Esthetic Technique: Crown Considerations, Preparations, and Material Selection For Esthetic Metal-Ceramic Restorations
Esthetic Technique: Crown Considerations, Preparations, and Material Selection For Esthetic Metal-Ceramic Restorations
Esthetic Technique: Crown Considerations, Preparations, and Material Selection For Esthetic Metal-Ceramic Restorations
4, 2001
Esthetic
Technique ™
Dear Reader:
There has been a continuous increase in demand for more esthet-
ic, or “tooth-colored,” restorations by the dental profession and the
public over the past few decades. This demand has come about
because of an increased public awareness of and desire for esthetic Nasser Barghi, Bruce Crispin, Lee Culp, CDT
DDS DDS, MS
materials over metallic-based restorations, the introduction of new
technologies by industry and the scientific community, and a growing
population of clinicians who have elected a preference for enhancing
the esthetics of their patients. It would be safe to assume that all clini-
cians would favor an esthetic restorative procedure as long as there
was no significant compromise in health care delivery to their
patients.
Dr. McLaren and Dr. Vigoren have presented a comprehensive dis-
cussion of improving esthetics without compromising basic principles
of ceramic crown restorations. Specifically, they focus their article on John Kois, Gerard Kugel,
the proper use of the Captek™ technique of a metal-ceramic crown. DMD, MSD DMD, MS
Using a balance of science and personal experience, they are able to
discuss in depth many of the basic guidelines and principles that can
assist clinicians with achieving successful results when using this
technology. They discuss important factors such as depth of prepara-
tions, indications for specifically designed burs or diamonds, type of
core materials present, and single vs multiple units. The end result is
a three-dimensional, integrated outline of the principles of ceramic
crown restorations. Both the experienced and novice clinician will
benefit from the authors’ experiences and knowledge. Edward A. Larry Rosenthal, Howard
Dr. Goldstein reviews the use and significance of a series of dia- McLaren, DDS DDS Strassler, DMD
mond instruments that should assist clinicians when performing vari-
ous esthtic procedures. Behind each procedural step are principles
related to optimizing the final esthetic procedure. Dentists should
find this information useful in developing a consistent approach to
tooth preparation rather than relying on a history of inconsistent
preparation routines that may not meet the demands of today’s
newer technologies.
Dental Learning Systems would like to thank Brasseler USA® for
sponsoring this clinical series for the dental profession. Douglas A. Thomas F.
Terry, DDS Trinkner, DDS
Sincerely,
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D452
The Esthetic Technique™ series is made possible through an educational grant from Brasseler USA®.
To order additional copies call 800-926-7636, x180. D452
Crown Considerations, Edward A. McLaren, DDS
Director, Center for Esthetic
Dentistry
Preparations, and Material Director, School for Esthetic Dental
Design
Selection for Esthetic Metal- School of Dentistry
University of California at
Los Angeles
Ceramic Restorations Los Angeles, California
Private Practice
Newport Beach, California
E
sthetic metal ceramics have seemed almost oxy- Excess tooth structure should never be mutilated to sat-
moronic to many dentists and patients. The isfy the requirements of a certain material when a more
esthetic push in recent years has been for the conservative approach will satisfy functional, biologic,
metal-free restoration under the guise that superior and esthetic requirements. Clinical situations that
esthetics can be obtained only without using metal sub- require a conventional PFM are the same for a Captek™-
strates in crown restorations. Also, concerns over supported restoration.
potential metal toxicity have led the public and many a
Captek, Altamonte Springs, FL 32714; 800-921-2227
dentists to choose metal-free restorations. Many of Vita Zahnfabrik, Germany distributed in US by Vident™, Brea, CA 92621; 800-
b
Full-coverage crowns support- extend several millimeters occlusal- that a 1.2-mm facial crown dimen-
ed by a high-strength core should be ly or incisally in situations where sion allowed predictable shape
considered in the following clinical the stresses placed on it will be pri- reproduction and subjective esthet-
situations: to replace an existing marily compressive in nature and ic success. Thus, it is recommend-
PFM restoration; when there is a the substrate is stiff. ed to reduce facially to allow for a
compromised substrate (tooth); and final restoration with a facial
when there is need for support for dimension of 1.2 mm. This may not
I
the porcelain. It is important to mean that 1.2 mm of tooth struc-
understand that porcelain gets its t is possible to fab- ture needs to be removed facially.
