Restorative Procedure - Kerr Hawe

Clinical Guide for Restorative Procedure 

Adhesives | Composites | Finishing and Polishing 

Your practice is our inspiration. 

Restorative Procedure 

Clinical Guide

All you need is Kerr 

Introduction 


INDEX 

Restorative procedure steps and products overview 3-6 

Bonding: 

Bonding & Adhesion, Prof. David Watts, Dr. Nick Silikas 7-8 

OptiBond Family 9-10 

OptiBond FL 11-12 

OptiBond Solo Plus 13-14 

OptiBond All-In-One 15-16 

Composites: 

Aesthetics and composite, Prof. Angelo Putignano 17-20 

Herculite XRV Ultra 21-22 

Clinical case: Class IV 23-24 

Clinical case: Class V 25-26 

Clinical case: Class II 27-28 

Clinical case: Class I 29 

Finishing and Polishing: 

Finishing and polishing of composite restorations, Prof. Martin Jung 31-33 

Surface treatment of composite filling overview 34-36 

OptiDisc 37-38 

HiLuster Plus Polishing System 39-40 

OptiShine 41 

Herculite XRV, OptiBond FL References 42 

Authors Biographies 43 

1

Everyday challenge in restorative procedure is 

to achieve aesthetic results in a simple, fast and 

reliable way. Kerr’s competence in composites 

and adhesive systems accompanied with smart 

Hawe restorative tools offer solutions for 

predictable and faster results in each clinical 

situation. 

This guide for restorative procedure summarizes 

different materials, tools and techniques which 

are essential to achieve high quality restorations 

with long term clinical success. 

2 

Your practice is our inspiration.


Introduction 


STEP PRODUCT KERR PRODUCTS 

Caries 

diagnostic 

X-rays 

Film and Sensor Holder Line 

Kwik-Bite SuperBite Anterior SuperBite Posterior 

Cavity 

preparation 

Burs 

Beavers Carbide Jet Burs 

BlueWhite Diamond Burs 

Beavers Carbide Jet Bur 

BlueWhite Diamond Bur 

Accessories 

OptiDam 

SoftClamp 

Fixafloss 

OptiDam 

OptiView 

SoftClamp 

OptiView 

Fixafloss 

3

STEP PRODUCT KERR PRODUCTS 

Adhesion 

Total-Etch 

OptiBond FL 

OptiBond Solo Plus 

Self-Etch 

OptiBond All-In-One 

Composite 

Filling 

Nanohybrid 

Microhybrid 

Premise 

Premise Packable 

Herculite ® XRV Ultra 

Herculite ® XRV 

Point 4 

Flowable 

Premise Flowable 

Premise 

Premise Packable 

Herculite XRV Ultra 

Revolution Formula 2 

Premise Flowable 

4 



Introduction 


STEP PRODUCT KERRHAWE PRODUCTS 

Application 

methods 

Matrices 

SuperMat ® System 

Hawe Adapt ® Matrices 

Lucifix ® Matrices 

Adapt SuperCap 

Steel and Transparent Matrices 

Lucifix Matrice 

SuperMat System 

Hawe Adapt ® Sectional Matrices 

Hawe Transparent Cervical Matrices 

Wedges 

Hawe Sycamore Wedges 

Sectional Matrice 

Cervical Matrices 

Wedge Dispenser 

Hand shaping 

instruments 

CompoRoller 

CompoRoller 

Polymerization 

Halogen curing lights 

LED lamps 

OptiLux 501, Demetron LC 

Demetron A1 and A2 

LEDemetron II 

DEMI 

Demetron A1 and A2 

Demi 

5

Finishing and 

polishing 

Flexible disc 

Abrasive strips 

OptiDisc ® 

OptiStrip 

OptiDisc 

OptiStrip 

Abrasive brushes 

Occlubrush ® 

OptiShine 

Occlubrush 

OptiShine 

Polishers 

HiLuster Polishing System 

Gloss Plus Polishers 

HiLuster Plus Polishers 

Professional cleaning 

Cleanic ® 

CleanPolish and SuperPolish 

Pro-Cup ® 

Brushes 

Cleanic Mint, Apple and Bubble Gum 

Pro-Cup 

6 



Adhesives 


Adhesives 

Bonding & Adhesion 

Prof. David Watts, Dr. Nick Silikas, University of Manchester, UK 

The mechanism of enamel bonding is based on a 

micro-mechanical bond between the resin and the 

phosphoric acid conditioned rough surface of the 

enamel.Enamel conditioning remains the most 

commonly used method to bond resin-composites 

to enamel surface. It provides strong bonds. 

Enamel conditioning may be regained by re-etching 

the surface and applying the resin, thus recovering 

the required shear bond strength at the enamel-resin 

interface, and allowing the resin to mechanically 

bond onto its surface. 

Dentine however has a much more complex 

structure than enamel. Prior to dentine-bonding, 

the removal or modification of the smear layer is 

indicated to clear the openings of the dentine 

tubules by conditioning the surface of the dentine. 

A fluid adhesive is then applied over the dentine 

and cured, ensuring that optimum wetting of the 

surface and absorption into the dentinal tubules 

is achieved; thus creating an inter-penetrating 

network with the demineralised collagen in the 

dentinal tubules, hence forming the hybrid layer. 

Preservation of the hybrid layer prior to the 

application of the hydrophobic resin restoration 

is imperative for an efficient bond to form between 

the resin and dentine. Therefore, any contamination 

of any region of the adhesive system would 

evidently jeopardise the integrity of the bond. 

The mechanism proposed for this material was 

to bond to the organic component of the dentine, 

namely the collagen. The first work to investigate 

the mechanism of bonding to the dentine was by 

Nakabayashi (1). He first identified a layer between 

the resin and dentine substrate referred to as 

“hybrid” dentine, in that it was the organic components 

of the dentine that had been permeated by 

resin. 

The term “hybrid layer” has now become synonymous 

with bonding of resins to etched dentine. 

There has been a tremendous amount of research 

done on the hybrid layer, its structure, formation 

and how it can be improved. This layer has also 

been referred to as the “resin-dentine interdiffusion 

zone” (2). 

Classification 

Numerous dentine bonding agents have been 

commercially introduced. These changes have 

been referred by some people as “generations”, 

implying that there was a chronological development. 

This can be very confusing. A more consistent 

and logical approach is to classify bonding 

agents by the number of steps needed to complete 

the bonding process. 

“Three-step” or “Conventional” systems 

This group typically consists of three separate 

application steps: etching, priming and adhesive 

resin. They are also known as “etch-and-rinse” 

7

systems. Although they were the first ones 

introduced, they are still widely used and have 

been shown to provide reliable bonding. Their 

main drawback seems to be technique sensitivity, 

since any deviation from the recommended 

procedure will result in inferior bonding. 

“Two-step” systems 

This group can be subdivided into two subgroups: 

i) they have a separate etch and have combined 

the priming and bonding steps. These systems 

are often referred to as “Single-bottle” systems. 

