Beruflich Dokumente
Kultur Dokumente
CONTENTS:
INTRODUCTION:
The main objective of an operative dentist is to restore individual teeth to its
form and functions along with imparting pleasing esthetics as well
as to maintain periodontal tissues in good esteem.
Rough surfaces invite microbial flora to flourish. Light reflected by these
surfaces may not be even and uniform. The process of making the surface
smooth so as to enable them to reflect light evenly is known as Finishing &
Polishing.
DEFINITIONS:
Finishing
Polishing
Finishing
Polishing
Finishing
Polishing
Polishing is the process in which the polishing materials do not cut, but
fills fine scratches to produce a perfectly smooth surface. During polishing, highly
stressed microcrystalline layer is formed on the surface called as Beilby layer.
This layer, composed of non-oriented crystals on the restoration, is 20-40 A0 thick.
Health Hazards:
Production of aerosol:
An Aerosol is a dispersion of fine solid or liquid particles in air.
Hazardous to dentists & patients.
These are sources for chronic & infectious disease of lungs, eyes &
skin.
Causes Cross contamination.
Silicosis or Grinders disease.
Aerosol production minimized by:
Adequate ventilation.
Self-protection.
Use of rubber dam.
Use of infection control procedures & high vacuum suction.
Production of vapour:
Mercury vapour, sealants, acrylic resin & composite vapour particles
may be inhaled leading to alveolar irritation & tissue reactions.
To Minimize Vapour:
Using low speed.
Intermittent pressure.
Pulpal Reactions:
To prevent excessive heat.
Use of cup brushes.
Use of intermittent polishing at slow speed.
FINISHING & POLISHING INSTRUMENTS:
Bonded Abrasives
Elastic binders right
binders. (i.e. diamond
white stones)
Coated abrasives
Aluminium oxide silicon
oxide, quartz
Loose abrasives,
Aluminium oxide, Ultra
fine diamonds.
Finishing Burs:
Finishing Burs generally made up of Stainless steel (or) Tungsten
carbide.
12-40 fluted carbide burs are usually recommended for finishing
Burs are available in difference sizes & shapes such as, straight
fissure, tapering, flame shaped, rounded, wheel etc.
Composed of
Calcium carbonate.
Uses
Polish enamel, gold foil
amalgam & plastic materials.
Pumice
Pumice slurry
Pumice paste
Corundum (white)
Aluminium oxide.
Finishing
metal
plastic materials.
Garnet
Sand
Silica
Obtained
by
crushing Polishing metal alloys plastic
sandstone bonded to paper material.
with glue.
Derived
from
siliceous
sedimentary rock.
Kieselguhr .
To
remove
Investment
materials from base metal
alloys.
Quartz (colourless).
Fine abrasive.
alloys,
Trade Name
Soflex XT disc
Coarse
Medium
Manufacturer
3M
Fine
Superfine
Aluminium oxide
Shofu dental co
Silicon carbide
E.C. Moore co
Shofu dental co
Enhance finishing
polishing strips.
Alumina porcelain
paste.
Porcelain laminate
polishing kit
Shofu dental co
Diamond polishing
paste
Porcelain
system
polishing Brassler
is also accomplished in this step. Abrasive devices used for intermediate finishing
usually contain abrasive particles much less than 100 but greater than 15 to 20.
Final abrasive polishing. This final step in finishing of dental restoratives is
designed to impart an enamel-like luster to the surface of the restored tooth.
Coated abrasive discs, rubber polishing devices, or loose abrasive polishing
pastes applied with appropriate devices are the usual method to produce high
luster or surface reflectivity on dental restoratives. Abrasive particles used in
polishing devices and loose abrasive pastes range from less than 20 to 0.3 for
extra-fine, alumina-based composite polishing pastes.
Plaque
accumulation
and
incidence
of
gingival
Procedure:
The cavity is slightly overfilled during amalgam condensation. The mercury
rich layer of the last increment removed during carving.
Burnishing should be done both prior & after carving to smooth the surface
to prepare restorations for finishing & polishing.
Polishing of amalgam restoration not attempted within 24 hours following
insertion since crystallization is not complete.
1st Appointment:
The patient is cautioned that heavy biting force should not be applied
to the filling for a period for 7-8 hours after insertion.
