Background <p>To compare the effects of air-polishing and conventional prophylaxis methods on the surface roughness and gloss of composite restorations.</p> Methods <p>Seventy composite resin specimens were prepared and randomly assigned to seven groups: control, rubber cup + pumice, brush + pumice, rubber cup + polishing paste, brush + polishing paste, Sylc bioactive glass powder, and sodium bicarbonate powder (<i>n</i> = 10). Surface roughness was measured using atomic force microscopy, surface morphology was evaluated by scanning electron microscopy, and gloss was measured using a glossmeter.</p> Results <p>The highest surface roughness values were observed in the Sylc and sodium bicarbonate groups, whereas the lowest values were recorded in the control group. Conventional prophylaxis methods showed no significant differences compared with the control group, while air-polishing powders significantly increased surface roughness. Gloss values were highest in the control and pumice groups and lowest in the Sylc and sodium bicarbonate groups. A significant inverse relationship was observed between surface roughness and gloss. Air-polishing procedures significantly increased surface roughness and reduced gloss compared with conventional prophylaxis methods.</p> Conclusion <p>These findings suggest that air-polishing may adversely affect the surface integrity and esthetic properties of composite restorations.</p>