Similar problems found with the “Three-step” 

system can also be seen here. 

ii) etching and priming steps are combined together 

and bonding is separate. This is referred to as 

“Self-etching primers”. An acidic resin etches and 

infiltrates the dentine simultaneously. The tooth 

does not need to be rinsed which decreases 

the clinical application time and also reduces 

technique sensitivity by eliminating the need to 

maintain the dentine in a moist state. 

“One-bottle” or “All-in-one” systems 

This is when all steps are combined into one 

process. Their mode of action is similar to that of 

the “self-etching primers”, but the bonding resin is 

also incorporated. It is considered that these do 

not etch as effectively as the previous ones. They 

are the most recently introduced so limited clinical 

data is available. 

Bonding mechanism 

This micromechanical coupling of restorative 

materials to dentine, via an intermediate adhesive 

layer, is referred to as dentine bonding (3). The 

resin in the primer and bonding step penetrates 

the collapsed collagen fibrils (after demineralisation), 

and forms an interpenetrating network. This 

layer had been described extensively and in great 

detail (4, 5). The thickness of the hybrid layer 

ranges from less than 1 µm for the all-in-one 

systems to up to 5 µm for the conventional systems. 

The bond strength is not dependent on the 

thickness of the hybrid layer, as the self-etching 

priming materials have shown bond strengths 

greater than many other systems but exhibit a 

thin hybrid layer. The etching, rinsing and drying 

process cause the dentine to collapse due to the 

loss of the supporting hydroxyapatite structure. 

The collapsed state of collagen fibrils was hindering 

the successful diffusion of the resin monomers. 

To overcome this problem, two approaches were 

introduced. The first one is called “dry-bonding 

technique” and involves air-drying of dentine after 

etching and subsequent application of a waterbased 

primer that can re-expand the collapsed 

collagen (6, 7). The second one is the “wet bonding 

technique” in which the demineralized collagen is 

supported by residual water after washing (8). This 

allows the priming solution to diffuse throughout 

the collagen fibre network more successfully. 

However, when it comes to clinical practice, it is 

very difficult to find the correct balance of residual 

moisture. Excess water can be detrimental to 

bonding and these problems have been described 

as “overwetting phenomena” (9). Since the 

“dry-bonding technique” is considered to be 

significantly less technique sensitive, it should 

be preferred over the most difficult to standardize 

“wet bonding technique” (2). 

Relevant in-vitro bond strength studies can provide 

a useful indication of the prospective clinical 

success of a system. However, the highest level of 

evidence for comparing the efficiency of a bonding 

system is obtained from randomised clinical trials. 

Randomised clinical trials with elongated the 

treatment periods will be very useful in assessing 

both the effectiveness of a particular group and 

a particular method of application. 

References 

1. Nakabayashi N, Kojima K, Masuhara E. The promotion of adhesion by 

the infiltration of monomers into tooth substrates. J Biomed Mater Res 

1982;16:265-273. 

2. Van Landuyt K, De Munck J, Coutinho E, Peumans M, Lambrechts P, 

Van Meerbeek B. Bonding to Dentin: Smear Layer and the Process of 

Hybridization. In: Eliades G, Watts DC, Eliades T, editors. Dental Hard 

Tissues and Bonding Interfacial Phenomena and Related Properties Berlin: 

Springer; 2005. p. 89-122. 

3. Eick JD, Gwinnett AJ, Pashley DH, Robinson SJ. Current concepts on 

adhesion to dentin. Crit Rev Oral Biol Med 1997;8:306-335. 

4. Van Meerbeek B, Braem M, Lambrechts P, Vanherle G. Morphological 

characterization of the interface between resin and sclerotic dentine. 

J Dent Res 1994;22:141-146. 

5. Van Meerbeek B, Inokoshi S, Braem M, Lambrechts P, Vanherle G. 

Morphological aspects of the resin-dentin interdiffusion zone with 

different dentin adhesive systems. J Dent Res 1992;71:1530-1540. 

6. Finger WJ, Balkenhol M. Rewetting strategies for bonding to dry dentin 

with an acetone-based adhesive. J Adhes Dent 2000;2:51-56. 

7. Frankenberger R, Krämer N, Petschelt A. Technique sensitivity of dentin 

bonding: effect of application mistakes on bond strength and marginal 

adaptation. Oper Dent 2000;25:324-330. 

8. Kanca JI. Effect of resin primer solvents and surface wetness on resin 

composite bond strength to dentin. Am J Dent 1992;5:213-215. 

9. Tay FR, Gwinnett JA, Wei SH. Micromorphological spectrum from 

overdrying to overwetting acid-conditioned dentin in water-free acetonebased, 

single-bottle primer/adhesives. Dent Mater 1996;12:236-244. 

8 



Adhesives 


OptiBond 

Respected by leading opinion leaders, perceived as the gold 

standard of the adhesive technology OptiBond family provides 

performance, versatility and predictable results. 

... the name that stands 

for adhesive brilliance... 

OptiBond Family 

Total-etch 

Self-etch 

Chemistry Behind 

GPDM Adhesive Monomer 

No. of steps 3 2 1 

Gel Etchant 

All OptiBond adhesives comprise the unique 

proprietary chemistry which made OptiBond TM 

FL the gold standard among bonding agents. 

Proven GPDM adhesive monomers are effective 

in creating a superb bond with minimized risk of 

microleakage and post-operative sensitivity. 

Primer 

Adhesive 

4 th generation 5 th generation 7 th generation 

GPDM = Glycero-Phosphate-1.3 Dimethacrylate 

9

OptiBond OptiBond OptiBond 

FL Solo Plus All-In-One 

Years in market 15 years 10 years 3 years 

Application 

Direct procedure • • • 

Indirect procedure - • • 

Etching Yes Yes No 

Application time 1:30 min. 1:10 min. 0:55 min. 

Bond strength Mpa 

To dentine 32 MPa 31 MPa 36 MPa 

To enamel 33 MPa 34 MPa 26 MPa 

Properties 

Filler load 48% 15% 7% 

Works on wet or dry dentine • • • 

Film thickness ~60 µ ~10 µ ~5 µ 

Radiopacity 267% Al - - 

Solvent Water Ethanol Water, Ethanol, 

Ethanol 

Acetone 

Packaging 

Storage conditions Ambient Ambient Refrigeration 

temperature temperature 2 °C to 8 °C 

Bottle content 

Primer Bottle 8 ml 

Adhesive Bottle 8 ml 

5 ml 5 ml 

Unidose content 0.1 ml 0.1 ml 0.18 ml 

Filled adhesive technology 

The technology of filled adhesives was first 

time ever introduced by Kerr in its OptiBond FL 

adhesive. 