strength from being bonded to a ricate PFM restora- Esthetic and functional require-
high-strength substrate—either tions that rival any all- ments will dictate whether more or
enamel, metal, or ceramic core. If ceramic restoration less tooth should be removed,
the substrate has only dentin or because labializing or lingualizing
composite—both of which are low
esthetically with the the facial surface may need to be
modulus (flexible) materials—then proper use of new- accomplished. The correct reduc-
the less flexible and more brittle generation porcelains tion for a single crown is fairly
ceramic will absorb a disproportion- and alloy systems. easy, but the correct reduction for
ate amount of stress under load, multiple-crown situations is much
which increases the chance for brit- more complex.
tle failure.7 In a study that looked at PREPARATIONS
the failure load of bonded, pressed The correct reduction for the SINGLE-CROWN SITUATIONS
ceramics to materials of different room necessary for the esthetic Reduction for single crowns is
elastic moduli, it was concluded fabrication of a Captek™ or, for that generally dictated by the adjacent
that the failure load was proportion- matter, any PFM restoration is teeth, which is easy to visualize and
al to the flexibility of the substrate.8 paramount. Evaluation of more compare. It is sometimes necessary
The more flexible the substrate, the than 700 Captek™ restorations in to build up the tooth to the desired
lower the failure load. Thus, thin which the primary author per- final shape before initiating the
teeth or extremely broken-down formed all clinical and ceramic pro- preparation process to better visu-
teeth, especially those with a large cedures has led to the determina- alize the correct amount of reduc-
(and flexible) composite buildup, tion that 1.2 mm of overall labial tion necessary for the final restora-
should not be considered for bond- crown thickness was the minimum tion. Before crown preparation,
ed porcelain restorations that have ideal dimension for predictable caries and old restoration removal
no core support. In these clinical sit- esthetics. All of those 700-plus with concomitant foundation
uations, a crown should be placed restorations were documented and restoration placement should be
that uses a high-strength core. measured for final crown dimen- accomplished.
A core system should also be sions before cementation, and sub- Small carious lesions or old
used in situations where porcelain jective analysis was made as to the restorations can be removed during
would be subjected to high shear esthetic success of the cemented the gross reduction steps of the
and tensile stresses. Porcelain can restorations. It was determined crown preparation. Figure 4 dem-
A
prepared next with either a KS1c or does not work if the labial position
KS2c diamond (Figures 6A and 6B). n underprepared of the tooth is being altered in the
The marginal preparation is done marginal area is final restoration. Depth grooves
right to the level of the gingiva impossible to compen- generally allow the correct reduc-
(Figure 7). The marginal area is the sate for in the labora- tion in single-crown situations
most critical area when preparing where the final restoration will fol-
for a PFM with a porcelain margin or
tory. low the contour of adjacent teeth.
an all-ceramic crown, and experi- Depth grooves are placed with a
ence has shown that a 360-degree, 1- marginal area is impossible to KS1, KS2, or KS3c diamond (Figure
mm shoulder preparation with a 90- compensate for in the laboratory 9) depending on the necessary
degree exit angle and rounded inter- and would require repreparation reduction. The same diamond
nal line angles is ideal for these and reimpressioning, hence the used for the depth cuts is used to
restorations (Figure 8). rationale for preparing the margin remove the remaining tooth struc-
c
Brasseler USA®, Savannah, GA 31419; 800-841- early in the preparation process. ture to the desired depth (Figure
4522 Axial reduction is next, and 10). The goal for a Captek ™
Figure 4—The UCLA Center for Figure 5—Breaking contact with Figure 6A—Profile view of initial
Esthetic Dentistry Metal-Ceramic and the #5858-014 diamond on a margin placement done with either
All-Ceramic Preparation Kit by Dr. demonstration model in which nat- the KS1 or KS2 diamond.
McLaren. ural teeth are mounted.
Figure 6B—Facial view of margin Figure 7—Initial margin placement Figure 8—Shoulder margin with
placement done with either the KS1 or is done right to the level of the gingi- rounded axial-gingival line angle.
KS2 diamond. va facially and interproximally.
Interproximally, a KS1 is used so as
not to damage adjacent teeth.
Figure 12—Using the 2-mm Figure 13—Lingual reduction is Figure 14—Lingual reduction for
Reduction Guide to check the occlusal accomplished on anterior teeth with posterior teeth is done with a KS2 or
reduction on tooth No. 30. the egg-shaped KS4-024 diamond. KS3 diamond.
restoration should be to allow for a reduction guide. Posteriorly, it is tion is the 2-mm Reduction Guided.
