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Ask the Expert: An Interview with Dean Vafiadis, DDS on Adjusting and Polishing Zirconia Restorations

With Dean Vafiadis, DDS

Question

How are you currently polishing your zirconia restorations post-adjustment?

Answer

I have always used a red-stripe or fine diamond bur to adjust my ceramic and zirconia restorations; however, it has been a big challenge to find a polishing system to remove the bur marks left on the restoration and reproduce the lab-like luster. Up until now, I couldn’t find a polishing system to do this. I still use a fine diamond for my contact and re-contouring adjustments but now use the A.S.A.P. Indirect+ Polishing System (Clinician’s Choice) to bring the adjusted surface back to a high gloss. It is a fast and simplified 2-step polishing system that brings the modified zirconia surface back to its high gloss. A.S.A.P. Indirect+ can be used both intra-orally and extra-orally, pre- and post-cementation and is capable of minor adjustments when you use the coarse adjusters that come with the kit, but they are also very effective in removing the scratches left behind after adjustments made with the fine diamond bur.

Question

How much chairtime does it typically take for you to make adjustments to your zirconia restorations?

Answer

Adjusting zirconia is so much faster now. Evaluating and adjusting proximal contacts and occlusion has always been very straightforward. The time-consuming part was progressing through various polishing steps to get the high shine back to the adjusted surfaces. The A.S.A.P. Indirect+ system is a 2-step polishing system, but the kit includes coarse adjusters that I have incorporated into my polishing regimen to remove bur scratches. Now my adjustment/polishing of zirconia takes anywhere from 2–4 minutes, and the result is exactly what I want.

Question

Are you finding A.S.A.P. Indirect+ Adjusters and Polishers durable during use as well as after multiple sterilizations?

Answer

My experience with the A.S.A.P. Indirect+ system is that I do not need to replace any component very often at all. I am polishing at least 30 zirconia crowns before I have to replace these polishers as the polishers are wearing at a very slow rate and are not breaking down with the numerous sterilizations.

 

extra oral adjustment, polisher
diamond bur, scratch removal

Intraoral Disc Coarse Adjuster

 

 

Question

Can you take us through a typical zirconia restoration chairside adjustment?

Answer

Whether it is a proximal contact or occlusal interference, I use a fine diamond bur in a high-speed handpiece to make the adjustment extra-orally, maintaining a speed at about 20,000 RPMs. (FIG. 1) Once I am satisfied with the modification, I use the disc-shaped gray adjuster from the A.S.A.P. Indirect+ kit to remove the scratches left from the diamond bur. I use light pressure with this for 10 seconds and without water. (FIG.2–3) The blue pre-polisher is applied with relatively heavy pressure for about 20 seconds, followed by the pink final polisher with light pressure (without water spray) for 10 seconds at approximately 1,700 RPMs. (FIG. 4–5) I follow these zirconia adjustments with a wet Robinson brush over the adjusted surface.

 

intraoral pre-polisher, intraoral final polisher

zirconia adjustments

adjusted surface, zirconia restoration post-adjustment

ABOUT THE AUTHOR

Dr. Dean Vafiadis received his dental degree and Prosthodontic specialty training at New York University College of Dentistry. He is the Director of the Full-Mouth Rehabilitation CE course at NYU and is an Associate Professor of Prosthodontics at NYU College of Dentistry. Dr. Vafiadis publishes and lectures on various topics such as aesthetics, implant designs, computer restorations, ceramic materials and occlusion. He is the founder of New York Smile Institute in NY, an educational center, full-service laboratory and learning facility as well as a private practice location for a multi-specialty practice for Implant and Aesthetic Dentistry. Dr. Vafiadis’ primary professional mission is to educate, publish, and invent new technologies that will help change the dental profession and patient’s lives. He is a member of the ACP, AAED, AO, AAID, ICOI, AACD and the ADA.

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Products Mentioned in this article

A.S.A.P. Indirect+ All Surface Access Polishers

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