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7 Finishing And Polishing Of Restorations.ppt.2 Final000




Finishing and Polishing Introduction Benefits Basic of finishing and polishing armamentarium Principles  Air - Cutting, Grinding, Bulk reduction process, Contouring dispersed Hazards during finishing process What is Abrasive & Erosive wear Abrasive Types Instrument Designs of Abrasives - Natural abrasives & Manufactured abrasives Abrasive Finishing motion of various restorations composite, amalgam, ceramic, GIC, and cast gold REFERENCES CONCLUSION Introduction Benefits Basic of finishing and polishing armamentarium Principles  Air - Cutting, Grinding, Bulk reduction process, Contouring dispersed Hazards during finishing process What is Abrasive & Erosive wear Abrasive Types Instrument Designs of Abrasives - Natural abrasives & Manufactured abrasives Abrasive Finishing motion of various restorations composite, amalgam, ceramic, GIC, and cast gold REFERENCES CONCLUSION Introduction  The finishing process usually removes material such that :    Surface blemishes & imperfections are removed Material is shaped to an ideal form Outermost surface of the material is developed to a desired state Benefits of Finishing and Polishing  Benefits : (a) Health (b) Function (c) Aesthetics There are distinct differences in function of cutting, grinding, finishing and polishing Cutting  Cutting refers to use of a bladed instrument or the use of any instrument in a bladelike fashion.  Course of action  –  Cutting operation – may divide substrate into large separate pieces / produce deep notches or grooves  E.g. High speed tungsten carbide burs steel burs predominantly unidirectional Grinding     It is a process that removes small particle of a substrate through the action of bonded or coated abrasive instruments . Course of action  –  predominantly unidirectional Grinding instrument - contain many randomly arranged abrasive particle . Each particle may contain several sharp points that run along the substrate surface and remove particles of materials . Eg Diamond coated rotary instrument disk & strips . Bulk reduction process  Instruments used     Abrasive coated disks –   Diamond, carbide and steel burs  Abrasive coated disks or separating disks popular bulk reduction of resin based composite restorations Clinician should choose 8 to 12 fluted carbide burs or abrasives with particle size of 100 micrometers or more with sufficient hardness. Contouring  Though it can be achieved during bulk reduction, in some cases it requires finer cutting instruments or abrasives to provide better control of contouring and surface details.   At the end of the process, desired anatomy and margins should be established.  Usually 12 to 16 fluted carbide burs or abrasives ranging in size from 30 to 100 micrometers provide the fine contouring action. FINISHING AND POLISHING Provides blemish free & smooth surfaces Requires step wise approach 18-30 8-20 um particle size POLISHING : provide enamel like luster Speed of achieving polishing depend on 2 factor a) hardness & size of abrasive b) method of abrasion Polishing & luster can be judged by : 1 , 2 , 3 methods What is Abrasive Blinding ?  AIR DISPERSED HAZARDS OF FINISHING PROCESS  AEROSOL – HEALTH HAZARD 95% of generated aerosol particles - < 5µm in diameter – can readily reach pulmonary alveoli during normal respiration 75% of aerosol particles – potentially contaminated with infectious microorganisms  Aerosols can remain airborne for >24hours – therefore capable of cross-contamination If inhaled, swallowed or if it enters the eyes Diseases of the lungs ,throat and eyes. Silica based materials if inhaled Silicosis or Grinders disease. (Fibrotic pulmonary disease) (major aerosol hazard) AEROSOL - CONTROL 3 ways :  1. 2. 3. Controlled at the source  –  adequate infection control procedures  High – volume suction Personal protection –  Safety glasses  Disposable face masks Adequate ventilation system  –  To remove any residual particulates from air WEAR  Wear – is a material removal process that can occur whenever surfaces slide against each other. 2 types a)  Abrasive wear b) erosive wear  Abrasive wear is divided into: - Two Body Abrasion - Three Body Abrasion The two processes are not mutually exclusive Two body abrasion occurs when the abrasive particles are firmly bonded to the surface of the abrasive instrument and no other abrasive particles are used. Eg. Diamond bur abrading a tooth. •Three body abrasion when abrasive particles are free to translate and rotate between two surfaces. Eg. Dental Prophylaxis Pastes. How to prevent it ?... . Erosion  Erosive wear is caused by hard particles impacting a substrate surface, carried either by a stream of liquid or air.  Eg. Air-driven grit-blasting units - employ hard particle erosion to remove surface material The rotational direction of a rotary abrasive instrument - important factor in controlling the instrument action on the substrate.  