1.2 mm of space labially. Incisal or necessary to have 2.5 mm of If the 2-mm guide passes with only
occlusal reduction is initiated with occlusal reduction for both esthet- slight binding through the occlud-
a KS3 diamond. Incisal edge reduc- ic metal-ceramic and all-ceramic ed opposing arches, then there is
tion of 2 mm is adequate for good restorations, especially if natural, close to 2.5 mm of interocclusal
esthetics. The diameter of the KS3 unworn occlusal anatomy is space (Figure 12). Lingual reduc-
is 1.6 mm, so going slightly deeper desired in the final restoration. tion is done with the KS4-024c dia-
gives the necessary 2-mm reduc- The best aid the authors have mond for anterior teeth (Figure
tion (Figure 11). The adjacent found to accomplish this reduc- 13) and a KS2 or KS3 for posterior
incisal edge can also be gauged as d
KerrLab, Orange, CA 92867; 800-537-7123 teeth (Figure 14) to allow for at
least 0.7 mm of crown thickness
for anterior teeth and 1.0 mm
thickness for posterior teeth.
Before finishing the prepara-
tion, one layer of Ultrapack® #000e
is placed in the sulcus (Figure 15).
This generally gives 0.5 mm of gin-
gival displacement. The margin is
apically positioned 0.5 mm with
either a KS1 or KS2 (Figure 16)
diamond or, in cases with exces-
Figure 15—A clinical case with Figure 16—The apical position of sively scalloped gingival margins,
Ultrapak® #000 cord placed to the margin is placed with either the KS6c. The depth to which the
obtain initial gingival retraction so a KS1, KS2, or, as shown, a KS6 margin should be placed in the sul-
that the margins can be finished. diamond.
The margin was prepared to the cus is a complex issue and affect-
level of the retraction cord. e
Ultradent Products, Inc, South Jordan, UT 84095;
800-552-5512
Figure 20—Using a polypropylene Figure 21—A clinical case in which Figure 22A—Rough preparations
matrix to gauge gross reduction. all maxillary teeth are to receive all- immediately after old restoration
ceramic crowns. In these situations removal.
where adjacent teeth are prepared,
the contact is broken using either
the KS1 or KS2 diamond.
ed by many variables.9,10 The ulti- present extreme difficulties in with potential problems. When
mate goal of margin placement is controlling proper tooth reduc- placed over the teeth, it is difficult
to have an esthetic restoration/gin- tion. Often, old crowns are being to judge if the changes in tooth
gival interface without biologic removed or the three-dimensional form that are incorporated into the
complications (ie, violation of bio- shape of the tooth is going to be matrix are in fact correct estheti-
logic width). The marginal area is altered significantly. In these situa- cally and functionally. Also, it is
then finished with either the easy to displace the matrix in one
#8845KR-018c or #8845KR-025c fin- direction or another up to almost 1
T
ishing diamonds, or the H158-014c mm without knowing it. All of the
carbide finishing bur (Figures 17 he depth to which above conditions could easily lead
and 18). Axial contours are fin- the margin should to overprepared or underprepared
ished with the #8881-014 c or be placed in the sulcus teeth. McLean described a tech-
#8856L-020c fine diamonds (Figure is a complex issue and nique where the prototype (tempo-
19). For all-ceramic crowns, it is rary) is completed on the prepared
affected by many vari-
critical to round all internal line teeth and then measured with a
angles with one of the fine dia- ables. caliper to gauge proper tooth
monds. This minimizes stress con- reduction.11 Although this is the
centrations in the ceramic crown tions, axial depth grooves are of best method, two or three relines
by eliminating sharp angles. limited value. It has generally been may be necessary to finalize the
recommended to make a poly- reduction amount, which is not
PREPARATIONS FOR propylene vacuum-formed matrix very practical. One problem with
M ULTIPLE CROWNS to be used intraorally to control this technique is that acrylic
Clinical situations in which tooth reduction (Figure 20). While monomers left on the prepared
multiple crowns are necessary this is a useful adjunct, it is fraught tooth will inhibit the set of
Figures 24A and 24B—Two views of the final preparations on the master Figure 25A—View of the seated,
casts, demonstrating ideal reduction for Captek™ restorations. final Captek™ crowns.
polyvinyl siloxane (PVS) impres- have used for years. After gross benefit of this technique is that
sion materials. Therefore, an alter- reduction, a preformed shell pro- debris is cleaned off the prepared
native technique will be discussed totype made from the preoperative teeth before final impressioning.
