Indirect and Direct Restorative Protocols - Caulk

››Principles & Practices
Aesthetic Finishing & Polishing:
Techniques for
Ceramic Restorations
››Abstract:
Contemporary ceramic materials
enable dental professionals to
instill natural aesthetics and
luster in the restorations of
their patients. The long-term
function and performance of
these restorations depend on
numerous factors that include
marginal integrity and the
creation of a proper finish and
polish. Development of an optimal
surface reduces stain and plaque
accumulation, minimizes wear,
and enhances the appearance of
the definitive restoration. This
presentation exhibits a simplified
protocol for finishing and polishing
ceramic restorations.
The increased patient demand
for restorations that
closely resemble natural
dentition in aesthetics
and function has contributed
to the development of ceramic materials
that provide the needed strength,
durability, and beauty to meet those
expectations. Although porcelain restorations
such as CERCON® Zirconia
and Finesse® (DENTSPLY Prosthetics,
York, PA) possess intrinsic optical properties
such as opalescence, fluorescence,
and translucency that enable clinicians
to achieve beautiful outcomes for their
patients, minor marginal finishing is
needed in virtually every indirect treatment
to remove excess cement or during
finalization of aesthetics or the occlusion
(Figure 1). The use of a systematic finishing
technique following cementation
will improve a restoration’s long-term
performance and maintenance of its
marginal integrity.
Once the restoration is seated, excess
cement must be carefully removed, as
any residual cement or marginal roughness
will lead to plaque retention and the
associated gingival inflammation. This
will compromise not only the biological
integration of the restoration with the gingival
tissues but also the aesthetics, leading
to chronic marginal inflammation
and a potential for recurrent marginal
decay. The restoration, therefore, must
remain as biocompatible as possible (eg,
particularly where in contact with soft
tissues) to provide mechanical strength
and aesthetics. Non-cutting, safe-end tips,
which are featured in most tapered burs
in the Midwest® Esthetic Finishing Bur
system (DENTSPLY Professional, York,
PA), enable the clinician to finish gingival
margins while protecting the soft tissues
throughout the procedure (Figure 2).
Prior to selecting or using finishing
instrumentation of any kind, the
clinician should examine his or her
Figure 1. Although ceramic restorations are delivered from the dental
laboratory with a high luster and accuracy, minimal reduction may be
necessary following cementation.
Figure 2. Soft tissues can be effectively protected during marginal finishing
with a Midwest ® Esthetic Finishing Bur (DENTSPLY Professional,
York, PA), which features a non-cutting tip on the end of the bur.
Inset: Cement can be removed marginally without lacerating the soft tissue.
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