If you could improve the efficiency of your Class II restorations without sacrificing procedure quality and outcome, would you do it? Of course, you would — it’s hard to find a dental practitioner that wouldn’t.
Well, research has shown that on average, finishing and polishing represents about 14% of total chair time for a Class II procedure.1 Yet, for some reason, finishing and polishing products and techniques are often forgotten when it comes to discussions around improving procedure outcomes and efficiency. It doesn't matter how diligently you worked if you don't ensure a smooth surface to withstand biofilm and plaque accumulation over time - which is accomplished during the finishing and polishing stage.
Our goal is to enable you to provide the best possible care for your patients, and that extends to helping you save time and provide more predictable outcomes. Below we’ve outlined the basics of composite finishing, including the best methods, techniques, and products to achieve the most predictable results without sacrificing time or efficiency.
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What’s more important, a smooth finish or a high polish? First, you should understand the difference between ‘finishing’ and ‘polishing’. Composite finishing is to refine the anatomy and smooth the restorative surface, reducing scratches and surface irregularities. Composite polishing is the act of creating a luster, or shine, on the surface of the restoration.
Are both composite finishing and composite polishing necessary? If you want happy patients, yes. It’s the finishing and polishing steps that can influence the overall longevity, aesthetics, color, and smooth shine on the surface of the restoration. And every patient wants to walk out of your office with a strong composite restoration and a (functional) smile they can be proud of.
We’ve established that finishing and polishing play a role in the aesthetics of the restoration, but the finishing step is a big deal for more reasons than a pretty smile. Studies show that clinicians can potentially increase the overall longevity of their Class II restorations with proper finishing technique.2 Here’s how: A smooth surface finish minimizes the presence of surface irregularities that can lead to plaque retention, staining, gingival irritation, recurrent caries, and tactile perception by the patient.3,4
For example, let’s say you use a diamond finishing bur. The bur may provide a highly efficient rate of material removal, but it may also leave the surface rough. If you follow the diamond bur with a polisher like the Enhance Pogo system but skip the finishing step, the surface may have luster and be reflective but will still be rough and prone to plaque retention and staining. Now, let’s say you defined the occlusal anatomy with a finishing bur, and then used a finer grit ‘finishing’ product like the Enhance Finishing System to further smooth the surface before polishing. The result is a smoother surface that is also resistant to plaque accumulation and staining.
Choosing the right products and techniques are key for achieving optimal performance and efficiency. Here are a few things to consider to shorten the time spent on this step, all while improving the clinical results:
We all know the importance of creating a tight, contoured interproximal contact. You may have found a way to achieve contact, but if the matrix system you are using does not tightly seal the margins and create accurate contours, you might end up having to take a finishing strip interproximally to smooth and shape that surface. If you grind it down too far though, the contact might be lost. Eliminate the agony of this step and save time by making sure you are using a good matrix system, like our Palodent Plus or Palodent 360, that creates a tight seal minimizing the amount of flash created.
What composite are you using?
If you’re not using a composite from the same company as your finishing and polishing products, you may not get the best results. We recommend using a composite like TPH Spectra ST which has been shown to generate smooth, highly polished surfaces when used with Enhance Finishers and Polishers.
What happens when your current finisher contacts adjacent teeth? You may be utilizing tungsten carbide burs and multi-step dental composite polishing disc systems as a part of your finishing and polishing protocol. However, studies have shown that while these products may decrease composite surface irregularities, they may increase scratching of enamel.5 The scratches in the enamel then become sites for bacteria to collect, which can lead to recurrent caries and an ultimate failure in the restoration.
That’s why we recommend using finishing products that safeguard enamel, like our Enhance Finishing System. The Enhance Finishing System accomplishes the entire process of excess removal, contouring, and finishing simply by varying the pressure. Push to remove excess composite, ease off to smooth and buff the surface. In just one step the Enhance Finishing System delivers a smooth, contoured surface with a natural looking finish.
More than 70% of dentists say that simplicity is one of the most important factors for a finishing and polishing system.6 Yet many dentists still rely on using a multi-step disc system that consists of four (coarse, medium, fine, ultra-fine) discs. But what if you could simplify the finishing process? With Enhance Finishers, you can. Enhance Finishers allow you to apply more pressure for excess removal and initial contouring and then back it off for a naturally smooth surface. With no need to change instruments, you can stay focused on the procedure to achieve a better finish, faster. Not only that, but surface roughness testing proves1 that the composite surface is smoother when Enhance Finishers are used after gross contouring with a bur.
Of course, not all composite restorations will be the same, and there are stipulations when it comes to success, but that’s where we come in. Dentsply Sirona’s Class II Total Practice Solution helps clinicians identify their unique Class II challenges and provides them tools and training to implement solutions for a better practice all around. To get started, contact us now!