Establish occlusal contacts.
2nd Appointment:
After 24 hrs, restoration is rough due to heterogeneous structure of
amalgam on setting.
Finishing begun with use of steel finishing burs to trim over extension
& excess margins.
High point in amalgam appears as shiny area, which is decreased by
carborandum stones on sharp finishing burs.
For proximoocclusal restoration finishing begins with cervical,
buccal, lingual, proximal and occlusal margins.
Gingival over hangs decreased by Finishing Burs, BP Knives,
Periodontal files or Gold foil knives.
Final finish obtained by abrasives in descending grades.
polishing
are
usually
conducted
during
the
placement
appointment. (Esthetics)
The appropriate instruments and materials for polishing of every type
of composite should be available and used in a logical sequence.
The surface smoothness varies with the types of composite resin,
owing to the nature of filler particles. (Vimal Sikri)
(a)
Conventional composites:
Conventional composites have greatest difficulty in achieving smooth
surface because of the difference in hardness of organic & inorganic
phases.
(b)
Hybrid Composites:
Hybrid composite can be polished to a semigloss but the surface is
somewhat hydrophobic which makes it quite unpleasant for the
patient.
(c)
described separately.
Direct composite restorations:
Excess composite scraped using scalpel or sharp gold knife.
Stainless steel instrument should be avoided.
Inaccessible areas and occlusal areas : Alpine stone, 12-30 fluted
carbide burs and diamond points.
Accessible and convex areas : Aluminium oxide, cuttle fish or silicon
dioxide, coated discs
abrasiveness.
Gross reduction by coarse discs.
Smooth surface texture and refined marginal adaptation by Finer
discs.
Lubricant vaseline or petroleum jelly should be used as a lubricant
with these discs and strips.
The strips are used in to and fro motion.
Facial areas :
Flame shaped carbide-finishing burs.
Final Finish:
Rubber polishing point & Aluminium oxide polishing paste.
Remove excess with:
Sand paper disc
Sof-lex disc
Pop on discs
Lingual areas:
Narrow Contouring
Surface Roughness ( m)
12-Fluted Bur
Diamond SF-1
30Fluted bur
Diamond SF-2
Diamond SF-3
No57 fissure bur
2.0
1.4
0.85
0.80
0.60
0.60
Modified from Herrgott AML, Ziemiecki TL, Dennison JB: J Am Dent Assoc
119:729, 1989.
Surface Roughness ( m) of Composites Finished with Various Disks
and Polishing Pastes.
Fine Particle
Composite
0.13
Hybrid
Composite
0.12
Microfilled
Composite
0.09
Coarse disk
1.96
2.00
1.87
Medium disk
0.61
0.59
0.71
Fine disk
0.33
0.26
0.25
x x Fina disk
0.17
0.14
0.16
Superfine fisk
Polishing paste
Sof-Lex fine
Moore x x-fine
0.12
0.06
0.10
0.33
0.26
0.25
0.17
0.15
0.16
0.14
0.09
0.13
Sof-lex superfine
0.12
0.06
0.10
Prisma Gloss
0.11
0.03
0.09
Surface Treatment
Mylar Strip Disks
Modified from Herrgott AML, Ziemiecki TL, Dennison JB: J Am Dent Asoc
119:729, 1989.
Occlusal
Poly acrylic gel has been used for polishing GIC restorations. Auj yap et al
investigated the surface texture of two resin-modified glass ionomer cements
(RMGICs) in the vertical and horizontal axis after treatment with different
finishing/polishing systems. Class V preparations were made on the buccal and
lingual/palatal surfaces of freshly extracted teeth. The cavities on each tooth were
restored with, Fuji II LC (GC) and Photac-Fil Quick (ESPE) according to
manufacturers instructions. Immediately after light-polymerization, gross finishing
was done with 8-flute tungsten carbide burs. The teeth were then randomly
divided into four groups and finished/polished with (a) Robot Carbides (RC); (b)
Super-Snap system (SS); (c) One Gloss (OG) and (d) Composite Points (CS).
