pediatric liquid medicaments: a scanning electron microscope study. J Paediatr Dent 2017; 5 (01) 14-20
  • 20 Adusumilli H, Avula JSS, Kakarla P, Bandi S, Mallela GMK, Vallabhaneni K. Color stability of esthetic restorative materials used in pediatric dentistry: an in vitro study. J Indian Soc Pedod Prev Dent 2016; 34 (03) 233-237
  • 21 Hotwani K, Thosar N, Baliga S. Comparative in vitro assessment of color stability of hybrid esthetic restorative materials against various children's beverages. J Conserv Dent 2014; 17 (01) 70-74
  • 22 Tüzüner T, Turgut S, Baygin O, Yilmaz N, Tuna EB, Ozen B. Effects of different pediatric drugs on the color stability of various restorative materials Bibliography 69 applicable in pediatric dentistry. BioMed Res Int 2017; 2017: 9684193
  • 23 Candan M, Unal M. The effect of various asthma medications on surface roughness of pediatric dental restorative materials: an atomic force microscopy and scanning electron microscopy study. Microsc Res Tech 2021; 84 (02) 271-283
  • 24 Mundim FM, Garcia LdaF, Pires-de-Souza FdeC. Effect of staining solutions and repolishing on color stability of direct composites. J Appl Oral Sci 2010; 18 (03) 249-254
  • 25 Heintze SD, Forjanic M, Ohmiti K, Rousson V. Surface deterioration of dental materials after simulated toothbrushing in relation to brushing time and load. Dent Mater 2010; 26 (04) 306-319
  • 26 Nayyer M, Zahid S, Hassan SH. et al. Comparative abrasive wear resistance and surface analysis of dental resin-based materials. Eur J Dent 2018; 12 (01) 57-66
  • 27 Miličević A, Goršeta K, van Duinen RN, Glavina D. Surface roughness of glass ionomer cements after application of different polishing techniques. Acta Stomatol Croat 2018; 52 (04) 314-321
  • 28 Jefferies SR. The art and science of abrasive finishing and polishing in restorative dentistry. Dent Clin North Am 1998; 42 (04) 613-627
  • 29 Habib AN, Abdelmoniem SA, Mahmoud SA. Effect of children's drinks on color stability of different dental composites: an in vitro study. J Clin Pediatr Dent 2017; 41 (02) 120-125
  • 30 LeSage BP. Aesthetic anterior composite restorations: a guide to direct placement. Dent Clin North Am 2007; 51 (02) 359-378 , viii
  • 31 Ho W, Lin Seow L, Musawi A. Viscosity effects of polyvinyl siloxane impression materials on the accuracy of the stone die produced. J Clin Transl Res 2018; 4 (01) 70-74
  • 32 Vinyl polysiloxane impression materials: a status report. Council on Dental Materials, Instruments, and Equipment. J Am Dent Assoc 1990; 120 (05) 595-600
  • 33 Craig RG, Urquiola NJ, Liu CC. Comparison of commercial elastomeric impression materials. Oper Dent 1990; 15 (03) 94-104
  • 34 McCabe JF, Storer R. Elastomeric impression materials. The measurement of some properties relevant to clinical practice. Br Dent J 1980; 149 (03) 73-79
  • 35 Barutcigil C, Harorli OT, Yildiz M, Özcan E, Arslan H, Bayindir F. The color differences of direct esthetic restorative materials after setting and compared with a shade guide. J Am Dent Assoc 2011; 142 (06) 658-665
  • 36 Güler AU, Duran I, Yücel AÇ, Özkan P. Effects of air-polishing powders on color stability of composite resins. J Appl Oral Sci 2011; 19 (05) 505-510
  • 37 Gedik R, Hürmüzlü F, Coşkun A, Bektaş OO, Ozdemir AK. Surface roughness of new microhybrid resin-based composites. J Am Dent Assoc 2005; 136 (08) 1106-1112
  • 38 Li J, Jang M. Kinetic study of esterification of sulfuric acid with alcohols in aerosol bulk phase. Atmos Chem Phys Discuss 2013; 13 (09) 23217-23250
  • 39 Kumari RV, Nagaraj H, Siddaraju K, Poluri RK. Evaluation of the effect of surface polishing, oral beverages and food colorants on color stability and surface roughness of nanocomposite resins. J Int Oral Health 2015; 7 (07) 63-70
  • 40 Park C, Park H, Lee J, Seo H, Lee S. Surface roughness and microbial adhesion after finishing of alkasite restorative material. J Kor Acad Pedtatr Dent 2020; 47 (02) 188-195
  • 41 Nayak M, Shenoy V. Sorption and solubility of alkasite restorative material- an in vitro study j dent. Med Sci 2019; 18 (05) 69-73
  • 42 Sideridou I, Tserki V, Papanastasiou G. Study of water sorption, solubility and modulus of elasticity of light-cured dimethacrylate-based dental resins. Biomaterials 2003; 24 (04) 655-665
  • 43 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. Microsc Res Tech 2018; 81 (12) 1422-1433
  • 44 Ren Y-F, Feng L, Serban D, Malmstrom HS. Effects of common beverage colorants on color stability of dental composite resins: the utility of a thermocycling stain challenge model in vitro. J Dent 2012; 40 (Suppl. 01) e48-e56
  • 45 Choi M-S, Lee Y-K, Lim B-S, Rhee S-H, Yang H-C. Changes in surface characteristics of dental resin composites after polishing. J Mater Sci Mater Med 2005; 16 (04) 347-353
  • 46 Anusavice KJ, Shen C, Rawls VI HR. eds. Phillips' Science of Dental Materials. Philadelphia, United States: Elsevier; 2012: 578-579