Fall Lecture 2: Amalgam Finishing and Polishing

Question 1

When do we finish the amalgam restoration?

Answer 1

same day it’s placed

Question 2

instruments to finish amalgam:

Answer 2

discoid, cleoid, rotatory

Question 3

Polishing:

Answer 3

smooth amalgam to high gloss/ luster

Question 4

TF? The clinical outcome will be compromised if the amalgam is not polished.

Answer 4

F. Prognosis the same.

Question 5

Purpose of finishing

Answer 5

no uneven areas bw amalgam and cavity prep wall, ensure contour and occlusion are correct, resto is smooth

Question 6

Is it more important to finish high copper or low copper amalgam?

Answer 6

low copper, high copper less susceptible to tarnish and corrosion (no g2 phase)

Question 7

When to polish amalgam:

Answer 7

at least 24h after placement

Question 8

What can sometimes serve as a viable substitue for conventional polishing?

Answer 8

pre-carve burnishing in conjunction w post-carve burnishing

Question 9

TF? If the amalgam restoration is not smooth after 24h and you are ready to polish, you should smooth, but you must wait another 24h’s.

Answer 9

F. Refinish, then polish

Question 10

This will occur if there is a gap between the amalgam and the cavity prep:

Answer 10

marginal leakage

Question 11

Effects of proper condensation:

Answer 11

red marginal leakage, Hg content in resto, and corrosion, inc strength and marginal integrity

Question 12

Condensors for finishing, condensor for overpacking

Answer 12

smaller, larger

Question 13

Explain the condensing strokes:

Answer 13

each condensing stroke should overlap the previous

Question 14

How much to overpack amalgam:

Answer 14

1mm+

Question 15

Overpacking prevents:

Answer 15

undercontouring of resto

Question 16

General condesation time:

Answer 16

2.5 - 3.5m

Question 17

Type of condensor for spherical amalgam:

Answer 17

large condensor (plastic, buttery consistency)

Question 18

Type of condensor initially used for admixed amalgam:

Answer 18

small condensor, more resistant to pressure

Question 19

condensor with 2X the diameter requires how much more pressure?

Answer 19

4X

Question 20

Pre-carve burnishing:

Answer 20

to ensure marginal amalgam is well condensed before polishing, burnishing immediately after over packing (M-D and F-L)

Question 21

benefits of pre-carve burnishing:

Answer 21

denser amalgam at margin, excess Hg release (?), inc marginal adaptation

Question 22

Size of ball burnisher to choose for pre-carve burnishing:

Answer 22

head contacts cusp slope but not margin

Question 23

When to carve amalgam:

Answer 23

immediately after pre-carve burnishing

Question 24

Best instrument for carving:

Answer 24

cleiod/ discoid carver, larger end at beginning

Question 25

Which has a sharper end, discoid or cleoid?

Answer 25

cleioid

Question 26

Instrument to use to carve CG and pit and fissure areas::

Answer 26

cleioid

Question 27

Position of discoid blade for carving:

Answer 27

edge perp to resto margin, resting on unprepped tooth, prevents overcarving amalgam, creates continuity of surface contour

Question 28

Carver should be pulled in a direction parallel to:

Answer 28

the margin of the prep

Question 29

Major issue with leaving flash:

Answer 29

chip away, damage margin, marginal leakage

Question 30

Post-carve burnishing:

Answer 30

light rubbing of surface of carved amalgam resto w burnisher (PKT3 burnisher, small burnisher) smooth, but not shiny appearance, don't create grooves

Question 31

How to check finishing:

Answer 31

check occlusion (before and after procedure), explorer around margins (don't scratch restoration)

Question 32

Type of contact amalgam should have (CG of molar)

Answer 32

light occlusal contact

Question 33

Appearance of heavy contact on amalgam:

Answer 33

dark area with shiny center

Question 34

How to adjust occlusion on amalgam or make a continuity of surface contour across the margin:

Answer 34

finish with different shapes of carbide burs, fine-grit white alumina stone or green carborundum stone

Question 35

Which is more aggressive, fine-grit white alumina stone or green carborundum stone

Answer 35

green

Question 36

How to blunt the tip of finishing stone:

Answer 36

diamond wheel, helps prevents alteration of the anatomical features

Question 37

Amalgam restoration is surfaced with:

Answer 37

a round finishing bur

Question 38

Position to hold the finishing stone:

Answer 38

long axis of stone or the bur's long axis at a R angle to the margin

Question 39

Instrument to use after finishing stone or bur:

Answer 39

large, round finishing bur

Question 40

Pre-polishing step if the resto is not smooth enough yet and is already set, can't smooth anymore:

Answer 40

rubber prophy cup w wet pumice, tin oxide in water or alcohol carrier for high luster, faster, creates luster

Question 41

Shapes of carbide finishing burs we have:

Answer 41

bullet, neumeyer, egg, long pear

Question 42

use brownie and greenie for:

Answer 42

finishing and polishing

Question 43

To polish convex surfaces:

Answer 43

Sof-Lex discs (composite or amalgam), high luster and finishing polishing, abrasive impregnated polishing cups

Question 44

To polish concave surfaces:

Answer 44

abrasive impregnated polishing tips

Question 45

Should polishing begin with the coarse rubber abrasive disc/ cup/ point on high or low speed?

Answer 45

low speed, just above "stall out" speed

Question 46

How long should amalgam w smooth surface take to shine w first, coarse disc/ cup/ point?

Answer 46

few sec, if not, refinish with finishing bur and repolish, point should get rid of all scratches (same thing w each successive, finer grit)

Question 47

3 reasons to polish at low speed, just above "stall out" speed with the presence of air-water coolant:

Answer 47

1. point disintegrates at high speeds. 2. over-heating of resto --> pulpal damage. 3. Heat brings liquid Hg to surface, causing excessive volatilization of Hg and weaker amalgam surface.

Question 48

Appearance of amalgam when over heated:

Answer 48

cloudy, even though it may have a high polish (Hg has been brought ot surface, corrosion, loss of strength

Question 49

Purpose of wedge in Topplemeyer placement:

Answer 49

recreate embrasure

Question 50

Fxn of inner knob of Topplemeyer:

Answer 50

changes diameter of matrix band

Question 51

Ends of matrix band fit into:

Answer 51

vice

Question 52

The matrix band can go to the R or the L through the:

Answer 52

guide slots

Question 53

guide slots always face toward:

Answer 53

gingiva

Question 54

Which knob to turn to tighted the matrix band:

Answer 54

inner

Question 55

Insert wedge from buccal/lingual aspect:

Answer 55

lingual, only needed on side of missing wall

Question 56

How to take off Topplemeyer:

Answer 56

unscrew outer knob, releases the band ends

Question 57

Why remove Topplemeyer while leaving the band, initially?

Answer 57

prevent material from crumbling interproximally