The sample size for each material-finishing/polishing system combination was
eight. The mean surface roughness (mm) in vertical (RaV) and horizontal (RaH)
axis was measured using a profilometer. Data was subjected to ANOVA/Scheffe's
tests and Independent Samples t-test at significance level 0.05. Mean RaV
ranged from 0.59-1.31 and 0.83-1.52, while mean RaH ranged from 0.80-1.43 and
0.85-1.58 for Fuji II LC and Photac-Fil, respectively. Results of statistical analysis
were as follows: Fuji II LC: RaV-RC, SS<OG & SS<CS; RaH-SS, CS<RC, OG;
Photac-Fil: RaV- SS, CS<OG; RaH-SS<RC, OG & CS<RC (where < indicates
significantly greater Ra values). Significant differences in RaV and RaH values
were observed when Fuji II LC was finished with RC. The use of carbides'(RC)
and one-step rubber abrasive system (OG) for finishing/polishing of RMGICs is
not recommended. Graded abrasive disk (SS) or two-step rubber abrasive (CS)
systems should be used instead.
Hazards :
Production of aerosol.
Excess temperature, dehydration & moisture contamination may
damage restoration.
Marginal defects due to sharp hand instruments.
1st Step:
Burnishing is the 1st step in finishing a gold restoration. For the occlusal
surfaces, a spartely burnisher is moved with considerable pressure from
the metal to the tooth surface.
2nd step:
The next step is giving optimum contours by use of morse scaler, jones
knife or cleoid- discoid carver on the occlusal surface.
3rd Step:
Removing excess by abrasive strips and discs. The disk should be small
, 3/8, , inch in diameter to prevent any damage to the gingival
tissue.
4th Step:
Excess gold in gingival area of the restoration is removed using contra
angle bevel of wedelstedt chisel in a gentle shaving motion.
5th Step:
After the surface has been smoothened burnishing is repeated once
again on all the margins.
6th Step:
Polishing with Tin oxide, Extra fine silex applied with rubber cups gives the
restoration a high metallic luster & satin finish.
FINISHING & POLISHING OF CAST GOLD RESTORATIONS:
Initial Finishing of gold inlay is carried out on the die and most of the
finishing is completed within the laboratory.
The casting is separated from the investment and cleaned using steam
at pressure.
It is critical to examine casting carefully for any defects.
Nodules (or) blebs if present are removed carefully with chisels, discs or
small burs.
The casting is then pickled in 15% HCL & neutralized in Sodium
bicarbonate.
After all these procedure has been carried out, trial seating of casting on
the die is allowed.
Procedure:
Difficulties during their use are mainly because of two reasons - finishing
very high hardness and resistant to abrasion.
Procedure :
Casting is separated from the investment and cleaned under steam.
Trimming of edges with a fine flexible wheels .
Finishing process Electrolyte Polishing is commonly used as a part of
finishing process.
It is a method used to clean metallic surfaces and to smooth the surface
irregularities.
Principle :
Electrolyte polishing works on the principle of reverse electroplating in
which the restoration acts as the anode.
The Electrolyte is usually a mixture of
Sulphuric acid
Phosphoric acid
Glycerine
Water
A current density of 0.5 - 1.0 amps/mm2 at voltage of 4-10v is passed for
a few minutes at room temperature.
The anode i.e. the restoration ionizes and is depleted of a very small
amount of alloy more readily on the rough surfaces than the smooth
surfaces.
These first products of electrolysis are collected in the hollows of rough
metal surface.
The prominences are gradually dissolved and a smooth surface results.
Advantages :
Reduces time and effort for mechanical finishing.
Group II
Semigloss
D3-A3.5
910C
30 Sec hold polish
Group III
Glossy
B4-C4
920 C
1 Min hold polish
Before the ceramic inlay /onlay is cemented into the cavity, the cavity
side of the restoration is etched.
After etching, etched surface treated with a silanating agent to improve
its bond with the cementing medium.
A dual cure composite is preferred as luting.
After all adjustments have been made repolishing done in all those
areas where the glaze has been damaged.
Haywood et al (1988) have recommended the following sequence to
attain a smooth finish comparable to a glazed surface.
Use of fine grit diamonds.
30- Fluted carbide finishing burs.
Rubber abrasive points and cups.
Diamond polishing pastes applied with a bristle brush.