6 -- Dental Composite- Polishing: Bhattacharya

What is composite finishing

Finishing is the procedure of contouring and shaping a composite restoration after placement and curing to obtain the correct anatomy, margins, and occlusion, while removing excess restorative material

Purpose of composite finishing

Establish proper anatomy and evaluate restoration margins and contours to eliminate overhangs and excess coposite. Restoration has to be smooth here

What is composite Polishing

Polishing is the procedure of smoothing the finished composite surface with fine abrasives to produce a glossy, enamel-like surface

Purpose of composite polishing

Create a shiny surface to reduce plaque accumulation, improve esthetics and patient comfort

Why do we need to polish composite

1. Reduce plaque accumulation (gingivitis and periodontal disease)

2. Surface discoloration

3. Decrease risk of recurrent caries

4. Increase long term wear resistance

5. Increase esthetics

when a composite restoration is not polished, the surface remains ____ and _____. These microscopic irregularitites act as a retentive site for ____ and bacteria

rough and irregular

plaque

a smoothed, polished surface reduces ______ ____ and helps maintin _______ health

bacterial adhesion

periodontial

rough composite surfaces have microporosities that easily trap ____ from foods and bevarages

pigments

Common staining sources

Coffee

Tea

Red wine

Tobacco

Colored foods

bacteria in plaque produce ____ that demineralize tooth structure. This can lead to ____ ____ which occurs at the margins between the tooth and the restoration

acid

reccurrent caries

proper polishing reduces plaque retention anf therefore lowers the risk of ____ decay

secondary

microdefects thare are created during finishing with burs act as stress concentration points leading to _____ ____ and _____ and cause fracture or breakdown of the composite material over time

surface wear and degredation

polishing removes the superficial damaged layer and improves the ____ ____ of the restoration

mechanical durability

When to finish and polish

Occlusal adjustments

Remove the rubber dam

Check the bite with articulating paper

Check the bite with articulating paper more than one time

Then start finishing and polishing

Instruments for finishing and polishing

Diamond and carbide burs

No. 12 blade and carver

Metal diamond strips

sof-lex disks

Green rubber cup

Rubber cups and points

Finishing strips (epitex)

Finishing instruments

No. 12 blade

Metal diamond strips

FG restoration polish 4500 rpm with water

Interproximal carber

Mandrel FG restoration polish 4500 rpm no water

Instruments for polishing

Mandrel FG restoration polish 4500 no water

Latch restoration polish 6000 rpm with water

Finishing Diamond bur: Material

Diamond particles bonded to metal

Finishing Diamond bur: Cutting mechanism

Abrasion (grinding action)

Finishing Diamond bur: Surface finish

Produce slightly rougher surface

Finishing Diamond bur: Main purpose

initial finishing and contouring

Finishing Diamond bur: Material removal

faster removal of material

Finishing Diamond bur: Heat generation

more friction --> may generate more heat

Finishing Carbide bur: Material

Tungsten carbide with multiple blades

Finishing Carbide bur: Cutting mechanism

Shearing/cutting with blades

Finishing Carbide bur: Surface finish

Produced a smoother surface finish

Finishing Carbide bur: Main purpose

Final finishing and refining anatomy

Finishing Carbide bur: Material removal

More controlled and precise cutting

Finishing Carbide bur: Heat generation

Less friction --> smoother cutting

Composite polishing for posterior teeth

Finishing carbide and diamond burs on the occlusal surface

Sof-lex disk for smooth surfaces

Final polishing by green cups followed by brush then blue and grey rubber tips

Polishing paste

Enamelize is final polishing step

NO water

Use it with high speed handpiece in FG restoration polish at 4500 rpm

IT IS NOT MANDATORY FOR OCCLUSAL SURFACE

Work flow for composite finishing and polishing

1. Length of restoration

2. Incisal-facial line angle

3. Facial profile/crest of contour

4. Line angles

5. Embrasures

6. Point angles

7. Axial inclination

8. Depressions and elevations

9. Surface texture

10. gloss

1. Length of restoration

2. Incisal-facial line angle

3. Facial profile/crest of contour

4. Line angles

5. Embrasures

6. Point angles

7. Axial inclination

To advanced for us rn

8. Depressions and elevations

To advanced for us rn

9. Surface texture

To advanced for us rn

10. gloss

needs to be glossy

Depending on the class of cavity

Depends on if you need to do every step of the workflow

Example:

Don't need to worry about length of restoration on a class 5 bro

SUMMARY: Benefits of proper finishing and polishing

1. reduce plaque accumulation

2. maintain marginal integrity

3. reduced gingival irritation

4. increased restoration longevity

5. enhances esthetics

SUMMARY: Finishing and polishing instruments

SUMMARY: Contouring and polishing of composite restorations