Bur in high speed handpiece rotates in clockwise direction.  Smoother grinding action – when handpiece & bur are translated in a direction opposite to rotational direction of the bur.  Rougher surface – when handpiece & bur are translated in the same direction as rotational direction of the bur. (Bur tends to “runaway” from the substrate)  ABRASIVE INSTRUMENT DESIGNS These are :   Abrasive grits  Bonded abrasives  Coated abrasive disks and strips  Non bonded abrasives  Abrasive Grits Derived from crushed materials passed through a series of mesh screens to obtain different particle size ranges. Classification according to particle size ranges:     Coarse Medium coarse Medium fine Super fine Bonded Abrasives Consist of abrasive particles incorporated through a binder to form grinding tools such as points, wheels etc. Particles are bonded by four methods:     Sintering Vitreous bonding Resinoid bonding Rubber bonding Coated Abrasive Disks  And Strips  Fabricated by securing abrasive particles to a flexible backing material with a suitable adhesive material.  Supplied as disks and finishing strips. Non Bonded Abrasives      Polishing pastes are considered non bonded abrasives Primarily for final polishing Need to be applied to the substrate with a non abrasive device like synthetic foam, rubber felt etc. Abrasive particles are dispersed in a water soluble medium such as glycerin. Most popular aluminium oxide and diamond Types of Abrasives NATURAL ABRASIVES:              Arkansas stone Chalk Corundum Diamond Emery Garnet Pumice Quartz Sand Tripoli Zirconium silicate Cuttle Kieselguhr MANUFACTURED ABRASIVES: Synthesized material that are usually preferred  – more predictable physical properties      Silicon carbide, Aluminium oxide Synthetic diamond Rouge Tin oxide ARKANSAS STONE: - Semi translucent, light gray, siliceous sedimentary rock, mined in Arkansas. - Contains micro crystalline quartz - Dense, hard and uniformly textured. - Can be made into various shapes. - Use : to grind tooth enamel & metal alloys CHALK: - Mineral form of calcite. - White abrasive - Composed of calcium carbonate. - Use : polish tooth enamel, gold foil, amalgam & plastic materials. CORUNDUM: - Mineral form of aluminium oxide - Usually white - Use : grinding metal alloys. - Most commonly used in instrument known as “white stone” NATURAL DIAMOND: - Transparent colorless mineral - Composed of carbon - Hardest substance. - various forms : Bonded rotary instruments Diamond polishing pastes Flexible metal-backed abrasive strips - Use : on ceramic & resin-based composite materials Difference between natural & synthetic diamond SYNTHETIC DIAMOND ABRASIVES: - Advantage: controllable consistent size and shape lower cost - Resin bonded diamonds sharp edge the sharp edge breaks down; exposes new sharp edges, corners. - Metal bonded diamonds regular, more consistent in size. Use cutting points. - Large synthetic diamond particles greenish. EMERY: - Grayish - black - Fine grain form - Used form of coated abrasive disks. - Use : Finishing metal alloys or plastic materials GARNET: - Includes number of different minerals that possess similar physical properties & crystalline forms - Usually dark red. - Extremely hard - Use : Grinding metal alloys and plastic materials PUMICE: - Light - Gray - Highly siliceous material - 2 form:-Grit -Rubber bonded abrasives - Use :- polishing tooth enamel - gold foil - dental amalgam QUARTZ:   Most commonly used is very hard colourless and transparent. Use : - finish metal alloys, - grind dental enamel. SAND: - Mixture of small mineral particles - Predominantly composed of silica. - Rounded to angular shape - Use : Grinding metal alloys & plastic materials TRIPOLI: - Derived from a lightweight siliceous sedimentary rock. - grey and red coloured are the most commonly used - Use: Polishing metal alloys and some acrylic resins. ZIRCONIUM SILICATE: - Supplied as an off white material - Use: - To make coated abrasive disks & strips - As component of dental prophylaxis pastes. KIESELGUHR: - Composed of siliceous remains of minute aquatic plants known as diatoms. - Use : Mild abrasive - Significant risk of respiratory silicosis SILICON CARBIDE: - First of synthetic abrasives - Two types; green and blue - They are extremely hard and brittle ROUGE: - Iron oxide is a fine, red abrasive component of rouge. - Use : Polish high noble metal alloys TIN OXIDE: - Extremely fine abrasive - Use : polishing agent for polishing teeth and metallic restorations ALUMINIUM OXIDE: - Second synthetic abrasive developed - Use : To make bonded abrasives, coated abrasives and air propelled grit abrasives. - Sintered aluminium dioxide is used to make white stone (popular for adjusting dental enamel and finishing metal alloys & ceramic materials)  