DR. DENNIS HARTLIEB

Composite Polishing – Back To The Basics

She’s back, and she’s not happy. The composite that you placed last month on tooth #9 is already staining. She especially notices that her lipstick sticks to the bonded tooth.

If this hasn’t happened to you, it’s probably because your composite polishing techniques for anterior composite restorations are great. But some of you might notice this staining even if you are being diligent with your polishing techniques.

I want to help those that are seeing staining on their bonding cases, either because of the techniques that are being used, or with the materials that we are using to polish.

What are you polishing?

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Hybrids vs. Microfills - Why particle size matters? (Masking the Dark Tooth with Direct Resin Course)
Before we begin the conversation on technique for polishing, we need to discuss the various composites that are in the marketplace, and the “polishability” of those materials.

It’s been my experience that many dentists are unsure of the ‘type’ of composite they are using in their practice; let’s review this issue first.

The three direct composites available today are: microhybrids, microfills, and nanofills.

Most, but not all, composite systems today are nano based – either nanofills or nanohybrids. These nano-based composites are generally referred to as ‘Universal Systems’.

Before the nanofills were introduced to dentistry, dentists were typically using microhybrids. The microhybrids were the universal composite back in the late 1980’s thru the 1990’s. The challenges that we encountered typically with microhybrids was a lack of a durable polish. We would be able to get a decent polish initially, but the polish faded away quite rapidly after the patient left, due to tooth brushing and the foods and drinks that the patient consumed.

An alternative to using the microhybrids, was to use microfilled composites on the esthetic surfaces of teeth. Microfills, given their smaller particle size and shape, are able to be polished to a much higher luster than the microhybrids, and the polish is long lasting.

Unfortunatley, the microfill composites have poor flexural strength and are prone to fracture if used on a biting edge. To prevent the microfill fracturing, microhybrid composites would be used to support the microfill, combining the best properties of both materials.
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What about Nanofill Composites? (Masking the Dark Tooth with Direct Resin Course)

The nano-based composites were introduced to dentistry in the late 1990’s as a ‘Universal’ composite – strong enough to replace the microhybrids where needed for strength, and as polishable as the microfills, where needed for high esthetics.

While the nano-based composites are a step in the right direction for a true ‘universal’ material, evaluation of these materials over time have found that while they are strong, and can replace the microhybrid composite, they are not quite as flexure resistant as the microhybrids. And while the nano-based composites are more polishable than the microhybrids, they fall short of the polishability of the microfills 1.

To simplify the discussion, lets break these three different types of composites into two main assets – strength and polishability.

In my dental practice, for anterior teeth, I tend to use either a microhybrid (if I need greatest strength) or a nanofill for the palatal wall of an anterior restoration. I’ll use a microfill for the facial surface which gives me the ultimate polishability and luster of the restoration. If I am less concerned about ultimate esthetics, like when I do prototype or transitional bonding, then I tend to use a nanofill, or nanohybrid, composite which gives me good strength, and good polishability.

Composite Polishing Systems

Our composite polishing systems today are a bit confusing. To simplify our conversation, we’ll break the polishing systems down to either a disc system, or rubber-based polishers.

The rubber-based polishers will either be a one-step, or a two-step system. 

These polishers will typically have diamond or other abrasive particles impregnated into the polisher which, when used over the composite, will remove surface defects and create a smooth surface.

They come in a variety of shapes and sizes, but typically are brush, wheel, cup or point shaped. The polishers are use with a slow-speed handpiece at a slow, to moderate speed, with light to moderate pressure. 

I have come to favor the ‘Feather-Lite’ polishers from Brasseler when I’m using a rubber-based polisher for anterior composites.  For posterior restorations, I may still use the feather-lite polishers, but tend to use cups, points or brush shape polishers to be able to more adequately polish the composite, and the composite-tooth interface.

The disc system I would compare to a series of sandpapers that go from coarse grit to super fine grit. 

