POLISHING PROTOCOL
Other variables that affect the abrasive properties of a product include quantity of the paste applied, the rotation speed of the hand piece applying the paste, how much pressure is applied to the surface being polished, and how much time is spent polishing per surface.6,10
Keep in mind that friction and heat generation are other factors to consider. Slight modifications of current polishing techniques are required even when polishing aesthetic restorations with the properly indicated paste. Handpieces should be operated below 3,000 rpm. Adaptation of a soft cup is preferred with the lip of the cup flared slightly against the surface as seen in Figures 1 and 2. Figures 3 and 4 illustrate adapting the cup to the bicuspids with medium or coarse prophy paste to remove interproximal staining. Afterward, the restorations are polished with a fine paste to restore a smooth glasslike surface as seen in Figure 5. If additional polishing is required to re-establish surface integrity, a diamond polish may be utilized.
The cup should be adequately filled (not overfilled) with paste, as shown in Figure 6, and held at a 90° angle against the tooth. Utilizing intermittent pressure strokes on the tooth, and keeping sufficient paste in the cup, will help avoid any frictional heat. Too much external pressure can contribute to increased abrasion against the surface being polished. A limited number of teeth (2 to 3) should be treated at a time. Time spent on each surface should be approximately 5 seconds. Following the complete manufacturer’s recommendations regarding the specific polishing agent will ensure proper results and success of the product.9,10
SELECTIVE POLISHING
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| Figure 1. A soft rubber cup, with slight flaring, is applied against the surface being polished. Too much external pressure can contribute to increased abrasion. |
Figure 2. Surface is polished with a fine paste (Proxyt [Ivoclar Vivadent] shown here) to create a smooth glasslike surface to the ceramic. If additional polishing is required to re-establish surface integrity, a diamond polish may be utilized. |
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Figure 3. Adapt the cup to the bicuspids with medium or coarse paste to remove interproximal staining. Then, the restorations are polished with fine Proxyt to maintain a smooth surface. |
Figure 4. Proper posterior adaptation necessitates retracting the cheeks. |
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Figure 5. Handpieces should be operated below 3,000 rpm, and a limited number of teeth (2 to 3) should be treated at a time. |
Figure 6. The cup should be adequately filled (not overfilled) as illustrated. |
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| Figure 7. Eight pressed-ceramic (IPS Empress [Ivoclar Vivadent]) restorations (teeth Nos. 5 to 12) placed 6 years ago. Slight interproximal stain was removed utilizing Proxyt coarse, and the restorations were then polished with Proxyt fine. |
Figure 8. The pastes have been thoroughly rinsed from the restorations. |
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| Figure 9. Postoperative photo: Although the restorations may not appear very different from the start, the patient stated that her restorations feel smooth, slick, and glasslike to her tongue again. |
In an ideal situation, if a restoration does not have stain present, it is an option to selectively polish. This technique is supported by the American Dental Hygienists’ Association.1,9 However, many patients feel that the “cleaning” is not complete without having their teeth and/or restorations polished, in some sort of fashion. This is where the hygienist can triage the polishing protocol specific for each patient. It may be just selecting a polishing paste that is needed to satisfy the patient’s desires. Several polishing pastes are on the market specific to aesthetic restorations.