Finishing and polishing

Finishing amalgam\\ removing

marginal irregularities defining
anatomical contours and smoothing
surface roughness of restoration
Polishing \\ to obtain smooth shiny
luster on surface of amalgam
NB\\finishing and polishing started
when amalgam reached its final set
approximately 48 hours after it has
been placed and carved
Effects of finishing and polishing on restoration

prevention of recurrent caries\\it result in smooth lustrous finish-1 

on surfaces and margins plaque and debris collection are reduced and
restoration is easier to clean
prevention of amalgam deterioration\\tarnish is film on surface-2 
of amalgam produces discoloration as tarnish layer becomes thicker
and darkens with aging of amalgam it becomes visible
corrsion\\is destructive attack on both surface and subsurface of 
restoration that results from chemical or electrochemical reaction with
oral environment this chemical reaction called corrsion products lead to
detrioration of amalgam smooth polishing surface reduce accumulate
acids plaque debris which encourage galvanic action on surface
maintenance of periodontal health \\any restoration must-3 
not only maintain healthy environment for soft tissues but must also
ensure the patients ability to cleanse the area
facial lingual and proximal surface are critical areas that may affect 
patients oral hygiene and periodontium

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restoration are overcontoured or have faulty placement of facial and lingual contour
lead toperiodontal breakdown than undercontoured restoration
overcontoured axial surface present area that quickly collects and harbours plaque
result in irritation
bulky contour may interfere with pations ability to clean the area
sightly undercontoured restoration is less of potential problem because it is less
to interfere with patients ability to clean area
interproximal or gingival embrasure houses the interdental papilla restoration
restoration overcontoured in this area leaves less space for papilla lead to strangulation
or physical displacement of papilla
NB\\ either situation increases tissue breakdown
udercontoured proximal area may have poor contact which increases potontial
for food impaction which is not only frustrated for patient but irritation to soft tissue
NB\\ aproperly contoured proximal surface is easly cleansed with dental floss
the frustration of patient may contribute to inadequate flossing
gingival floor of proximal box is frequently subgingival
NB\\ presence of restoration margins in gingival sulcus increases incidence of gingival
disease
overhangs not only accumulate more plaque than smooth flush margin but also
interfere
with removal of the plaque the floss may get caught or tear creating source of frustration
for patient who is then discouraged from cleaning the area
NB\\ recontouring finishing and polishing provide to correct discrepancies in anatomical
contours of restoration
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 prevention of occlusal-4
problems
 potential occlusal problems may be prevented
by finishing of amalgam restorations
 restoration may be left in premature occlusion
lead toseveral problems
 tooth may exihbit pain or sensitivity especialy
during mastication in more severe cases
restoration or opposing tooth may fracture
 tooth may undergo slight orthodontic
movement because of pressures of
premature occlusion
 this problem can be corrected during
recontouring process
 Proced
ure
when abrasive agents and instruments are used two coniderations can affect result of final
restoration
Heat is created which is potontial detrimental to amalgam[both increase pressure and
speed contribute to heat production

heat brings mercury to surface result in dull surface and restoration more susceptible to
corrosion
NB\\ once mercury is brought to surface it can be corrected only by removing surface layer
of amalgam which produce under contoured restoration

heat production can be minimized by using only moderate speed on rotary instruments
intermittent light pressure to cause less heat than heavier or prolonged pressure
using abrasive agents that wet instead of dry will reduce heat production
abrasive agents remove fine layers of amalgam and leave scratches in surface as finer and finer
abrasive agents are used these scratches become finer until they are no longer visible giving
smooth lustrous surface

NB\\ it is very important to use abrasive agents in order of decreasing coarseness finishing
with least abrasive material
NB\\ instruments for recon touring finishing and polishing are both hand and rotary instruments
limiting number of instruments will help keep technique simple and contribute to speed and efficiency
Rotary instruments
Burs abrasive stones and finishing discs
Burs used for recontouring and finishing amalgam are made of plain steel in contrast to carbide
steel burs that are used to prepare cavities

flame-shaped plug-shaped pear-shaped barrel-shaped finishing burs

white and green tapered stones and impregnated rubber cups and points

steel burs have varing number of flutes or blades for very gross amalgam
removal six –fluted cutting bur
may be used to cuts amalgam more rapidly its use is minimal because of deep
scratches it leave on surface
burs used for finishing have more blades which are finer and
leave smooth surface
NB\\selection shapes and sizes of finishing burs is needed to
gain access to all areas of restoration
 flam-shaped bur for narrow areas as embrasure areas and deep
grooves on occlusal and smooth surface restoration
 round and plug-shaped burs small or larger size for fossa

 apear-shaped or barrel-shaped bur that allows contact with adjacent

tooth structure for finishing cusp inclines

long and tapered used on occlusal or smooth surface of stones

restoration
rounded for use in fossa
NB\\abrsiveness depends on type of particles incorporated in
matrix of stone
particles in green stones are more abrasive than particles in white stones
green stones is used to remove relative large bulk of amalgam
white stones for reducing small areas of enamel around marginal discrepancies
as well as small amounts of amalgam
Fig-5.24 From left: Five steel burs, two
stone burs, three abrasive rubber point
burs, and one abrasive rubber cup burs
 finishing discs used for recontouring and finishing amalgam
the thin flate shape of discs can be adapted along broad smooth
surfaces with good access
NB\\discs are ideal for smoothing class V restoration or
facial and lingual extensions of large restoration

finishing discs are available in variety of sizes and grits

size used depend on size of restoration andits proximity
to vulnerable adjacent soft tissues
girt selected depend on amount of excess amalgamator be
removed
fine girt sufficient for most situations
A coarser grit followed by progressively finer-girt abrasives to
minimized size of scratches left in amalgam
 Two
Twohand
handinstruments
instrumentsused
usedfor
forrecontouring
recontouringare
areamalgam
amalgamknife
knifeand
andfile
file

amalgam file used to smooth amalgam after use amalgam knife

sharp amalgam knife used to shave away excess amalgam

NB large areas of excess amalgam can be crushed or broken apart by large amalgam file
this is dependent on age and strength of amalgam