to control axial reduction. cast or a diagnostic wax-up is One layer of Ultrapack® #000 is
Preparations for multiple- placed over the prepared teeth then placed in the sulcus to obtain
crown situations begin by either (Figure 22B). This prototype is the initial tissue displacement. The
removing the old crowns or break- then evaluated for esthetics and final finishing steps and diamonds
ing contact (Figures 21 and 22A). altered as necessary for esthetic used are exactly the same as for
Contact is broken in the same single-crown situations (Figures
manner as for a single crown, but 24A and 24B). Figures 25A through
C
larger diamonds can be used if the 25C represent a completed case of
adjacent tooth is going to be pre- linical situations Captek™-supported PFM restora-
pared. The margins for all the in which multiple tions using the preparation proto-
teeth being prepared are placed crowns are necessary col presented in this article.
second using either the KS1 or KS2 present extreme diffi-
diamond. The margins are placed culties in controlling SUMMARY
at this juncture following the same Many different criteria are
rationale as stated for single
proper tooth reduction. involved in choosing the correct
crowns. Gross axial reduction is material or technique to treat a
done using the clear vacuum acceptance. The prototype can clinical situation. The authors pre-
matrix as a guide, but should not then be relined with a fast-set PVS sented a clinical rationale for
be relied on for the final reduction bite registration material (Figure choosing a crown system with a
for the reasons stated previously. 23A) and measured to verify high-strength core of metal or
Final reduction is accomplished reduction (Figure 23B). The tooth ceramic vs an unsupported porce-
using an alternative and very effi- is then reduced as necessary with lain. Metal-ceramic restorations
cient technique that the authors any of the KS diamonds. Another can rival all-ceramic restorations if
Figure 1—Scribing a 1.5-mm diam- Figure 2—Using the same diamond to Figure 3—Continuing over the
eter depth cut around the cervical create precise, 1.5-mm depth reduc- incisal edge, down the lingual, and
with the #5801-016 coarse round tions up the facial aspect of the tooth. around the cervical with the same
diamond. depth-reduction diamond.
area permits ideal adaptation of this technique is either the small For the clinician who wishes to
either an all-ceramic crown or a (#5856-016a) or large (#5856-021a) continue, for example, to develop a
PFM crown with a large enough barrel-shaped, tapered, coarse porcelain margin for either an all-
porcelain margin to obscure the bulk-reduction diamond. For a porcelain or PFM crown, the steps
metal. Although some clinicians may small tooth, such as a lateral
prefer a depth reduction measuring incisor, the small barrel-shaped dia-
S
less than 1.5 mm, the maximum mond should be selected. For a
depth produced by the bur yields a larger tooth, such as a molar or mooth-finished,
margin of ideal thickness, particular- central incisor, the larger diamond precise margins
ly from the laboratory technician’s is an ideal choice. free of jagged enamel
perspective, because space is suffi- First, the incisal edge (or edges can be produced
cient to develop an esthetic margin. occlusal surface for a molar) is
supragingivally or sub-
reduced (Figure 4). Next, the same
diamond removes the interproximal gingivally, according to
specific case require-
C
(Figure 5) and facial enamel (Figure
ontaining only nine 6) down to the extent of the depth ments, enhancing the
instruments, the grooves. Note that the coarse, cone- adaptation of the
kit is designed to per- shaped diamond is used to open restoration to the
tight interproximal contacts and to
mit the dentist to tooth.
place bevels for extra retention.
address the esthetic Finally, this same diamond removes
requirements of anteri- the lingual wall of enamel (Figure 7). described below produce an ideally
or or posterior crown The next diamond in the smooth, polished margin with no
cases for patients with sequence, the football-shaped dia- exposed enamel prisms, thus allow-
high or low lip lines. mond (#379-023a) (Figure 8), can be ing optimal adaptation of the
used to shape the lingual concavity. porcelain to the preparation.