Glass Filler in OptiBond Adhesive: 

• Reinforces the dentin tubules for high bond 

strengths and protection against microleakage 

• Releases fluoride over the long-term 

• Decreases polymerization shrinkage 

• Works as a shock absorber and thermal barrier 

between the restorative material and the tooth 

• Virtually eliminates post-operative sensitivity 

• Works well in dry, moist or wet environment 

10 



Adhesives 


OptiBond FL 

Two-bottle total-etch adhesive system 

OptiBond FL launched in 1995 established from 

the beginning the standard in the adhesive 

technology. Over 15 years it has been successful 

worldwide, proven in long-term clinical studies 

and recommended as the gold standard by 

leading dental universities worldwide. 

After applying OptiBond FL I can achieve a 

reliable bonding without any post-operative 

sensitivity. Also I can use successfuly 

OptiBond FL in any bonding procedure. 

Prof. Marco Ferrari 

Features 

• Unique structural bond. 48% filler load 

delivers superior bond strength. 

• Efficient application flow. One coat primer. 

One coat adhesive. Wet or dry prep. 

• Highly radiopaque. 267% radiopacity makes 

X-ray detection easy. 

• Delivery options. The only two-bottle 

adhesive available in bottle and Unidose delivery. 

• Proven long-term performance. 

The legend among 

the adhesives 

11

OptiBond FL 

Application Guide 

OptiBond FL wins 

REALITY’S 20 th 

Anniversary Legacy 

Award, emblematic of 

extraordinary long-term 

clinical performance. 

Technique 

Technique 

Summary 

Summary 

Clinical Success 

13-year Clinical Study 

Clinical Evaluation of a Dentin Adhesive 

System: 13 Year Results, A. A. Boghosian 

and J.L. Drummond and E. P. Lautenschlager, 

Northwestern University Feinberg School of 

Medicine 

1. Etch enamel with Kerr 

Gel Etchant 

(35% phosphoric acid) 

for 15 seconds. 

2. Rinse thoroughly for 

15 seconds. 

3. Air dry for 3 seconds. 

Do not dessicate. 

4. Apply Primer (yellow 

rocket for Unidose delivery) 

with light brushing motion 

for 15 secs. 

Conclusion: At thirteen years, the OptiBond 

adhesive system has demonstrated outstanding 

performance in both retention and sealing of 

the tooth. OptiBond has further demonstrated 

effectiveness, in conjunction with composite, 

eliminating sensitivity resulting from abfraction 

lesions. 

Over 10 years 

posttreament with 

OptiBond FL. 

5. Air dry for 5 seconds. 6. Using second applicator, 

apply Adhesive (black 

rocket for Unidose 

delivery) with light 

brushing motion for 

15 secs. 

7. Air thin for 3 seconds. 8. Light cure for 

20 seconds*. Surface 

is ready for composite 

placement. 

Over 13 years 

posttreatment with 

OptiBond FL 

Cases courtesy of Dr. Alan Boghosian 

* Recommended Cure Times: Demi 5 sec., L.E.Demetron II 5 sec., L.E.Demetron I, 10 sec. or Optilux 501 in Boost mode 10 sec. 

12 



Adhesives 


OptiBond Solo Plus 

Single component total-etch adhesive 

OptiBond Solo Plus is a single component 

adhesive that combines primer and adhesive 

in one step. Combining primer and adhesive 

in one bottle answered the need for a simplerto-use 

bonding agent that maintained total-etch 

strength and durability. 

Case courtesy of Prof. Angelo Putignano 

Features 

• Strong bond. Proven performance achieved 

with simplified application procedure. 

The durable chemical and micro-mechanical 

bonds protect against microleakage to ensure 

superior marginal integrity. 

• Filled technology. OptiBond Solo Plus is 

15%-filled with the same 0.4 micron filler 

found in Kerr's industry-recognized composites. 

• Ethanol based. The adhesion promoters are 

carried in an ethanol solvent, diminishing both 

the tedious need for multiple coats and constant 

reapplication commonly found with acetone 

adhesives. 

• Versatile. Effective in use for all direct 

and indirect indications. Use in moist or 

dry environment. 

• Unidose delivery. Available in bottle and 

Unidose delivery. 

High performance easy-touse 

total-etch adhesive 

13



Clinical Research 

Dentin Shear Bond Strength (MPa) 

of 5th-Generation Adhesives 

35 

30 

25 

31 

20 

15 

10 

5 

20 21 22 

Table missing 

23 23 

0 

Excite ® XP Bond Adper Prime ® & One Step ® OptiBond ® 

Single Bond Bond NT Plus Solo Plus 

Published by H. Lu*, H. Bui, X. Qian, D. Tobia, Kerr Corporation, 

IADR 2008, #401 

1. Etch enamel and dentine 


2. Rinse thoroughly 


3. Air dry for 3 seconds. 

Do not dessicate. 

4. Shake unidose before 

dispensing. 

5. Twist open the 

unidose. 

6. Dip brush. Apply 


for 15 seconds using 

light brushing motion. 

7. Air thin for 3 seconds. 8. Light cure for 20 

seconds*. Surface is 

ready for composite 

placement. 

STRONG DURABLE BOND. SEM Image 

shows excellent penetration of OptiBond 

Solo Plus into demineralized dentin, 

forming long resin tags and a well-defined 

hybrid layer, which results in superior bond 

strength. 


14 



Adhesives 



Single step, self-etch adhesive 

OptiBond All·In·One Self-Etch Adhesive delivers excellent penetration 

of dentin tubules, providing exceptional bond strength and protection 

against microleakage and post-op sensitivity. Its unique nano-etching 

capability enables the most effective enamel etching of any existing 

single-component adhesive, creating a deeper etched surface for higher 

mechanical retention and chemical bonding. In addition its low film 

thickness creates an effective, single-phase adhesive interface for easier 

seating and better fit of your final restoration. 

Effective enamel nano-etching 

SEM image shows clearly 

exposed nanoscale enamel 

hydroxyapatite crystals, 

which present greater 

rough surface area 

for micromechanical 

retention and chemical 

bonding. 

Well defined adhesive layer 

Dentin Interface and 

Superb Sealing Ability 

Provides a Well Defined 

Adhesive. 

SEM shows the composite, 


adhesive layer and dentin 

bonding interface. 

Effective bonding 

in a simple way 

15




Shear Bond Strength of Single-Component 

Self-Etch Adhesive Systems to Human Dentine 

(24 hr)* 

20 seconds 

Shear Bond Strength (MPa) 

35 

30 

25 

20 

15 

10 

5 

0 

30,4 

10,3 

20,2 

32,2 

35,0 

Clearfil ® GBond iBond Xeno ® IV OptiBond ® 

S 3 Bond 

All•In•One 

1. Shake. 

2. Twist open. 3. Dip brush. 4. Apply first application 

with scrubbing motion. 

Shear Bond Strength of Single-Component 

Self-Etch Adhesive Systems to Bovine 

Enamel (24 hr)* 

20 seconds 

5. Dip brush. 4. Apply second 

application with 

scrubbing motion. 

7. Gently air dry, then 

use medium force 

to air dry for at least 

5 seconds. 

8. Light cure for 

10 seconds*. 

