Dental polishers
Dental Polishers
In dentistry and dental technology very different materials require smoothing and polishing. This ranges from exceptionally hard natural tooth enamel to the surfaces of filling materials (composites, compomers or amalgam), fixed restorations (metal alloys or ceramics), implant components (titanium, other metals or zirconia), appliances, splints or dentures (all types of hard and soft materials).
The dental polishers used in standard handpieces are rotary instruments with a metal or plastic shank. The smoothing and polishing section of the instrument is attached to the shank – whether rigidly connected or via press-on, clamp or screw connection (e.g. with mandrels). Some polishers are not active themselves and require the additional use of polishing pastes as consumable materials (in particular for prophylaxis).
Easy, clean results are produced with all other polishers. In this case the working section is made of rubber or silicone. Abrasive materials (e.g., silicon carbide or corundum and mainly diamonds are used for very hard materials, in particular ceramics) of a suitable, selected grit size are embedded in the surface or impregnate the entire working section.
A wide range of polisher shapes is available for different applications. Typical shapes are points, cups and discs for the dental practice and wheels, cylinders/arbor bands and torpedoes for the dental laboratory.
A dental polisher
Surfaces of materials are smoothed and polished in one or more working stages. Technically, the individual processing stages vary either in the different pressure applied and/or motor speed but mainly by using abrasives/polishers with different degrees of hardness and grit sizes (specific for each stage). Polishing techniques often differentiate between two-step pre-polishing (coarse polish) and high-lustre polishing (fine polish), depending on the material, initial condition, required final state and up to three steps. The first/coarsest step is frequently a transition from preparing/contouring; at this stage significant (macroscopic) amounts of material are still removed. In the subsequent steps the main focus of the work is more on reducing (increasingly microscopic) surface irregularities (surface roughness). The final step produces a smooth surface, in general with a silky sheen or high-lustre/shining finish. Often the different colours of the polishers facilitate the assignment of specific instruments to the respective working stages. All diamond grit polishers have uniformly standardised coloured rings for identifying the different fineness of each polishing step.
To rule out cross contamination between patients in clinical dental medical applications, preference should be given to polishers, which are either suitable for sterilisation in an autoclave to ensure safe multiple use or which are designed as single-use products from the outset (use for one single patient only).
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Word of the day
| English | German |
|---|---|
| disposable brush | Einmalpinsel, Einwegpinsel |
Focus text of the month
Periodontology is that branch of dentistry involved with the healthy and sick periodontium ("attachment apparatus"), i.e. those anatomical structures surrounding, supporting and retaining the tooth. These include the marginal periodontium or gingiva (free marginal and attached… Periodontology is that branch of dentistry involved with the healthy and sick periodontium ("attachment apparatus"), i.e. those anatomical structures surrounding, supporting and retaining the tooth. These include the marginal periodontium or gingiva (free marginal and attached gingiva), desmodontium (connective tissue in the periodontal cleft with hemi-desmosomes, Sharpey's fibres, cementum) and bony socket (alveolar bone). A healthy periodontium is considered a prerequisite for every other type of dental treatment, in particular prosthodontics and implants. Many aspects of periodontology also apply to implant treatment – this is referred to as peri-implantology. Periodontal diseases The estimated prevalence is 75%. Chronic or acute forms of these diseases can be divided into degrees of severity (superficial, profund, aggressive), the age of onset (juvenile, adult), spread (local, general) or the cause. The different inflammatory forms ("periodontitis" - lay term: "periodontosis", and "peri-implantitis" involving implants) are virtually always due to bacteria. Hereditary factors (e.g. immune system), the anatomical situation (ligament attachments, malocclusion), functional overloading (bruxism), behavioural aspects (e.g. oral care, nutrition, smoking), medicines (anti-epileptic, anti-hypertensive medication, chemotherapy), hormone balance (menstruation, pregnancy, hormone substitution) and systemic diseases (metabolic or immunological diseases, tumours) also play a role. Periodontitides and diabetes have been proven to promote the effects mutually. Periodontitis is often a result of gingivitis along with (due to accumulation of calculus, plaque, bacteria, toxic substances and inflammation mediators) detachment and resorption of the periodontium (formation of deeper gingival pockets) and gingival recession accompanied by loss of bone around the tooth root (intrabony pockets, vertical bone resorption) or even sinking of the entire bony jaw (horizontal bone loss). The visible and perceptible, yet rarely painful, consequences are exposed ("longer") tooth cervixes, mobile, tilting or drifting teeth and even tooth loss.
When allowed to go untreated, periodontal disease progresses slowly over years or even decades but may worsen intermittently at any time. It usually results in premature loss of some, many or all teeth. Pulp and periodontium An apical lesion with endodontic causes is referred to as "apical periodontitis". As the pulp and periodontal cleft communicate with each other anatomically, infections can be transferred from one to the other. This results in "combined lesions" which are complicated to treat. Screening Indexes including the pocket probing depth (PPD) and other parameters such as the tendency to bleed (BOP), e.g. the PSI (periodontal screening index) are used for exploratory examination and determination of the necessity for further diagnostics. Periodontal status Prior to commencing periodontal treatment the periodontal status must be determined and documented either by hand or electronically. This involves precise measurement of the gingival pocket depths at 2 to 6 defined locations per periodontium as well as further parameters (furcation involvement, recession, tooth mobility and drifting etc.). In addition, an X-ray is taken of all teeth and usually consists of 10 – 14 overlapping individual images ("radiographic status") or a panographic radiograph. Periodontal treatment The primary objective of periodontal therapy is to impede or prevent recession of periodontal structures, augment lost sections where necessary, as well as create and maintain easily cared for conditions. Periodontal pre-treatment involves removing all plaque and calculus (from teeth, gingiva, interdental spaces, restorations) and instructing the patient in the oral care procedures required for the prevention of further plaque accumulation and elimination of risk factors. The actual periodontal treatment comprises removal of subgingival accretion, inflamed tissue, calculus and infected cementum ("scaling") as well as planing those root surfaces accessible immediately or following surgical exposure (e.g. raising a flap) using hand or ultrasonic instruments (curettes or scalers) to allow reattachment of tissue on the tooth surface. Periodontal surgical procedures and suturing techniques are employed for contouring the periodontium and/or eliminating deep gingival and bony pockets either partly or in full. In addition, disinfection may be achieved by means of laser (if necessary including the photodynamic therapy yet to be evidence-based), locally active solutions or gels (such as chlorhexidine) as well as local or systemic antibiosis (if necessary following germ determination, such as with DNA probes, for clinical monitoring). Autogenous or heterogenous tissue (graft) and/or augmentation materials (such as for bone) can be used for augmenting lost anatomical structures. Membranes or blood constituents (such as growth factors) promote and guide regeneration of autogenous periodontal tissue (guided tissue regeneration/GTR, guided bone regeneration/GBR). Supportive therapy Once treatment has been completed, the patient attends recall appointments for supportive periodontal therapy (SPT), where possible for the rest of his/her life (such as a regular screening index/scaling and polishing) in order to check and maintain the stable condition already achieved as well as identify and treat relapses at an early stage. |
Intrabony pockets resulting from periodontitis