For all crowns, the healthiest
After the initial depth-reduc- margin—that is, the least inva- SUPRAGINGIVAL MARGIN
tion procedure, the same diamond sive—is placed above the gingiva; POLISHING
is applied up the facial aspect of the therefore, analysis of the patient’s To develop a smooth, polished
tooth, producing an exact 1.5-mm lip line is critical—whether it is supragingival margin, two smooth
facial trough (Figure 2). The same high, medium, or low—before diamond burs that correspond in
round depth-reduction diamond undertaking tooth preparation and size to the coarse, barrel-shaped dia-
can next be used over the incisal before the patient is anesthetized. monds initially used are provided in
edge, swept down onto the lingual A patient with a low lip line can the kit. The small, smooth, barrel-
aspect of the tooth, and then used have any margin—including a shaped diamond (#8856-016a) corre-
to scribe a 1.5-mm line around the facial collar of metal or a bevel—as sponds to the small, coarse, barrel-
cervical of the lingual (Figure 3). long as the patient understands this shaped diamond (#5856-016); the
The next diamond employed in and accepts it. large, smooth, barrel-shaped dia-
mond (#8856-021a) corresponds to begin from the midfacial surface of tip of the instrument (Figure 11).
the larger coarse diamond (#5856- the preparation, and the cord Because no diamond grit is on
021). The smooth diamonds round would be packed circumferentially the sides of the bur, and because
off any sharp line angles in the around the tooth until it abuts per- of its beveled configuration, the
preparation, and they also smooth fectly at the facial surface, right in diamond-tipped end can be
the margins. the center of the tooth. For each placed precisely on the edge of the
After the fine, barrel-shaped tooth being prepared, the cord is tooth, and moved circumferential-
diamond has been used to smooth packed very gently into the sulcus ly around the margin.
and round the line angles, the white and left in place for 3 to 5 minutes, The beveled configuration of
stone (#649-420a), included in the allowing the tissue to retract. the diamond essentially pushes the
kit, should be applied around the tissue out of the way and prevents
margin one last time to produce a tissue laceration when the instru-
polished surface. Figure 9 shows a ment is placed close to the gingiva,
finished supragingival preparation
that is ready for impression.
The burs in the crown design
kit used to this point provide two
A patient with a
low lip line can
have any margin—
even when working subgingivally.
The instrument is applied around
the edge of the tooth to completely
smooth any jagged enamel prisms.
types of preparations: one, a very including a facial collar After the smoothing procedure
rapid preparation for metal mar- of metal or a bevel—as with the TPE diamond, the white
gins that require minimal smooth- long as the patient stone (#649-420a) is used for further
ness; the other, a smooth, polished understands this and finishing and polishing of the mar-
margin to meet the requirements accepts it. gin (Figure 12).
for porcelain restorations. The
instruments in the kit, however, I MPRESSION PROCEDURE
also yield exceptional subgingival With the retraction cord left in To make an impression at this
margins. place, the coarse, barrel-shaped point, a white Number 1 GingiGel®
diamond is used to drop the margin cordc is placed circumferentially
SUPRAGINGIVAL circumferentially all the way around the tooth on top of the pur-
PREPARATION around the tooth to the height of ple retraction cord (previously
If a subgingival margin is the retracted tissue (Figure 10). placed) and left in place for 3 to 5
desired in an esthetic case involv- The corresponding fine, barrel- minutes (Figure 13). The site
ing a patient with a medium to high shaped diamond is used to produce should be washed, making certain
lip line, retraction cord (such as the a smooth surface at the margin. the white cord is wet. The white
purple Number 1 Ultrapak® cordb, Because the margin is extend- cord is then removed, and the
which packs dry) would be placed ed subgingivally, the next bur used preparation is thoroughly dried
after the coarse barrel-shaped dia- in the sequence should be the tis- and evaluated. If all margins are
mond is used. Cord packing should sue-protecting-end (TPE) cutting clearly visible, the impression
b
Ultradent Products, Inc, South Jordan, UT 84095; diamond (#10839-016a), which fea- c
Van R® Dental Inc, Oxnard, CA 93033; 800-833-
800-552-5512 tures diamond grit only at the very 8267
should be taken with the purple Because the impression extends speed and precision. Using the
cord still in place. The purple cord subgingivally, the laboratory tech- instruments in the appropriate
should remain in place throughout nician can perfectly visualize the sequence produces smooth, fin-
the entire preparation and impres- margins for die trimming and pro- ished margins that can be accurate-
sion procedure because it acts as a vide a proper emergence angle for ly recorded during impression mak-
gasket between the sulcus and the the final restorations. ing, thus facilitating laboratory
tooth, stopping crevicular flow or The Goldstein Crown Design communications and reducing the
hemorrhage. This double-cord Kit offers exceptional versatility in likelihood of remakes and returns.
technique can produce a perfect its applications, allowing the clini-
impression because it eliminates cian to address virtually any crown
REFERENCE
1. Goldstein RE: In: Esthetics in Dentistry.
any fluids at the preparation site. preparation requirements with London, England: Quintessence; p395, 1998.
