Finishing of composite restoration: texture and relief
This presentationn was created during hands-on course in Pereira, Colombia. Clinical part by dr. Maxim Belograd, photos by dr. Lina Maria Munoz.
60% of success for direct composite restoration belong to finishing and polishing procedures. Shape, form and relief are responsible for visualization of the tooth. Proper light reflection from the surface creates optical effects of bright/dark tooth, short/long, wide/narrow.
This presentation will demonstrate simplified protocol of finishingg and polish ing in order to obtain natural tooth surface effects.
Firs step is to create solid surface of restoration. For that purpose we use diamond burs with low speed rotation and without any pressure. Grit of the bur influents on the final microtexture. If it is necessary to make an accent on this effect we may use medium of coarse grit burs (blue or grin mark), if you would like to make texture slightly visible - burs with red marks are the good choice. This procedure is done without water cooling. This will help to see any irregularity. After this setp the surface of composite restoration has to be satin.
Zoomed photo shows micro texture
Next stage is to work with surface planes.
We have to consider specific angulation of each plane (cervical plane is convex, middle plane is flat and incisal one has palatal angulation). For better visualisation of transitions betwee planes we may point them with pencil. Important to know: length of the planes on symmetrical teeth has to be identical.
The same bur as for the first step is used considering angulation of each plane.
Next stage is recreation of transitional angle lines. This manipulation influences how wide or narrow the tooth will become. It is important to follow the identity of distances between angle lines of symmetrical teeth. Pencil may be used for easy way to identify zones of future highlights. It is necessarily to obtain smooth transition from the highlightt zone of natural part of the tooth to the restorative part.
Performing small bevel on the peripheral part from the margin of transitional angle we create accent on the future high light zone. This procedure is done by the same bur.
Vertical anatomy. This component of natural tooth surface can be created by silicon point (i.e. Enhance, Dentsply). For easiest determination of anatomy that we would like to get, regular pencil is being used.
Next stage is to create horizontal anatomy. To get this effect we can use simple and effective tip. Silicone point during slow rotation touching to scalpel stepping on the blade. This way we performing grooves on polishing instrument that can be transferred to the tooth during horizontal movements.
Now we can polish. One of the most effective and «quick» instrument is goat wheel. It is used in dry mode, than with polishing paste.