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these instruments used to remove excess amalgam
extending apical to gingival cavosurface margin
of preparation where access is a problem
 Polishing agents are two common agents pumice and tin oxide

pumice is avaliable in variety of grits or particle sizes

fine grades as flour of pumice are used in first stage of polishing amalgam
NB\\it is usually mixed with water to form a slurry
Tin oxide is final polishing agent applied and it is also mixed with water or alcohol
NB\\because of its very fine particle size it produces a high luster or sheen
both pumice and tin oxide are applied with flexible rubber cups or occlusal brushes

other types of polishing agents are avaliable in the form of mounted rubber points cups
NB\\these may be impregnated with particles of varying degrees of abrasiveness
these cups and points are easier to use and adapted into all areas of restoration
 finishing composite resin restoration

F inshing C R are to remove excess material and to contour and 

smooth surface of restoration which are accomplished with use
of coarse abrasive instruments as coarse and medium grit discs
and mounted white polystones
NB\\carbide finishing burs are specifically designed for C R and 
produce smooth surface can be used
it is important not to confuse carbide finishing burs with steel [  NEXT
used to finish amalgam it will be abraded by filler particles in C R
] producing discolored restoration
Diamond stones are used but not leave as smooth finish as 
carbide finishing burs
instruments such as gold knife or file may be useful along 
gingival cavosurface margin
NB\\ smoothing surface of restoration can be done with fine and 
extrafine discs composed of silicone carbide or zirconium
silicate
Finishing Instruments for composite; From left: : A mounted fine
white stone bur Two medium grit diamond burs Two fine grit diamond burs A
rubber disc A mandrel Two flexible discs Four plastic stubs discs with a mandrel
Matiaining and Sterilizing handpieces burs and stones; all hndpiece’s burs must
.be sterilized after used
 procedure

remove excess material from incisal margin adapt-1

edge[outer 1mm] of coarse disc
to the excess material using light sweeping strokes
to slowly reduce material and
contoure restoration to keep disc adapted to
contours of tooth rotate it slightly as it is moved
from distal to mesial end [caution to avoid
unnecessarily contacting enamel
gingival margin of preparation requires special
consideration during finishing because of
its proximity to root surface the use of rotary
instruments shouled be minimized
NB\\Cementum is very susceptible to abrasion even
fine finishing discs can rapidly remove cementum NEXT
use coarse disc to remove excess material from gingival margin if it is located on enamel -2
adapt it in manner similar to that for incisal margin directing sweeping strokes toward
center of restoration

use gold knife to remove excess material from gingival margins that extend onto root -3
surface shave thin layers of excess material with tip of the blade because it can nick or
abrade cementum exercise care in placing and using gold knife

remove excess material from distal margin rotate disc so that only outer edge is contacting -4
excess material use light sweeping strokes to move disc along entire margin

contour the center of restoration examine gingivoincisal contour by observing tooth from mesial -5
or distal view and mesiodistal contour by observing tooth from gingival by mirror or
incisal aspect
NB\\compare contoures with those of adjacent tooth or contra lateral tooth to determine need for
further contouring move outer edge of disc over excess bulk in middle of restoration
to blend middle with surrounding contours
check margin with explorer to determine amount of excess remaining continue using -6
coarse disc until bulk of excess material is removed

NB\\ if close proximity of rubber dam gingival tissue or gingival retractor limits access to
specific areas of gingival margin [use aflame-shaped or tapered carbide finishing bur ]
position side of bur against excess material [ use light sweeping motion to run bur against bulk areas
]move bur parallel to gingival margin using light to moderate pressure
NB\\ USE CAUTION to avoid scarring enamel and damage adjacent soft tissue

continue contouring and removing excess composite resin using medium grit disc-7
adapt disc to all four margins and to center of restoration
NB\\medium disc removes slight excess while leaving smoother surface
follow same steps and adaptation described for coarse disc

check restoration with an explorer use very light pressure to avoid abrading-8
metal and producing streaks of discoloration on surface
NB\\at this stage margins should be flush with cavosurface and original
contours should be replaced [ restoration has a grainy appearance

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 NB\\ if detect submarginal discrepancy of 0.2 mm or less reduce adjacent enamel
with white stone
if discrepancy greater than 0.2 mm or is long gingival margin reduction of enamel
is not indicated [enamel in this area is very thin and margin is difficult to adjacet
without causing damage to cementum or surrounding structures

void on surface can be repaired unless surface contaminated by saliva hemorrhage or non –water
soluble lubricating agents
mechanical retention can be placed around void with carbide bur
mix small amount of composite resin and place it into the void after material set
finish area with discs

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 polish micro filled composite resin restoration specific rotary instruments are avaliable
in variety of types and shapes [follow manufactures specific instructions for using different
types use intermittent pressure moving instruments over entire surface untile aluster is achiev

evaluation of esthetics is accomplished visually

it is important to do this after rubber dam removed
and tooth and restoration have moistened FINISH
dry composite has slightly different shade
just as dry isolated tooth changes color slightly