Shear Bond Strength (MPa) 

30 

25 

20 

15 

10 

5 

0 

21,7 

23,0 

11,3 

21,6 

28,2 

Clearfil ® GBond iBond Xeno ® IV OptiBond ® 

S 3 Bond 

All•In•One 

* Study conducted by Dr. James Dunn of Loma Linda University. 

Trademarks are property of their respective owners. 


16 



Composites 


COMPOSITES 

Aesthetics and composite 

Prof. Angelo Putignano, University of Marche, Ancona, Italy 

Since the ancient Greeks great philosophers, such 

as Plato, Baumgarten, Kant, Hegel, Vico and Croce, 

have sought to place the concept of aesthetics and 

beauty on a rational and “scientific” basis.The triad 

of beauty, goodness and truth represents the ideal 

to which individuals should aspire in the attainment 

of what is called “perfection”, which perhaps does 

not exist. Most widely shared concepts on 

perceived beauty arise from interaction between 

“sensibility” emotional and instinctive influence, 

and “intellect” or rational factors. Hutchinson and 

Shaftesbury defined felicitously aesthetics as the 

aptitude for perceiving harmony (Inquiry into the 

origin of our ideas of beauty 1725). 

Cosmetics tend to be distinguished from aesthetics, 

which is searching for a stereotype of beauty 

regardless of the natural context in which the 

subject is placed. Aesthetics, on the other hand, 

would be an expression of a natural archetype 

in accordance with mathematical theorem, with 

clear and translatable principles of beauty. 

In this respect, an ethical inner sense of aesthetics 

has been theorized, defined as the passive ability 

to receive ideas of beauty from all objects in which 

there is uniformity in variety ("harmony") (1). These 

objective factors, which accept an interaction 

between the object and the “mental categories” of 

the observer, provide the rational basis of beauty. 

Numerous rules of beauty have been applied to 

anatomy in formulating dentofacial proportions 

coherent with the “golden section” (Leonardo), or 

in accordance with anthropometric (cephalometric) 

parameters adopted from epidemiological studies. 

However, there are a series of subjective factors 

peculiar to instinctive emotional and psychological 

context of the observer, which can significantly 

condition the sensitivity to beauty. Also to assimilate 

to “taste” and perception of beauty correlated with 

the epoch and specific historical, cultural and social 

context in which the observer inhabits. Pilkington 

defined dental aesthetics in 1936 as “the science of 

copying, harmonising our work with that of nature, 

seeking to minimise it as much as possible”. 

A few decades ago, the majority of dentists working 

in the field of restoration concentrated on long-term 

solutions and the appearance of the restorations 

was of secondary importance (2). Thus, in ordinary 

practice, restorations made of amalgam and crowns 

made of gold alloy were utilised as the main and 

most lasting solutions and patients accepted these 

dental restorations despite their unpleasant 

appearance. The evolution of preventive and 

conservative dentistry has had a great impact on 

the development of restorative aesthetic dentistry. 

The success of preventive dentistry has resulted 

in teeth without caries and therefore white and not 

restored, with a resulting increase in the demand 

for aesthetic restorations. 

Good appearance, together with good overall health, 

with adequate restoration of function, and an 

attractive smile play an important role in modern 

society. In general, a smile is beautiful when the 

teeth are well characterised in respect to their 

shape, contour, colour, surface texture and detail, 

emergence profile, angle and position, and incisal 

occlusion. The aim of every aesthetic restoration is 

to be credible and natural with regards to function 

with maximum preservation of dentition and 

periodontal tissues, in achieving this objective the 

clinician must select the most suitable materials 

17

for resistance, biocompatibility, and of course 

aesthetic appearance. Composite resins have now 

been in use for over three decades and in recent 

years have become a solution that is adopted 

more often, because of their excellent aesthetics 

and their ever better mechanical properties (3). 

The term composite refers to a combination of at 

least two chemically diverse materials, with a distinct 

interface to separate the two components. Superior 

properties are exhibited when in combination, 

opposed to when used separately. 

When formulating a composite resin, we identify 

three different components: 

• Organic matrix; 

• Inorganic filler; 

• Binding agent. 

The organic matrix of the most modern composite 

resins consists mainly of the monomer developed 

by Bowen in 1957, through a reaction between 

one molecule of bisphenol A and two molecules 

of glycidyl methacrylate (GMA), yields a viscous 

monomer of high molecular weight which is called 

BISGMA. In the formulation of the matrix of 

composite resins we then find other monomers of 

lower molecular weight in lower percentages such 

as TEDGMA (triethylene glycol dimethacrylate, the 

most used), UEDMA (diurethane dimethacrylate, 

sometimes used as the sole component of the 

matrix), MMA (methyl methacrylate) and others of 

less importance and little used. 

The second component of a composite resin is 

the inorganic filler, which is added to the matrix 

to increase its resistance characteristics, which 

are otherwise insufficient, such as hardness, 

resistance to compression, resistance to wear 

and impermeable. 

The fillers can be classified on the basis of their 

chemical nature into fillers based on silicon dioxide 

or colloidal silica, quartz, vitreous materials, other 

metals or zirconium. 

On the other hand, Bayne in 1994 suggested the 

following subdivision based on the diameter of 

the particles: 

• mega fillers (from 2 to 0.5 mm) 

• macro fillers (from 100 to 10 µm) 

• medium fillers (from 10 to 1 µm) 

• mini fillers (from 1 to 0.1 µm) 

• micro fillers (from 0.1 to 0.01 µm) 

• nano fillers (from 0.01 to 0.005 µm) 

Based on production techniques, conventional or 

traditional fillers are produced by trituration of the 

inorganic substances listed above, obtaining a 

macro filler with particles of irregular shape and 

size, which require little monomer to become wet, 

therefore conferring less viscosity, but they make 

the restoration difficult to finish and polish and 

also favour the formation of micro fractures. 

Fillers obtained by precipitation of pyrogenic silica 

at high temperatures, introduced successively, 

18 



Composites 


consist of spherical particles of microfiller 

(between 0.04 and 0.06 µm). One of the most 

innovative products in this family of materials is 

the micro filler composite with prepolymerised 

spherical particles. The micro fillers in general are 

able to provide a significant advance in the qualities 

of the composite; in addition, this particular type 

of micro filler confers further advantages due to 

the spherical shape of the filler: 

• Better matrix-filler bond; 

• Less internal matrix-filler tension as there are 

prepolymerised spheres loaded with evenly 

distributed SiO 2 ; 

• Consequent improvement in wear and fatigue 

characteristics. 

However, this class of materials does not represent 

the solution to all the conditions required by a 

dental restoration, as even they are affected by 

technical gaps: the micro fillers are not capable of 

supporting high occlusal loads, especially because 

of the lower resistance of the pyrogenic silica when 

compared with fillers based on glass and above all 

quartz. Moreover, contraction due to polymerisation 

represents one of the major weak points of the 

micro fillers; this can compromise the tooth-obturation 

interface, the most critical zone of a restorative 

treatment (4,5). 

