Once you have your resin/composite in place, it's time to begin finishing your Class IV restoration. It begins with doing your gross contours and using your choice of burs, finishers and polishers.

If you have done everything else correctly, there should be little to no flash noted interproximally. If there is, I recommend using a #12 blade in a Bard-Parker handle to remove any areas of flash interproximally.

 

I will use a large course disc in combination with 12-fluted carbide burs to remove any excess and start to develop my primary anatomy and gross contours. I then use marking paper or a sterile pencil to mark the line angles to gain a better perception of them during finishing. I will continue to use a combination of discs of various sizes and grit to get my line angles "warped" into place.

After this is completed, I avoid these because I'll refine my secondary anatomy with fine diamonds. The key here is that you are trying to mimic the contralateral tooth, not only in primary anatomy and line angles, but also contours and overall surface texture (some are smooth vs. lots of texture, etc.).

Over-polishing a restoration on a tooth that is beside other teeth that have lots of surface anatomy and texture can be as noticeable as poor shade selection.

 

When you have achieved your overall contours and surface texture, it's important that we make sure that the overall finish is very close to the desired result prior to polishing the restoration to a final finish. Since this step is used to simply take the restoration that is dull in finish to a surface luster that mimics the adjacent teeth, the polishers at this step will not remove scratches and deeper imperfections. If you find deeper imperfections, you have to go back to your other discs and fine diamonds before proceeding. Otherwise, you will not get the end result you desire when you polish.



 

The final step includes a series of polishers like PoGo or a Jiffy brush. I use light pressure and keep the tooth and restoration slightly wet. I then use a FlexiBuff polisher and a polishing paste like Enamelize at a high speed, using light pressure and dry. As you polish your restoration in this final step, you will find that the final finish of the restoration will appear.

Jeff Lineberry, DDS, Visiting Faculty. [ www.jefflineberrydds.com ]

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