WARNING: Reading an article in Esthetic Technique™ does not necessarily qualify you to integrate new techniques or procedures into your practice. Dental Learning Systems
expects its readers to rely on their judgment regarding their clinical expertise and recommends further education when necessary before trying to implement any new pro-
cedure.
The views and opinions expressed in the article appearing in this publication are those of the author(s) and do not necessarily reflect the views or opinions of the editors, the
editorial board, or the publisher. As a matter of policy, the editors, the editorial board, the publisher, and the university affiliate do not endorse any products, medical tech-
niques, or diagnoses, and publication of any material in this journal should not be construed as such an endorsement.
1. In situations where minimal tooth structure 6. What was subsequently employed for the fabri-
removal is required, what restoration is indicated? cation of the provisional restorations?
a. full crown a. matrix
b. three-quarters crown b. copper tube
c. porcelain-bonded c. no provisional was used
d. amalgam d. alginate impression
3. In one study,7 the failure load of bonded, pressed 8. For the marginal area of a PFM, experience has
ceramics to materials of different elastic moduli shown that what type of shoulder with rounded
was: internal line angles is ideal for these restorations?
a. proportional to the flexibility of the substrate. a. 180 degrees, 1 mm
b. inversely proportional to the flexibility of the b. 270 degrees, 1.5 mm
substrate. c. 270 degrees, 0.5 mm
c. logarithmically proportional to the flexibility d. 360 degrees, 1 mm
of the substrate.
d. not proportional to the flexibility of the sub- 9. How much incisal edge reduction is adequate for
strate. good esthetics?
a. 1 mm
4. A core system should be used in situations b. 1.5 mm
where porcelain would be subjected to: c. 2 mm
a. high shear and high tensile stresses. d. 2.5 mm
b. low shear and low tensile stresses.
c. high shear and low tensile stresses. 10. Posteriorly, it is necessary to have how much
d. low shear and high tensile stresses. occlusal reduction?
a. 2 mm
5. How many millimeters of overall labial crown b. 2.5 mm
thickness was the minimum ideal dimension for c. 3 mm
predictable esthetics? d. 3.5 mm
a. 0.6 mm
b. 1.2 mm
c. 1.8 mm
d. 2.4 mm
Figure 4— Figure 5—
Acrylic polisher. Diacomp
point compos-
ite polisher.
A
djusting and polishing are inevitable for any pro-
visional restoration, whether it is composite or mamelon extensions, and personalizing provisional
acrylic, laboratory-fabricated or office-made. restorations:
These new Brasseler USA® instruments can make The new, open-meshed, diamond Vision Flex discs
adjusting temporaries faster, easier, and more precise. (6934-220 and 934-180) help to quickly and precisely
remove bulk composite and acrylic and restore per-
Trimming facial and lingual margins: fect proximal contour. The numerous honeycombs
The completely new blade geometry of the UK make the finishing disc flexible without impairing its
Universal tungsten carbide cutter (H138-023) facili- stability. A new version of this disc, the 952-140
tates fine shaping and contouring of tooth-colored (Figure 3), has snap-on mounting with a precision-fit,
materials. The clinician can control the desired mate- quick-change sliding chuck, which stops the disc if it
rial reduction and surface quality by varying the con- becomes engaged between the teeth. The 952-140 and
tact pressure—high contact pressure yields high 952-180 are available with a straight handpiece man-
material reduction; low contact pressure yields a drel or slow speed for intraoral use.
smooth, finished surface. New, specially staggered,
UK-toothing tungsten carbide cutters are ideal for Polishing temporary restorations:
trimming facial and lingual cervical margins and The knife-edge acrylic polishers BRO3, BRO2, and
facial embrasures (Figure 1). BRO1 (Figure 4) allow the clinician to quickly restore
a natural-appearing, lustrous surface. These polishers
Trimming and identifying interproximal margins: are autoclavable and, therefore, more hygienic and
The efficient and long-lasting diamond disc time-efficient than messy, wet, pumice polishing. For
(6918B-220) makes interproximal cuts that define high-polish temporary composite restorations, use the
facial embrasures without tearing or folding. To pre- autoclavable Diacomp points (DCH2DM and DCH2D)
vent clogging of the diamond disc when working on or Diacomp wheels (DCH8DM and DCH8M) (Figure 5).
composite material, it is helpful to rinse the temporary Temporization Kits are available with complete
in alcohol to remove the oxygen-inhibited layer instrumentation and assembled in cooperation with
(Figure 2). several lecturing clinicians.