The experience obtained with traditional macro 

composites (TC) and micro fillers, both homogeneous 

and non-homogeneous (HMC e IMC), has 

provided the producers with the knowledge base 

needed for achieving a material that can now be 

used in all classes of dental cavities, as it has both 

the physical characteristics of the former and the 

19 

aesthetic characteristics of the latter: the hybrid 

composites. Hybrid composites are highly loaded 

materials (over 70% in volume). 

The technology of the hybrids is based on the 

presence of a double dispersed phase, consisting 

of ceramic-vitreous macro particles similar to the 

macro fillers, though of more limited dimensions 

(for the most part between 10 and 50 µm), as well 

as micro particles consisting of pyrogenic silica, 

which are typical of the micro fillers (approximate 

dimensions 0.04-0.06 µm) (6). The mixed filler 

provides a clear improvement in the material on 

both fronts: the physical characteristics and the 

aesthetic benefit. The macro particles are responsible 

for the increased mechanical resistance of the 

material because they have a higher elasticity 

modulus compared to that of the matrix with which 

they form a single body; in this way, an applied force 

should induce flexion of the particles before it can 

act on the resin, which is the real weak point during 

the application of loads; furthermore, the high 

filling value reduces the percentage of resin 

employed, in consequence reducing the contraction 

on polymerisation for which this is responsible. The 

improved aesthetic benefit, on the other hand, is a 

function of the presence of the micro filler, which 

guarantees greater surface polishing and an 

extremely wide range of shades (7, 8). 

The third component of composite is a silane 

binding agent, a bifunctional molecule capable of 

binding two different materials. Silane is an organic 

silicon glue which has two functional groups, one 

of which binds to the methacrylate groups of the 

resin, the other to the silicon dioxide of the filler. 

Hardening of the composite resins is linked to a 

process of polymerisation in which the monomers 

form macromolecular complexes known as polymers. 

In addition, there is a primer in the resin, a 

molecule that, when activated, provides the free 

radicals necessary for polymerisation to progress; 

the most commonly used primers employ visible 

light or UV rays to become activated in turn (9). 

Those belonging to the second group, now fallen 

into disuse, are basically represented by benzoinodimethyl 

ether, whereas a diketone is the most 

widely used molecule in the most common and 

recent composites: camphoroquinone together 

with NN-dimethylaminoethylmethacrylate. 

Activation of the latter primer is by a lamp using 

visible light with a wavelength between 430 and 

480 nm. These molecules initiate polymerisation 

by forming a three-dimensional network with 

many cross-links; while the reticulation process 

is proceeding, the levels of free radicals and the 

dimethacrylate molecules not involved in the 

process tend to drop drastically, preventing 

complete conversion of the double bonds of 

the dimethacrylate. 

When the composite hardens, the degree of 

conversion (DC), which is the percentage of 

monomers that undergo polymerisation, hardly 

exceeds 75% under standard conditions. The 

degree of conversion is a determinant for a 

series of physical properties of the composite, 

such as hardness and resistance to wear.

When two monomers combine the molecular 

structure is shortened, and it can be concluded 

that the greater degree of conversion will increase 

the percentage of contraction, because the overall 

length of a polymer is less than that of the individual 

monomers. In fact, the monomers combine with 

covalent bonds, assuming a distance between one 

another that is three times lower than that of the 

Van der Waals bonds that exist between one 

monomer and another. For this reason, a composite 

will contract more when used in a single mass than 

with minimal successive increments. 

The direction of contraction depends on the shape 

of the cavity and the strength of adhesion. In fact, 

adhesive placed on the walls of the cavity opposes 

the contraction of the composite, so that the 

surface of the material that contracts in contact 

with a wall of the cavity cannot contract because 

of the prevailing effect of the adhesive. Therefore, 

if the composite is in contact with one wall only, 

the contraction takes place towards it and involves 

all the other free surfaces. If there are two walls, 

the remaining unsupported surface will be left free 

to contract; if all the walls of a cavity are present, 

the composite adheres to them and the only wall 

free to contract is the occlusal one. Therefore, the 

greater the number of walls to which the composite 

adheres, the greater is the C-factor, that is, the 

relationship between the adhesive surface and 

the free surface and thus the greater is the stress 

to which the material will be subjected when 

contracting, as Feilzer stated in 1987. The stress 

within the tooth-composite interface has been 

measured at about 4 MPa for each surface. 

During polymerisation, there are two phases, one 

called the pre-gel phase in which contraction of 

the composite is compensated by the intrinsic 

flowing of the material, so as to diminish the 

contraction and reduce stress; the second is called 

the post-gel phase, separated from the former by a 

gel point, in which the material is no longer able to 

run to compensate the contraction so that stress 

is produced. A rigid composite will have a higher 

modulus of elasticity or Young’s modulus, and 

will develop more stress during polymerisation, 

having a shorter pre-gel phase; conversely, a 

fluid composite will have a lower modulus of 

elasticity with a longer pre-gel phase. 

Although the composites are regarded as optimal 

materials, they certainly have certain limits that 

may potentially frustrate the aims of a restoration. 

The main deficiency, and this applies for all classes 

of composite including the hybrids, is contraction 

on polymerisation, that is, the reduction in volume 

that the resin undergoes during the polyaddition 

phase, once the reaction has begun. It can be 

concluded that at the end of the restoration a 

marginal fissure will form between the tooth and 

obturation caused by the contraction; on the other 

hand, absence of the formation of a fissure introduces 

tensile forces into the reconstituted element 

that will be discharge either on the residual tooth 

walls, with the risk of fracturing them, or on the 

body of the obturation; the result will be the same 

for the three analysed outcomes that should be 

considered, however unlikely they may be: failure 

of the restoration. To avoid this, cases that may 

undergo direct restorative treatment with composite 

resins should be assessed carefully, following the 

instructions for use and observing the limitations 

that are still present, albeit reduced, especially in 

the case of the hybrids. 

Even if the evolution of the composites has probably 

approached its technological limit, there is certainly 

scope for improvement and it is permissible to 

expect that in the near future there will yet be a 

composite resin, even self-adhesive, that will be 

the material of choice in aesthetic reconstructions. 

It may also be considered that the hybrids come 

closest to the ideal material from the aesthetic 

aspect, although, like all composites, they are 

affected by technical problems that have not yet 

been fully resolved. 

References 

1. Ceruti A, Mangani F, Putignano A. Odontoiatria estetica adesiva – Didattica 

Multimediale. Ed. Quintessence. 2008 Cap.1; p:18-20. 

2. Christensen GJ. Longevity versus Esthetics. The Great Restorative Debate. 

JADA 2007, 138, 1013-1015. 

3. Raj V, Macedo GV, Ritter AV. Longevity of Posterior Composite Restorations. 

Journal Compilation 2007, 19(1), 3-5. 

4. Abe Y, Lambrechts P, Inoue S, et al. Dynamic elastic modulus of “packable” 

composites. Dent Mater 2001;17:520-5. 