ABRASIVE MOTION Classified as    Rotary Planar Reciprocal Burs Disks Reciprocating hand pieces Note :Reciprocating hand pieces provide benefit of accessing interproximal and subgingival areas to remove overhangs, to finish subgingival margins without creating ditches and to create embrasures Finishing and Polishing of Different Restorations Composites   Armamentarium :       Fibro optic lighting and magnification (for visibility) Fine grit conventional diamonds (for gross reduction) Round tungsten carbide burs (finishing) Flame shaped fluted tungsten burs (finishing) Impregnated rubber wheels or points (finishing) Slurry of fine aluminium oxide (polishing) Composite finishing kit Composite finishing paste impregnated rubber wheels or points Initial finishing by a sharp knife Final Finishing In DCNA 1998 study was done on finishing procedure ………..  Amalgam   In the past a delay of 24 hrs had been suggested before finishing and polishing the newly inserted amalgam Armamentarium :           Rhein trimmers (Discrepancies in gingival area ) Bard parker knife number-12 (Bulky overhangs ) Narrow water resistant strip (19)(Cervical areas ) extra fine water proof disk (Buccal and lingual proximal margins ) small carrot shaped stone (20) (Occlusal margins ) plug finishing burs (21) (further adjustment ) Rubber cup (finish accessible proximal surfaces as well as occlusal contours) Abrasive impregnated silicon rubber points and cups tin oxide slurry (complete the finishing and polishing procedures) soft cut brush (complete the finishing and polishing procedures) Finishing and polishing cannot be started until a future visit when the amalgam will have set hard.  Any sizeable reduction may be undertaken with a carborundum point. Ceramics   Adequate cooling is important in vivo when finishing and polishing ceramic restoration  Using an air water spray and maintaining intermittent contact between restoration and rotary instruments are critical during operation  Continuous contact between restoration and rotary instruments should be avoided  Heat less stone like silicon carbide provide heat reduction and can be used as an alternative Techniques  Contour with flexible diamond disc, diamond burs, heatless or polymer stones or greenstones  Finish with white stones or abrasives impregnated rubber disc, cups and points   Apply over glaze or natural glaze on ceramic if necessary Glass Ionomer Cement Diagramatic representation of water balance in glass ionomer. Type ii and I restorative aesthetic restorations remain succeptible to water uptake for at least one day after placement.All the types are fast settig gic and so are resisting to water uptake within 5 to 6 mins from the beginning of mix. Problem of water loss continues for a longer period for both fast and slow set types and precautions should be taken to prevent dehydration.  The best surface attainable is that produced when the cement is allowed to set against the matrix.  Where access can be gained, carving the cement external to the cavity margins with sharp knives or scalers after initial set is the best process of finishing.  Whenever possible, margins should be smoothed with hand instruments.  Finishing with rotary instruments and final polishing can be undertaken at a subsequent visit.  Glass ionomer should never be finished under dry conditions; a petroleum lubricant may be used to prevent desiccation. Finishing Of GIC Restoration Finishing with a bur Finished GIC Restoration CAST GOLD RESTORATION Use a 1/2 inch medium garnet disc in a straight handpiece to reduce gold and tooth to the same plane on all surfaces (use contra-angle with grit in to reduce mesial-lingual, where necessary, for both maxillary and mandibular restorations). Air should be blown continuously on the tooth to prevent overheating during all disking, stripping and polishing procedures. Finished cast gold restoration Use fine and extra-fine narrow, extra-long cuttle strips to reduce the size of scratches. Complete disking with fine cuttle discs until all scratches have been removed.  Polish with flour of pumice. Do not use coarse pumice as it will destroy the finish achieved with the fine cuttle disc.  Use dry tin oxide powder over casting for final polish. Blow off excess tin oxide while utilizing a ribbed cup (webbed cup will throw powder away from tooth) at low speed to avoid heating the tooth. References Phillips Science of Dental Materials.   Atlas of operative Dentistry   Atlas of G. J. Mount   Allen D. Wilson  Charbenau  David Korson  Ratnadeep Patil  J.R. Grundy  CONCLUSION •Fluted carbide finishing bur appear to be the optimal rotary contouring device •FINISHING DIAMOND preferred for GROSS FINISHING •COATED DISK & STRIPS provides access for interproximal & incisal area •RUBBERIZED BONDED provide great range of  FINISHING • ALUMINIUM OXIDE & DIAMOND PASTE are highly effective against POLISHING