Finishing and polishing of composites / cosmetic dentistry training

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Finishing and polishing of composites / cosmetic dentistry training

  1. 1. Finishing and polishing of composite restorations INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  2. 2. Introducti on www.indiandentalacademy.com
  3. 3. • The aim of this paper is to elaborate on the commercial products available and their clinical application keeping them in line with the BASIC PRINCIPLES OF ABRASIVE SCIENCE as it relates to finishing and polishing of dental composites. • Additional highlighting of technique considerations in the finishing and polishing systems and devices and the use of specific devices for specific clinical situations will be done. www.indiandentalacademy.com
  4. 4. Back to basics……..  Finishing is the transformation of an object from a rough to a refined form.  Polishing is the production of a shiny mirror like surface, which reflects light similar to enamel without creating supplemental films by the addition of wax or lacquer  THUS…the final surface character of the composite is the combination of two distinct processes of finishing and polishing. www.indiandentalacademy.com
  5. 5. Inherent and Acquired polish  Acquired polish is the one in which the final surface characteristics achieved are as a result of finishing polishing procedures done by the operator.  Inherent polish is the one the surface naturally reverts to through mastication and erosion.  A:I polish ratio should be 1 so that the surface finish will not change over time. www.indiandentalacademy.com
  6. 6. FINISHING BURS  PRIMARILY USED FOR FINISHING COMPOSITES to begin with.  Tungsten carbide.  Available as 8 fluted,10 fluted, 12 fluted, 16 fluted, 20 fluted and 30 fluted. www.indiandentalacademy.com
  7. 7. ET Burs (Komet/Brasseler USA)  ET burs are the standard against which all the others are compared. So are RELIABLE.  Have rounded tips  Seem to produce a slightly higher gloss than the others that fall in this group.(1)  Available in a number of popular shapes.  Preferred shapes include ET3, ET4, ET6 ,ET9 as 8, 16 and 30 fluted and OS1, OS2 and OS3 as 12, 20, and 30 flutes FLIP SIDE  Most expensive.  Having 5 diferent flute selections may be excessive. www.indiandentalacademy.com
  8. 8. y www.indiandentalacademy.com
  9. 9.  Has only 2 flute options 12 fluted and 30 fluted.  Quality is comparable to Brasselers ET Burs but number of shapes and effectiveness are inferior to Brasseler. SAFE ENDED FINISHING BURS They are available as a different series especially useful for veneers. www.indiandentalacademy.com
  10. 10. Other products in this group. - BluWhite finishing burs (Sds/Kerr) - Least expensive. - Cut cleanly. - Midwest finishing burs (Dentsply/Professional) - Slightly lower gloss compared with ET Brasseler. www.indiandentalacademy.com
  11. 11. Finishing Diamonds  Primarily used to contour, adjust and smooth porcelain but also can be used to finish composites.  Typically used with water spray. www.indiandentalacademy.com
  12. 12. Wet or Dry ???????  Wet polishing has its advantage of avoiding overheating.  But forms a uniform reflecting smear obscuring the restoration tooth interface and the surface details of composites.  With dry polishing there is a definite visualization of both the surface and the margin.  Typically carbides are used dry and diamonds are used wet. Bottom line is…………….. Provided you use light pressure and slow speed , dry polishing is a better choice. www.indiandentalacademy.com
  13. 13. ET Diamonds (Brasseler USA) . Shapes are similar to ET finishing burs . Available in 3 Grits 30 microns (fine) Red 15 microns (extrafine) Yellow 8 microns (ultrafine) White www.indiandentalacademy.com
  14. 14. Other products in this group. . T & F Hybrid points (Shofu) . Available in 10 shapes but have only a single grit. . In studies they showed good durability(2) www.indiandentalacademy.com
  15. 15. . TDF (NTI/Axis dental) It is a clone of ET diamonds but has only 2 grits. . Two striper diamonds (Premier) www.indiandentalacademy.com
  16. 16. Diamonds or Carbides ????  Carbides: Cuts by pulverizing.  Resists clogging.  But Tends to dull out faster than diamond.  Diamonds:  Cut faster.  Light touch for optimal efficiency.  Long Lasting.  Can easily cut tooth by error. www.indiandentalacademy.com
  17. 17. RAPTOR  The Rapid Adapting Precision Transformer for Occlusal Resins or R.A.P.T.O.R.*, is the keystone of a simplified approach to finishing Class I and Class II posterior composite restorations. These burs feature angulations and planes which quickly re-establish proper occlusal anatomy and approximate occlusion. They are used in conjunction with specially designed 30-Flute safe tip Christmas Tree and 18-Flute needle and egg-shaped burs. www.indiandentalacademy.com
  18. 18. FINISHING DISCS  Discs allow us to perform finishing with more PRECISION and SAFETY compared to diamonds and burs.  Most discs use the abrasive agent as aluminium oxide or silicon carbide on a plastic backing a few diamond ;discs are also available.  Area of operation is limited so one has to go back to the finishing burs in areas which cannot be finished by the discs. www.indiandentalacademy.com
  19. 19. . Refinement of the incisal embrasure. . To adjust the incisal length. . To smooth the junction of the composite and the tooth without damaging the tooth enamel www.indiandentalacademy.com
  20. 20. Sof-Flex Contouring and Polishing Discs. (3M ESPE) and Sof-Flex extra thin contouring and polishing discs www.indiandentalacademy.com
  21. 21. Flipside  The effectiveness of Sof- Flex XT in producing shine was on the lower end as compared to Sof- Flex discs.(3)  Sof- Flex XT are the most expensive amongst other products in this group and are at low end of effectiveness.  Sof-Flex XT was found ineffective in repair of composite ditched margins www.indiandentalacademy.com