5. Burgess JO, Walker R, Davidson JM. Posterior resin-based composite: 

review of the literature. Pediatr Dent 2002;24:465-79. Review. 

6. Dino R, Cerutti A, Mangani F, Putignano A. Restauri estetico-adesivi indiretti 

parziali nei settori posteriori. Ed.U.T.E.T. 2007 Cap. 2; p: 18-22. 

7. Christensen GJ. Preventing postoperative tooth sensitivity in class I, II and 

V restorations. J Am Dent Assoc 2002;133:229-31. 

8. Fabianelli A, Goracci C, Ferrari M. Sealing ability of packable resin 

composites in class II restorations. J Adhes Dent 2003 Fall; 5:217-23 

9. Lee IB, Son HH, Um CM. Rheologic properties of flowable, conventional 

hybrid, and condensable composite resins. Dent Mater 2003;19:298-307. 

20 



Composites 


Herculite ® XRV Ultra 

The legacy of Herculite 

For 25 years Herculite XRV has been the 

industry standard for composite restoratives. 

Herculite XRV Ultra is a nanohybrid version of 

Herculite XRV (microhybrid), that incorporates 

more biomimetic, “tooth-like” features into a 

restoration. Based on the latest nanofiller 

technology, in addition to offering improved 

handling, polishability and wear resistance, 

Herculite XRV Ultra delivers an improved lifelike 

appearance to final restorations by replicating 

the opalescence and fluorescence of the natural 

tooth. 

Herculite restoration after 13 years 

Case courtesy of A. A. Boghosian, J. L. Drummond and 

E.P. Lautenschlager – Study conducted by Northwestern University 

The Advantages of Nanotechnology 

Herculite Ultra’s advanced nanotechnology 

delivers additional benefits that can’t be 

found in traditional microhybrid composites. 

As a nanohybrid composite, Herculite XRV 

Ultra combines conventional hybrid fillers with 

smaller filler particles in size of about 50 nm. 

These smaller particles enable Herculite XRV 

Ultra to deliver improved polish and clinical 

gloss, better aesthetics and superior 

mechanical strength. 

Compared to Other Composites 

Plucking, or natural wear over time, tends to 

occur faster in restorations with larger particles, 

decreasing the overall life and esthetics of 

the restoration. When polymerized, the large 

prepolymerized particles virtually disappear 

and the surface is easily polishable. The 

polished surface consists only of nanohybrid 

particles below the wavelength of visible light. 

Nanohybrid composite 

21

Improved Handling 

Handling Comparison Map 

Creamy 

TPH3 

Z100 

Venus 

Gradia Direct 

Filtek Supreme Plus 

Map was created with input from 

various clinicians and Kerr R&D. 

Grandio 

Point 4 

Sticky 

Non-Sticky 

Herculite Ultra 

Esthet X 

Herculite XRV 

Premise 

Here’s what clinicians are saying about 

Herculite Ultra 

Filtek Z250 

90% of focus group attendees said they would purchase Herculite 

Ultra over their current composite. 

“Adapts really well, not sticky at all, really sculptable”. 

“Superb for a nanohybrid. Best composite ever”. 

Best 

5 

4 

3 

4,85 

4,54 4,69 4,77 4,77 4,69 

Stiff 

4,92 


Gloss Retention 

Over time, resin in a composite restoration wears off, 

exposing glass fillers and creating a rough surface. 

If the filler size is smaller than the average wavelength of light 

(as in the case of Herculite Ultra, Premise, and Point 4), 

light will be diffused uniformly and the surface will appear 

glossy, resulting in superior gloss retention over time despite 

resin wear. 

Toothbrush test, University of Leeds 

90 

80 

70 

60 

50 

40 

30 

20 

10 

0 

Before 

73 

Herculite ® Ultra 

Kerr 

69.1 

Venus ® 

Heraeus Kulzer 

65.2 

Tetric EvoCeram ® 

Ivoclar 

62.3 

Miris 

Coltene Whaledent 

51.1 

Filtek Z250 

3M 

Gloss meter readings were taken using a gloss meter at 600 minutes 

after the initial reading. 

Herculite 

Ultra 

Venus 

Tetric 

Evoceram 

2 

1 

After 

Worst 

0 

Handling Stickiness/ Thickness Adaptability Compression Adherence Resistance 

Tackiness w/ Instrument to Instrument to Slumping 

Photographs courtesy of University of Leeds 

22 



Composites 


Herculite XRV Ultra in Clinical Cases 

Class IV 

Case courtesy of Prof. Angelo Putignano. 

1) Initial case. 2) Teeth prints taken for diagnostic wax-up. 3) Mask based on diagnostic wax-up. 

4) Mask test. 5) The case with applied OptiDam. 6) Mask test with OptiDam. 

23

7) Etching for 15 seconds with 

Gel Etchant. 

8) Palatinal wall A2 Enamel mass, small 

amount of A3 dentin on the most 

coronal part of the injury was placed. 

9) A2 dentin mass was applied to cover 

the former layer and sculpted with 

grooves. 

10) The incisal mass is used both around and 

between the grooves to create a translucent 

effect and to highlight the grooves. 

11) The most coronal part is then slightly 

pigmented with orange, while whitish 

areas are designed with Kolor + Plus ® White. 

12) Vestibular A2 enamel mass applied 

in a very fine layer. 

13) The case after fininishing and 

polishing. 

14) The completed case after the 

10-day follow-up. 

24 



Composites 


Class V 


The present case concerns a 30 year old patient with multiple erosions 

from particular alimentary habits and inadequate oral hygiene: 

1) Initial situation, erosions on 1.1 

and 2.1. 

2) Rubber Dum isolation. 3) Gentle roughening of sclerotic dentin 

with rounded carbide bur. 

4) Finishing line with 20 micron 

diamond bur. 

5) Etching with 37% phosphoric acid. 6) OptiBond Solo Plus adhesive applied 

with scrubbing motion for 15 seconds; 

light cured for 10 sec with Demi. 

25

7) Application of a thin layer of Premise 

Flow A3.5; light cure for 20 sec with 

Demi. 

8) First layer of Herculite XRV Ultra, 

A3 Enamel, on cervical part; 

light cure for 20 sec. 

9) Second and last layer of 

Herculite XRV Ultra, A3 Enamel; 

light cure for 20 sec. 

10) Finishing with OptiDisc 

Coarse/Medium, small size. 

11) Polishing with GlossPlus Polisher 

Minipoint. 

12) High gloss polishing with HiLuster Dia 

Polisher Minipoint. 

13) Final case after RubberDum removal. 

26 



Composites 


Class II 


1) Initial case. 2) Preliminary preparation. 

3) Cavity smoothing with Pasteless 

prophy without fluoride. 

4) Cavity preparation after caries removal 

revealing sclerotic dentin. 

5) Etching with Gel Etchant 15 sec. 

6) Bonding with OptiBond Solo Plus. 

Apply for 15 seconds and light cure 


7) A thin layer of Premise Flow. 8) Build-up of interproximal wall. 

