Finishing and Polishing the Amalgam.

Finishing of amalgam restorations may be necessary to correct

a marginal discrepancy or improve the contour. However, evidence suggests that polishing of high-
copper amalgams is unnecessary. 58 Although, they are less prone to corrosion and marginal
deterioration than their lowcopper predecessors, some operators still prefer to polish amalgam
restorations. Finishing (and polishing) is usually delayed until all proposed restorations have been
placed, rather than being done periodically during the course of treatment. Polishing an amalgam
restoration is not attempted within 24 hours after insertion because crystallization is not complete.
Finishing and polishing the occlusal portion is similar to the procedures described for the Class I
amalgam restoration (see Fig. 17-24).

Finishing and polishing of the proximal surface is indicated where the proximal amalgam is
accessible. This usually includes the facial and lingual margins and the amalgam occlusal to the
contact. The remainder of the proximal surface is often inaccessible; however, the matrix band
should have imparted sufficient smoothness to it.

If the amalgam along the facial and lingual proximal margins was slightly overcarved, the enamel
margin can be felt as the explorer tip passes from amalgam across the margin onto the external
enamel surface.

When this occurs (and where the proximal amalgam is accessible),

use sandpaper discs, rotating at slow speed, to smooth the enamel-and-amalgam margin. Sandpaper
discs can also be used to smooth and contour the marginal ridge. However, inappropriate use of
sandpaper discs may "ledge" the restoration around the contact, resulting in inappropriate proximal
contours. In very conservative preparations the facial and lingual proximal margins are generally
inaccessible for finishing and polishing.

However, fine abrasive discs or the tip of sharpened rubber polishing points should be used to polish
the proximal portion that is accessible. When proximal margins are inaccessible to finishing and
polishing with discs or rubber polishing points and there is some excess amalgam (such as at the
gingival corners and margins), the amalgam knives may occasionally be used to trim the amalgam
back to the margin and to improve the contour. Such light surfacing can produce a smooth surface.
Some polishing techniques include the use of dental tape with a polishing agent on the proximal
surface. With the polishing agent applied to the facial and lingual embrasures, pass dental tape
through the contact. Then press and slide the tape sideways in both directions several times against
the proximal surface gingival to the contact. Exercise care not to traumatize the soft tissue.

Accessible facial and lingual proximal margins may also be polished using the edge of an abrasive
rubber-polishing cup.

Final polishing of the occlusal surface and accessible areas of the proximal surface may be
accomplished with a fine-grit rubber polishing point or by the rubber cup with flour of pumice
followed by a high-luster agent, such as precipitated chalk. Fig. 17-106 illustrates examples of
properly finished and polished amalgam restorations.

QUADRANT DENTISTRY When several teeth are to be restored, experienced dentists usually treat
them by quadrants rather than individually. Quadrant dentistry implies more efficiency for the
dentist and less chair time for the patient. The use of the rubber dam is particularly important in
quadrant dentistry. For maximal efficiency, when a quadrant of amalgam tooth preparations is
planned, each rotary or hand instrument should be used on every tooth where it is needed before
being exchanged. When restoring a quadrant of Class 11 amalgam tooth preparations, it is
permissible to apply matrix bands on alternate preparations in the quadrant and restore the teeth
two at a time. Banding adjacent preparations requires excessive wedging to compensate for a
double thickness of band material and makes the control of proximal contours and interproximal
contacts very difficult. Extensive tooth preparations may need to be restored one at a time. If
proximal boxes differ in size, teeth with smaller boxes should be restored first, because often the
proximal margins are inaccessible to carving if the larger adjacent box is restored first. In addition,
smaller boxes can be more quickly and accurately restored, because more tooth structure remains
to guide the carver. If the larger proximal box is restored first, there is risk of damaging the gingival
contour of the restoration when the wedge is inserted to secure the matrix band for the second,
smaller restoration. If the adjacent proximal boxes are similar in size, start the banding of alternate
preparations with a most posterior preparation, because this allows the patient to close slightly as
subsequent restorations are inserted(Fig. 17-107). Before restoring the second of two adjacent
teeth, the operator should carefully establish the proximal contour of the first restoration (the first
half of each interproximal contact). Its anatomy will serve as the guide to establish proper contact
size and location of the second restoration; it will also serve as good embrasure form. If necessary, a
finishing strip can be used to refine the contour of the first proximal amalgam contour (Fig. 17-108).
However, the finishing strip is indicated only where the proximal contact is open. Using a finishing
strip between contacting amalgam restorations may lighten or eliminate the proximal contact.

FIG

FIG

17-107 Quadrant dentistry. Unless otherwise indicated, a quadrant of Class II preparations with
similarly sized proximal boxes can be restored using two bands simultaneously if they are placed on
every other prepared tooth. It is recommended to restore the most posterior tooth first.
17-111

Clinical examples of long-term amalgam restorations. A, 44-year-old amalgams. B, 58-year-old

amalgams in the first molar. C, 65-year-old amalgams in molars. (A and B, Courtesy of Drs. John
Osborne and James Summitt.)

17-111

Clinical examples of long-term amalgam restorations. A, 44-year-old amalgams. B, 58-year-old

amalgams in the first molar. C, 65-year-old amalgams in molars. (A and B, Courtesy of Drs. John
Osborne and James Summitt.)

17-24 Polishing the amalgam. A, When necessary, use fine-grit alumina or carborundum stone to
develop continuity of surface from tooth to restoration. B, Surface the restoration with a round
finishing bur. C, The stone's or bur's long axis is held at a right angle to the margin. D, Initiate
polishing with coarse, rubber abrasive point at low speed. E, Point should produce smooth, satiny
appearance. F, Obtain high polish with medium- and fine-grit abrasive points. G, Polished
restoration.