Indirect and Direct Restorative Protocols - Caulk

› PRINCIPLES & PRACTICES
Finishing and Polishing Composite
Resin Restorations
Clinical Parameters
› Abstract:
The use of composite resin
restorations continues to
increase as clinicians gain
proficiency with state-ofthe-art
dental materials
and contemporary adhesive
bonding techniques. In order
to ensure optimal aesthetics
in direct resin restoration,
proper finishing and polishing
procedures must be conducted.
These clinical steps predispose
the restoration for longterm
performance and the
patient for optimal oral health.
Accordingly, selection of the
appropriate instrumentation
and use of sound operative
principles as highlighted herein
are imperative.
Finishing and polishing composite
resin requires a systematic
approach to ensure an
aesthetic outcome. Effective
finishing and polishing of direct
restorations is necessary not only for
aesthetic purposes, but also to ensure optimum
oral health. The accumulation and
retention of bacteria and plaque around
composite restorations can be affected
by the marginal finish, surface texture,
and the integrity of the final restoration.
If a smooth, well-polished surface is not
achieved, this plaque accumulation can
lead to chronic gingival inflammation,
recurrent marginal decay, staining, and
restoration failure. The finishing and polishing
of composite restorations also aids
the clinician in establishing functional occlusion
and contour. Devices for finishing
and polishing include both cutting instruments
(eg, multi-fluted carbide finishing
burs) as well as abrasive finishing and polishing
systems that will be used to successively
refine restoration surfaces.
Carbide burs are available in various
sizes and utilized by the clinician to
achieve natural tooth contours as well as
to smooth restorative surfaces in advance
of the polishing sequence:
■ 12-fluted carbides—trimming and
contouring.
■ 18-fluted carbides—successive finishing
of surfaces.
■ 30-fluted carbides—final finishing
prior to polishing.
Selection of the appropriate bur for a
given clinical situation is dictated primarily
by the required anatomy of the
restoration. Embrasures, lingual regions,
occlusal surfaces, and the various tooth
shapes have differing contours that must
be achieved during a finishing procedure.
In this manner, longer shapes (eg,
tapered, interproximal) are indicated for
facial surfaces of anterior teeth or interproximal
regions of canine and posterior
teeth. Flame-shaped carbides are used for
primary anatomy and round-end burs for
contouring, whereas egg-shaped burs are
Figure 1. Carbide fi nishing burs (Midwest ® Esthetic Finishing Burs,
DENTSPLY Professional, York, PA) are ideal for refi ning margins and
obtaining optimal surface texture.
Inset: The helical shape improves contact with the tooth surface.
Figure 2. To provide a lasting surface luster with PoGo ® One Step
Diamond Micro Polisher (DENTSPLY Caulk, Milford, DE), light pressure
should be applied to the restoration surface.
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