27

9) First layer of Herculite XRV Ultra, 

Dentin A3,5, light cured for 20 

seconds. 

10) Vestibular dentin masses A3, 

light cured for 10 seconds. 

11) Lingual dentin masses A3, 

light cured for 10 seconds. 

12) A thin layer of Enamel A3 under 

glycerin to avoid air inhibition. 

13) Interproximal emergency profile 

of restoration. 

14) Finishing procedure with multi-blade 

bur. 

15) Occlusal check. 

16) Polishing with OptiShine. 

17) Final result. 

28 



Composites 


Class I 


1) Initial case. 2) Prepared cavity. 3) Etching with Gel Etchant 

15 seconds. 

4) Bonding with OptiBond Solo Plus, 

apply for 15 seconds and light cure 


5) Dentin layer A3, light cured for 

20 seconds. 

6) Final result. 

29

30 



Finishing and Polishing 



Finishing and polishing of composite restorations 

Prof. Martin Jung, Justus-Liebig-University, Giessen, Germany 

Aesthetic superiority is one of the key features of 

dental composite restorations. Shading, optical 

appearance and surface texture of a tooth 

coloured restoration is crucial not only with 

respect to patient’s satisfaction and comfort 

[Jones et al., 2004]. The behaviour of composites 

in the biological environment of the oral cavity 

and composite material properties are strongly 

influenced by surface quality. Surface irregularities 

enhance plaque accumulation [Ikeda et al., 2007], 

which in turn can lead to secondary caries and 

inflammation of the adjacent gingival tissues. 

Especially in case of restorations that are exposed 

to strong occlusal load and antagonistic activity, 

surface roughness affects the wear resistance and 

the abrasivity of dental composites [Willems et al., 

1991; Mandikos et al., 2001]. Rough composite 

surfaces are liable to discoloration and staining 

[Patel et al., 2004; Lu et al., 2005]. Moreover, 

material properties such as mechanical and 

flexural strength as well as microhardness of resin 

based composites are improved by minimizing 

surface roughness [Gordan et al., 2003; Venturini 

et al., 2006; Lohbauer et al., 2008]. Thus accomplishing 

a superior surface finish is a prerequisite 

for patient’s satisfaction and for the longevity of a 

composite restoration. 

Composite surfaces, which are cured against a 

mylar matrix, show minimum surface roughness 

[Yap et al., 1997; Ergücü and Türkün, 2007; Üctasli 

et al., 2007; Korkmaz et al., 2008] Clinically, most 

composite restorations require further finishing and 

polishing after placement. Finishing includes elimination 

of excessive material, adjustment of surface 

morphology and removal of occlusal interferences. 

Case courtesy of Prof. Angelo Putignano 

This causes a roughening of surfaces, which must 

be eliminated by subsequent polishing. Rotary 

instruments which are used for these purposes 

face a lot of requirements. They must be equally 

effective when exposed to hard filler particles and 

soft resin matrix, without having detrimental 

effects on the composite surface. Instruments for 

finishing require cutting efficiency to some degree 

without leaving the surfaces in a rough state. 

Finally, rotary instruments for finishing and polishing 

must work on different types of surface morphology 

(even and convex vs. structured and concave 

surfaces). 

With respect to initial finishing of composite 

restorations, there are mainly two types of burs 

which are recommended for this purpose: finishing 

diamonds and tungsten carbide finishing instruments. 

Finishing diamonds are characterized by a 

comparatively high cutting efficiency, depending 

on the size of the abrasive diamond particles 

[Jung, 1997]. Due to the aggressive effect of the 

diamond particles, finishing diamonds leave 

composite surfaces in a more or less rough state 

[Jung et al., 2007b]. 

31

Tungsten carbide finishing burs vary with respect 

to the number and orientation of the cutting flutes. 

These instruments are characterized by a limited 

cutting efficiency and achieve a smooth composite 

surface with only little remaining roughness [Jung, 

1997; Barbosa et al., 2005; Turssi et al., 2005]. 

There is some controversy in literature, whether 

there are significant differences between different 

types of tungsten carbide finishing burs with 

respect to the resultant surface quality [Jung, 

1997; Radlanski and Best, 2007]. 

After pre-treatment, the composite surfaces are in 

a variably rough state, depending on the extent 

and amount of corrective work and on the number 

and type of burs used. In order to accomplish a 

superior aesthetic result, maximum reduction of 

remaining roughness is necessary by subsequent 

polishing. 

There is a great number of polishing techniques 

available for application on composite restorations. 

Polishing systems vary with respect to shape and 

size of the individual instruments, number of working 

steps, matrix and abrasive particle composition as 

well as consistency. 

Flexible discs generally yield well smoothened 

composite surfaces and permit an effective 

reduction of remaining roughness. For this 

reason, flexible discs were regarded as some 

kind of clinical polishing standard for composite 

surfaces [Tjan and Clayton, 1989; Wilson et al., 

1990; Hoelscher et al., 1998; Setcos et al., 1999; 

Roeder et al., 2000; Üctasli et al., 2007]. Because 

of their shape, flexible discs are efficient on even 

or convex surfaces; they are not recommended for 

application on concave or structured surfaces 

[Chen et al., 1988; Tjan and Clayton, 1989]. By 

variation of disc diameter and thickness, their 

application can be adapted to several clinical situations. 

Most disc systems are available in three or 

even four working steps, thus permitting a high 

cutting efficiency and effective roughness reduction. 

For this reason, flexible discs represent the 

only technique which can be used both for finishing 

and polishing. 

Case courtesy of Dr. Joseph Sabbagh 

Rubber polishers comprise a great and heterogeneous 

group of polishing devices. Variations in size 

and shape enable the application of rubber 

polishers both on convex and on structured or 

concave composite restoration surfaces. Most of 

the products out of this group are characterized 

by a rubber-like silicon matrix. The abrasive 

particles which are integrated into the matrix 

are mostly made of silicon carbide or dioxide, 

aluminium oxide or diamond particles in different 

grain sizes. The clinical application mode for the 

various products differs considerably. It reaches 

from a single-step application to two, three or four 

working steps. Owing to these great variations, 

the polishing efficiency depends strongly on the 

individual products used. Many systems achieved 

a good composite surface quality, comparable or 

even better than flexible discs [Jung et al., 2003; 

Jung et al., 2007a]. Other products caused less 

favourable polishing results [Ergücü and Türkün, 

2007; Cenci et al., 2008]. The efficiency of onestep 

vs. multi-step systems is still discussed in 

literature [Da Costa et al., 2007; Jung et al., 2007a]. 

Polishing brushes represent a different approach 

towards minimizing composite roughness. Silicon 

carbide abrasive particles are integrated into the 

matrix of special synthetic filaments. This enables 

a universal application of polishing brushes on 

different types of composite surface morphology. 

Polishing brushes are one-step systems; their 

polishing efficiency is favourable, but depends 

on the quality of initial finishing [Krejci et al., 1999; 

Jung et al., 2007a]. 

