This commonly refers to perikymata and various forms of surface stippling usually present in younger teeth. This is commonly lost in older teeth or those that are in function longer due to frictional forces that erode this morphology over time.
Anterior composite finishing workflow
Suggested armamentarium for creating tooth anatomy and finishing composite resins that virtually mimic natural teeth are:
• Burs
• Disks
• Rubber points and cups
• Brushes and aluminum oxide paste
• Cotton wheel and aluminum oxide paste
Finishing and polishing a composite restoration well is probably the number one secret for a seamless integration where there currently exist myriad techniques and materials used to create a natural-appearing texture and polish. The technique described here is a very simple procedure the clinician can use to achieve a very lifelike tooth appearance, with only subtle modifications necessary from patient to patient due to the variability of natural human tooth anatomy and luster of the native enamel.6
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Armed with a sound knowledge of human tooth morphology, here is an effective, systematic approach to use. Once the last layer of resin has been cured, use a coarse-grit disc followed by a medium-grit disc (such as Sof-Lex from 3M or FlexiDisc from Cosmedent) to develop the primary anatomy of the tooth and properly contour the following:
• Incisal edge position
• Three facial planes
• Location of the proximal line angles
• Location of the point angles
• Determine how open or closed the facial and incisal embrasures are
• Use a sharp pencil to visualize and if needed to modify or move the location of the proximal line angles with the finishing discs
Author's note: It is very important to keep in mind that the proximal line angles, point angles, facial embrasures, and incisal embrasures all influence and are dependent on one another.
Once the primary anatomy has been obtained with the use of rotating discs, the secondary anatomy can be developed. A very effective method of placing secondary anatomy in a tooth is to visualize it first by drawing the locations onto the tooth with a pencil.