The last few weeks I have been working on putting together a composite bur block for Brasseler. They were surprised by two of the burs that I requested on the block, a friction grip brownie point and a friction grip white stone. There are several burs on my block that I could see myself switching out based on recommendations from another clinician, but not my brownie and white stone. I can’t imagine doing composite restorations without them.
Both are utilized after the composite has been placed and cured and is ready to be trimmed. Brownie points have a unique property that makes them indispensable when working with composite. They will remove cured composite and do not cut enamel.
This property means that a brownie point is uniquely able to create invisible margins, where the composite and tooth structure blend together undetectably. I utilize a brownie point in my high-speed handpiece, although I do not run it at high-speed. I dial down my electric handpieces to about half speed, for air driven you will have to moderate the speed using foot pressure on the rheostat. You do not want to run a brownie point at high-speed, as they turn into small grenades. Depending on the amount of excess composite it may take more than one brownie point per restoration, the goal is to remove all excess down to the margins.
Following this step, I then switch to a flame shaped white stone. Running again at less than full speed, I use the white stone to place the anatomy in the restoration. Carving grooves, fossa and shaping incline planes is easy with a white stone. It will not catch and dig into the composite like carbide burs do, and leaves behind a very smooth surface texture that is easy to polish. Another advantage of the white stone over carbides or diamonds is that if I run it along the enamel interface it will cut tooth structure, but minimally. Once I have all of my margins finished and the anatomy placed, I then emphasize the grooves with the tip of a mosquito diamond before polishing.
Great tips Lee. What do you think of indirect composite resin as opposed to porcelain? And if you like it…which do you recommend?
Barry
Barry,
I have been doing a great deal of indirect composite and I love it. I find for those cases where it will be a challenge to get a great contact with a matrix band, indirect composite is a slam dunk. I have been working with the 3M milled composite blocks that are part of their Paradigm series, they are made of Z100 I believe. I seat them with composite, either high filler flowable or composite that I have heated to make flow. The studies coming out now show they do superior in fracture resistance to glass. They are very esthetic, but don’t replace glass yet in my book for cusp coverage or where the facial esthetics of the tooth is critical.
Great stuff as usual, Lee. I enjoy your daily topics, and I’m learning lots.
Just wondering what instruments you use to shape your composites prior to curing?
Also, are the brownies and white points you use made by Brasseler?
Best regards,
CARL
I use a number of the gold tipped hand instruments to shape the composite, an acorn, a blade and one that comes to a very sharp point which I do not know the name of. Recently I have been working with Brasseler’s ET3000 oscillating composite placement tool, and I love it. Yes, the burs are from Brasseler.