Dental News - Polishing up your orthodontic finish

Dr S. Jay Bowman, USA

Mon. 12 April 2010

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The Axis Orthodontic Adhesive Removal Set (featuring a series of three polishing devices) was designed to both effectively and efficiently remove adhesives and cements after the completion of orthodontic treatment and to produce a smooth final enamel finish.

This set consists of the following components:

1. H375R-016 (7675) Red Carbide, a gross adhesive removal bur.
2. H246L-012UF White Finishing Carbide, a 30-fluted finishing bur.
3. P0153-031 Polisher, a green polishing point.

All are conveniently maintained in an aluminum bur block that can be sterilized. These three devices can be used with either low- or high-speed friction-grip dental handpieces (including electric handpieces). Using a high-speed handpiece to remove adhesives is more comfortable for patients due to reduced vibration compared to that from a slow-speed. Lower vibration also produces a smoother surface finish.¹ Clinical efficiency is improved with this simple, three-step system as a single contra-angle handpiece can be employed for the entire removal/finishing process.

After orthodontic appliances have been removed, the 7675 Carbide (Red) is used in a contra-angle dental handpiece to dislodge gross residual resin tags from the enamel. This round-end, tapered 12-blade bur is ideal for removing both orthodontic bonding adhesives and also cements that remain on the teeth after de-bracketing and de-banding. Eliades et al.² concluded that, “carbide burs are ideal cutting tools for ductile substrates such as resins.” Phil Campbell’s Angle Research Award publication1 reported, the “tungsten carbide bur appeared to be the most efficient method of removing highly filled resin and it produced the least amount of scarring.”

The tapered design of this bur makes it easy is easy to manipulate on facial surfaces of enamel while reducing the potential for gingival impingement. Enamoplasty of uneven incisal edges is also done at the same time. This bur is also ideal to remove composite attachments that are often employed with Invisalign.

Gross removal of residual adhesives and cements should be done to avoid disturbing enamel anatomy by over-polishing the surface. Residual resin is often visible on enamel surfaces after the air exhaust from the high-speed contra-angle desiccates the surface of the tooth. The consistent torque and low vibration of an electric dental handpiece (at 35-40,000 rpm) can also help to provide a more comfortable and consistent result.

After gross residual composite or cement is removed, then the White Finishing Carbide, a long, flame-shaped 30-blade bur, is used to remove the last remnants of adhesives while also finishing the enamel to a smooth surface.^1,2 The versatile, pointed shape of this bur allows positioning at the gingival margin.

The 30-blade carbide produces a very smooth surface during the finishing process that is followed with the P0153-031Polisher, a green friction-grip (FG) silicone point, to refine the enamel. These polishers can be used in the same high speed hanpiece as the previous carbides, but at slow revolutions as the silicone will degrade quickly. A feathering, light touch is required to reduce the build-up of heat and to avoid degradation of the polisher. After a suitable enamel surface is achieved, any additional final finishing can be performed using polishing pastes or slurry of fine pumice if needed.

About the author

Dr S. Jay Bowman is a diplomate of the American Board of Orthodontics, a member of the Angle Society of Orthodontists and Pierre Fauchard Academy, and a fellow of the American College of Dentists. He is an adjunct associate professor at Saint Louis University, an instructor at the University of Michigan, and adjunct clinical professor at Case Western Reserve University. He has developed and patented a number of innovations for clinical orthodontics, including his own signature bracket system and other appliances. He has published more than 85 articles, book chapters, and a textbook on mini-screw anchorage, has lectured in 27 countries, and has maintained a private practice for over 25 years.

* Dr. Bowman developed the AXIS Orthodontic Adhesive Removal Set; available from Axis Sybron Dental Specialties, 800 W. Sandy Lake Road, Suite 100, Coppell, TX 75019; +1 888 452-8879; Email: custser@axisdental.com.

References

1. Campbell, PM. Enamel surfaces after orthodontic bracket debonding. Angle Orthod. 1995;65(2):103-110.

2. Eliades, T; Gioka, C; Eliades, G; Makou, M. Enamel surface roughness following debonding using two resin-grinding methods. Eur J Orthod 2004;26:333-338.

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