Like the rubber-based polishers, these are also used with a slow-speed handpiece. Multiple studies have demonstrated a superior polish of composites, regardless of the type of composite, when using discs for polishing when compared to the rubber-based polishers. 1,2,3


There are several good disc systems available, but the disc system that I use is the Mini Flexidisc system from Cosmedent.  
There are 4 grits – coarse (sand color), medium (blue), fine (yellow) and superfine (pink).  I favor the disc systems for several reasons:

  1. I find it much easier to do contouring, especially working on the facial embrasures, when using discs
  2. The final polish with discs, once the clinician is experienced, has less surface irregularities
  3. The final polish maintains best long term when I have used discs for polishing.

Keys To Using Discs For Composite Polishing 

First, it is important to remove all surface defects with the coarse and medium discs.  

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Composite Finishing - Initial Contour (Maxillary Central Incisor: Tooth Shape and Form)
Here is my sequence for composite polishing when I use discs:

1- I start with the coarse disc with light pressure and light speed.  With an electric handpiece, I’ll be running at around 500-800 rpms.  The coarse discs can be quite aggressive, so be careful when using these discs.  The discs have ‘flex’ to them, however, the course disc is more rigid.  The rigidity helps remove the surface defects without having to use extra-large particle abrasives in the disc.
  
2- When the surface of the composite is free of scratches and any pits or defects, I’ll use the blue (medium) disc.  With the blue disc, and the other polishing dics, the discs are highly flexed when used.  I want to get as much of the disc surface onto the composite surface as possible.  With the blue disc, because it is less abrasive, I will increase the speed of the disc (around 800-1300 rpms).  I especially like using the smallest of the discs to open the facial embrasures to emphasize the light deflection zone from the light reflection zone of the composite restoration.

The final two discs in the system will only enhance any defects. 

3- When I am finished with the blue disc, the surface should look smooth and have a matte like finish.  The yellow and pink discs are used in sequence, increasing the speed and the pressure applied, being sure to flex the disc over the composite surface, resulting in an incredibly polished composite. 


4- As a final step, following either the 2-step rubber-based polishers, or the 4-step disc polishers, I use an
aluminum oxide polishing paste (Enamelize, Cosmedent) with a buff disc (Flexibuff, Cosmedent) for the ultimate luster.

Back to the Patient


The biggest advantage to me with the two-step rubber-based polishers is time; the 2-step polishing systems are absolutely, in my hands, faster than using the 4-step disc polishing systems. 

When I am in a time crunch, or when I am working on a patient that I am less concerned about potential staining, then I will tend to use the two-step polishers, i.e. Feather-Lites.

Keep in mind though that staining of the composites in the anterior esthetic zone can be a real practice killer.  So, if time allows, use the 4-step disc systems to get ultimate polish of your composites.


Understanding the various composite materials available today and learning the best polishing techniques to create the highest luster with the greatest longevity will be a key in helping you build an esthetic practice with raving fans! 

Footnotes:

  1. The Effect of Different Polishing Methods and Storage Media on Discoloration of Resin Composites Deljoo Z, Sadeghi M, Azar MR, and Bagheri R, J Dent Biomater. 2016 Jun; 3(2): 226–232.

  2. Comparative evaluation of effect of different polishing systems on surface roughness of composite resin: An in vitro study Rashmi G. Chour, Aman Moda,1 Arpana Arora,2 Muhmmed Y. Arafath, J , Int Soc Prev Community Dent. 2016 Aug; 6(Suppl 2): S166–S170.

  3. Comparison of Two-Step Versus Four-Step Composite Finishing/Polishing Disc Systems: Evaluation of a New Two-Step Composite Polishing Disc System  JB da Costa ; F Goncalves ; JL Ferracane, Oper Dent (2011) 36 (2): 205–212.



Dennis Hartlieb, DDS, AAACD

DOT Founder

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