Maria Cecilia Adarlo – Pasquil, DMD, DHpEd
UPHSD – College of Dentistry
Objectives
• Determine the importance of amalgam carving in relation to the
surface involved.
• Explain the objectives of amalgam finishing and polishing.
• Discuss the different types of amalgam carvers and it’s uses.
CARVING THE AMALGAM
Sharp carving instruments
• freshly condensed amalgam à increasing pressure on the
instrument and increases the likelihood of losing control and/or
increasing the amount of time required to complete the carving.
• After pre-carve burnishing à remainder of the accessible
restoration must be contoured to achieve proper form and
function
• insertion (condensation) and carving of the material à before the
material has hardened so much that it becomes uncarvable.
CARVING THE AMALGAM: Occlusal Area
• Discoid–Cleoid instrument
• discoid à positioned on the unprepared enamel
adjacent to the amalgam margin and pulled parallel
to the margin.
• cleoid à to define the primary grooves, fossae, and
cuspal inclines.
à Hollenback carver
• grooves and fossae à provide appropriate
mastication
• mesial and distal fossae à inferior to the marginal
ridge height, limit potential for food to be wedged
into the occlusal embrasure.
• rounded and shallow occlusal anatomy à 90-degree
amalgam margin on the occlusal surface ( adequate
occlusogingival dimension)
CARVING MULTIPLE SURFACE RESTORATIONS
• multiple surface restorations à should be rapid, concentrating primarily on the marginal ridge
height and occlusal embrasure areas.
• Occlusal embrasure areas à thin explorer tip or carving instrument by mirroring the contours of
the adjacent tooth
• Height of the amalgam MRà same as that of the adjacent tooth if the amalgam is too hard to
carve, the use of rotary instruments in the handpiece may be required.
Carving the Facial and Lingual areas
• Explorer, Hollenbeck carver or base of the amalgam knife – contours
• Cervical areas à remove excess and develop the proper contour, marginal
areas are blended together
Carving the Proximal Embrasure Area
• After removal of the matrix, the
amalgam knife (or scaler 34/35) is an
excellent instrument for removing
proximal excess and developing
proximal contours and embrasures
Proximal Contact
• amalgam overhang à may result in compromised gingival health.
• Voids à cavosurface margins may result in recurrent caries lesion formation.
• evaluated by: visual assessment and placement of very thin dental floss through the contact
area.
– floss may be inserted through the contact and into the gingival embrasure area by wrapping
the floss around the adjacent tooth and exerting pressure on that tooth rather than the
restored tooth while moving the floss through the contact area.
POST CARVE BURNISHING
• done by lightly rubbing the carved surface with a
burnisher of suitable size and shape to improve
smoothness and produce a satin (not shiny)
appearance.
• may improve the marginal integrity of low- and high-
copper amalgams and may improve the smoothness
of the restoration.
Evaluation of Occlusal Contact Area on the Restoration
• premature occlusal contact - A piece of articulating paper is placed over the restoration
and adjacent teeth, and the patient is instructed to close gently into occlusion.
• Firm bite à danger of fracturing the restoration; weak at this stage.
• two features of the occlusal relationship suggest that the restoration is high:
– (1) Cusp tips of adjacent teeth are not in occlusal contact when it is known from
the preoperative occlusal assessment that they should be touching
– (2) an opposing cusp prematurely occludes with the new restoration.
Evaluation of Occlusal Contact Area on the Restoration
• Deeply colored areas (heavy contacts) and those with light-colored centers (even
heavier contacts) are reduced until all markings are uniformly of a light hue, and
contacts are noted on adjacent teeth Heavy occlusal contacts are commonly referred
to as “prematurities” or “high spots.”
Finishing and Polishing of the Amalgam
• Objectives:
ü (1) refine the anatomy, contours, and marginal integrity
ü (2) refine the surface texture of the restoration.
• attempted within 24 hours of insertion because crystallization of the restoration is
incomplete.
• If used, these procedures are often delayed until all of the patient’s amalgam restorations
have been placed, rather than finishing and polishing periodically during the course of
treatment.
• less prone to tarnish and corrosion if a smooth, homogeneous surface is achieved
• Polishing of high- copper amalgams is less important than it is for low-copper amalgams
because high-copper amalgams are less susceptible to tarnishing and marginal breakdown
•
ü initiated by use of a green carborundum or
white alumina stone
ü surface may be smoothed further using
light pressure with an appropriate finishing
bur
ü long axis of the bur or stone should be at a
~45-degree angle to the margin to allow
the unprepared tooth structure to guide
the bur and prevent unnecessary removal
of amalgam
ü a coarse, rubber abrasive point at low
speed and air-water spray to produce an
amalgam surface with a smooth, satin
appearance (use lowspeed)à When
overheated, the amalgam surface appears
cloudy, indicates that mercury has been
brought to the surface, which results in
increased corrosion of the amalgam and
loss of strength.