  22. 22. Flexidisc Mini and Flexidisc (Cosmedent)  Studies show they consistently produced higher sine on the surface than Sof-Flex or Sof-Flex XT.  Significantly cheaper than Sof- Flex. www.indiandentalacademy.com
  23. 23. Super-Snap (Shofu) • Protected mandrel so no chance of marring the restoration. They are the highest in effectiveness in this group.www.indiandentalacademy.com
  24. 24. Other Products in this Category  Visionflex (Brasseler)  Esthetic Polishing System (Brasseler) and Fini (Pentron) both appear to be a virtual clone of Shofu in their design.  Flexidisc Plastic Center (Cosmedent)  Esthetic Polishing System (Brasseler) www.indiandentalacademy.com
  25. 25. Finishing Strips  Available in metal and plastic backing.  For composites plastic backing ones are used typically.  Indispensible for finishing and polishing of composite restorations. www.indiandentalacademy.com
  26. 26. Sof- Flex Finishing and polishing strips  Available in 4 grits each being colour coded.  Available in 2 widths 2mm and 4 mm  Gap in the center for easy passage through contacts.  Relatively expensive compared to others in the same group. www.indiandentalacademy.com
  27. 27. Flexistrip (Cosmedent)  Also available in 4 grits  Available in an ultrathin version to increase their flexibility and help in going through contacts without peeling of the abrasive from the mylar backing. www.indiandentalacademy.com
  28. 28. Epitex (GC) By far the thinnest strips available (0.05mm). . Easy passage through contacts . No stripping of siliconcarbide abrasive during insertion . Less tissue trauma FLIPSIDE . Tearing . Residue of silicon carbide after polishing www.indiandentalacademy.com
  29. 29.  Super-Snap polystrips (Shofu)  Finishing Strips (Bisco)- Least expensive in this category. Other Products in this category www.indiandentalacademy.com
  30. 30. POLISHING INSTRUMENTS RUBBER Abrasive particles are uniformly dispersed throughout the device matrix i.e. Rubber. Advantage- Good durabilty BRUSHES Advantages- - Unmatched access to hard to reach occlusal areas. Disadvantages – - Need to start with relatively smooth surface. - Need to apply substantial pressure for optimal performance. www.indiandentalacademy.com
  31. 31. ASTROPOL (Ivoclar Vivadent)  Rubber polishing system with 4 shapes a cup, small point, large point and a disc.  Has 3 Grits, Finisher (wears out fastest), polisher and high polisher (high polisher is impregnated with diamond particles of mean size 3.5 microns)  Tests have rated Astropol of producing highest gloss (4) www.indiandentalacademy.com
  32. 32. PoGo (Dentsply/Caulk)  Diamond impregnated version of Enhance discs.  Has only a single grit.  Has a cup, a disc and a point.  Needs practice to master correct pressure.  Very light pressure and polishing in one direction will give high shine www.indiandentalacademy.com
  33. 33. D Fine Diamond polishers for hybrid composite and D Fine Double diamond. (Clinicians Choice)Semi flexible rubber instruments impregnated with fine diamonds. Permanently attached to latch type mandrels. D Fine double diamond is an offshoot of the original product and is more flexible. D Fine Double Diamond also produced the highest shine on composites along with ASTROPOL. www.indiandentalacademy.com
  34. 34. Other Products in this category  Hawe HiLuster (Kerr)  CompoMaster (Shofu)  Jiffy Hishine (Ultradent)  Diacomp (Brasseler)  Diagloss (Axis)  Jiffy Polishing Cups Points and Discs (Ultradent)  Flexipoints Flexicups Flexiwheels (Cosmedent) www.indiandentalacademy.com
  35. 35. BRUSHES  Stiff brushes made from aromatic polyamide and impregnated with silicone carbide. Jiffy Brush (Ultradent)  3 Shapes regular cup, Small cup and Point.  They produced the lowest shine in intraoral simulation tests in comparison with others in their category. www.indiandentalacademy.com
  36. 36. ComposiPro Brushes (Brasseler)  Polyamide bristles with silicon carbide.  Similar in design to Jiffy Brushes.  But effectiveness is better than jiffy brushes. Other Products in this category  Groovy (Clinicians Choice) www.indiandentalacademy.com
  37. 37. Polishing Pastes  Retain the ability to take the gloss of a restoration one notch higher.  Messy and are produce splatter.  Abrasive may be aluminum oxide or diamond, diamond pastes being costlier.  They can be applied with one of Prophy cup- Internal part is Webbed. Felt Wheels Discs with felt like surface Brushes www.indiandentalacademy.com
  38. 38. Prisma-Gloss / Prisma-GlossExtraFine (Dentsply/Caulk)  Aluminum oxide as abrasive.  Begin with Prisma Gloss (Mean size 1 micron) and repeat with Prisma Gloss Extra Fine. (Mean size 0.1 micron)  Most effective in its group. www.indiandentalacademy.com
  39. 39.  Abrasive used is diamond with a grit size of less than 1 micron.  Semiviscous.  Tendency to Dry Out during polishing.  But produced remarkable gloss in intraoral simulation tests on composites. Sparkle (Pulpdent) www.indiandentalacademy.com
  40. 40.  Diamond Polish (Ultradent)  Enamelize (Cosmedent)  Luminescence Plus (Premier) Other Products www.indiandentalacademy.com
  41. 41.  Remember, no one system can give an enamel like luster to the surface. It is through the careful stepwise finishing polishing of every surface that a good restoration may be achieved.  Finishing and Polishing is not a runthrough affair. Sufficient time has to be given for it to obtain the best results. Patience is the a key factor. Never miss out Patience. CONCLUSION www.indiandentalacademy.com
  42. 42. Thank You….. For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com

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