I was trimming and polishing a bisacryl provisional this week, and one of my assistant’s asked if she could come and watch over my shoulder. My immediate response was “of course”, and a wondering at why I had never extended this invitation to her. As she watched, she asked great questions, and we got to talk through the “why” behind features of a temporary restoration, not just “how” to create it. As she watched me go through the last steps of polishing, a great question came out, “why do you polish the posteriors, since no one can see them?” Her question, is a valid one, and the answer is something I take for granted, and assumed my team members knew. Of course, you know what they say about the word “assume”.
There are four critical criteria that a provisional must meet to pass muster, and being highly polished is number four. As a first reason behind always creating an exquisitely smooth and polished surface is patient comfort. I have had many bisacryl provisionals in my own mouth, and they will never feel glassy smooth like natural enamel, or porcelain. On the other hand, when they are not polished or have been left rough, it is like having sandpaper to run your tongue over for a few weeks. One of the first things I ask when we see a patient to seat a final restoration is how they did with their “temporary”. The response I am hoping for is a weird, quizzical look, a shrug of their shoulders and “fine, didn’t even think about it.” I can only get that perfect answer if it has been highly polished and their tongue has ignored it.
The second reason for creating a highly polished surface is tissue health. Rough or poorly polished surfaces are great for the plaque to stick to. In my experience tissue health is vastly improved when I see the patient for the seat appointment if we have gone above and beyond with our polishing. In this day and age of materials needing a dry field during the bonding and cementation phase, healthy gums that aren’t bleeding makes my life easier and the clinical result superior. Add to this, yet again, patient experience. When the polished surface allows the tissue to heal and be free of inflammation, the soreness from retraction disappears quickly, and the patient doesn’t notice bleeding when they brush for the weeks the temporary is in place.
Lastly, highly polished provisionals are a statement that reflects what we stand for as a team. I love when patients rave about how their temporary looks, or comment that they don’t know which one it is. Our office gets many referrals from specialists that we work with. When I go and meet with them and their teams, over and over again I hear compliments about the provisionals they get to see. This last step, communicates to them our committment to our patients and the quality of care we provide.
Following the final refinement of my bisacryl provisionals with a n RWPPP contouring wheel, I disinfect it with Cavicide and move into the lab to polish. I start with the Provipro polishers from Brasseler. The Orange polisher goes first, and then you follow it with the pink. The last step is to use a bristle brush to create the high shine. I have been using this system since Brasseler came out with them, the finish is superior and I don’t have the hassle of working on a lathe wheel.