32 





Felt wheels are another one-step polishing system, 

with abrasive diamond particles attached to a felt 

matrix with the help of wax. Because of the soft 

matrix, felt wheels can be used on various types 

of composite surfaces. Due to its nature, felt 

wheels must be discarded after a single use. The 

polishing results depend strongly on the kind of 

pre-treatment [Jung et al., 1997; Jung et al., 2003; 

Scheibe et al., 2009]. 

Finally, gels are an alternative for polishing composites. 

Their application in a single or few steps 

is possible on all types of surfaces. Polishing 

gels are used on discs, plastic tips or brushes. 

A diamond based polishing paste achieved 

favourable results on a hybrid composite 

[Jung, 2002]. Polishing pastes based on diamond 

particles achieved lower roughness compared to 

aluminium-oxide gels [Kaplan et al., 1996]. 

The use of gels as a final polishing step is 

recommended [Turssi et al., 2000; Radlanski 

and Best, 2007]. 

For rotary instruments there is only limited access 

to proximal surfaces. This special situation requires 

the use of manual finishing and polishing strips, 

although their polishing efficiency seems to be 

limited [Whitehead et al., 1990]. Alternatively 

diamond-coated oscillating finishing files may be 

used in cases with greater amounts of excess 

composite material in the proximal-cervical area 

of composite restorations. Oscillating diamond 

files caused rough areas after application to cervical 

margins of composite-inlays. A subsequent use of 

polishing paste on plastic files achieved a reduction 

of remaining surface roughness [Small et al., 1992]. 

The choice of an appropriate system for finishing 

and polishing of composite restorations depends 

on a several factors; there is no universal system 

for all clinical indications. The accessibility and 

morphology (convex or structured) of surfaces and 

the need and extent for initial finishing is of great 

importance. Finally the choice of a certain polishing 

system should be made with respect to texture 

and roughness of the surfaces after initial finishing. 

The success of one-step polishing systems generally 

strongly depends on the surface condition and 

its remaining roughness after finishing. Polishing 

systems with two or more working steps are less 

sensitive to the kind of pre-treatment. 

All references are available upon request. 

33

Surface treatment of composite filling 

Occlusal / Concave Surfaces 

Surface 

Roughness 

CONTOURING 

Adjust primary 

geometric form. 

Carbide Bur 12 Blades 

Diamond 40 µm 

Dia: sRa=1.25 µm 

FINISHING 

Remove composite excesses. 

Shape Occlusal anatomy, 

lingual fissures, 

secondary anatomy. 



Dia: sRa=0.56 µm 

POLISHING 

Eliminate surface scratches. 

Reduce surface 

roughness below 

Ra = 0.35 µm. 

Occlubrush and 

OptiShine is 

universal polishing 

tool for all occlusal 

and concave 

posterior surfaces 

Occlubrush 

OptiShine 

Gloss 

GlossP: sRa=0.26 µm 

HIGH GLOSS POLISHING 

Reduce surface roughness till to 

high gloss below 

Ra = 0.2 µm. 

HiLuster 

HiLust: sRa=0.10 µm 

34 





Convex / Flat Surfaces 

Surface 

Roughness 

CONTOURING 





OptiDisc Extra-Coarse 

Disc: sRa=1.20 µm 

FINISHING 







OptiDisc Coarse-Medium 


POLISHING 




Ra = 0.35 µm. 

OptiDisc Fine 

OptiShine 

Gloss Polisher 





Ra = 0.2 µm. 

OptiDisc Extra-Fine 

HiLuster Polisher 


35

Interproximal Surfaces 

Surface 

Roughness 

CONTOURING 



Diamond strip not 

recommended for 

anterior application 


Diamond Strip 

Strip: sRa=0.90 µm 

FINISHING 






Finishing OptiStrip 

Strip: sRa=0.58 µm 

POLISHING 




Ra = 0.35 µm. 

OptiDisc can 

also be used 

interproximally 

Polishing OptiStrip 

OptiShine 

OptiDisc 

OShine: sRa=0.25 µm 




Ra = 0.2 µm. 

HiLuster 


36 





OptiDisc ® 

OptiDisc 

Sof-Lex XT 

The first translucent finishing and polishing disc, which is both gentle and more efficient. The flexible discs 

are used for finishing and polishing of composites, glassionomers, amalgams, semiprecious and precious 

metals. The use of the complete system gives the restoration a final polish equal to the natural dentition. 

Features 

• Unique fixation between disc and mandrel. Optimal torque transmission to disc, 

no sliding and no rpm sensitive. 

• Optimized disc flexibility. For excellent adaptation on tooth anatomy. 

• Translucent discs. Good view of the working area. 

• Colour coded stages of abrasivity. Easy recognition of grit size. 

• Green coding of abrasive side. Easy distinction between abrasive and non-abrasive side. 

• Ready to use abrasive layer. High efficiency. Uncoated cutting edges for high efficiency from the start. 

15.9mm 12.6mm 9.6mm 

Extra-Coarse 

80 µm 

Coarse/Medium 

40 µm 

Green active side 



The Mandrel 

• Metal mandrel 

• Patented mandrel design. Mandrel is placed 

below the surface of the disc to avoid 

contact with the tooth. 

• Special coating of the mandrel. Protection 

against scarring. 

Fine 

20 µm 


Extra-Fine 

10 µm 


37

Abrasive coating 

OptiDisc Kerr 

200 µm 

< > 

Extra-Coarse 

Coarse-Medium 

Fine 

Extra-Fine 

200 µm 

< > 

OptiDisc can be turned 

on the mandrel in order 

to have an easy access 

of active side on mesial 

and distal surface of 

the tooth. 

Coarse Medium Fine 

Sof-Lex XT 3M Espe 

Super Fine 

SEM pictures show comparison of abrasive 

coating of 2 competitive materials. 

SEM pictures courtesy of Dr. Jean-Pierre Salomon, France 

0.0160 

0.0140 

Mass removal after each application 

of 20 sec. on Point4 

3M Soft-Lex 

OptiDisc 

Abrasive 

Glue 

Polyester 

OptiDisc 

Sof-Lex XT 3M Espe 

OptiDisc has a ready to use abrasive layer - uncoated cutting edges for 

high efficiency from the start. 

Glue 

Abrasive 

Foil 

Mass removal (g) 

0.0120 

0.0100 

0.0080 

0.0060 

0.0040 

0.0020 

0.0000 

3M Coarse 3M Medium Fine Super Fine 

Hawe Extra coarse Hawe Medium/Coarse 

38 





HiLuster Plus Polishing system 

2-step polishing system for composites 

Features 

• High-gloss results in only 2 steps. Smooth surface and high gloss in two steps. 

• Efficient. Pre- and gloss polishing in one single step by efficient Gloss PLUS polishers, 

final roughness after first step around sRa 0.25 µm. 

• Diamond particles. Outstanding final result thanks to diamond particles integrated in the HiLuster PLUS 

polisher, final roughness around sRa 0.10 µm is achieved after second step. 

• Optimum flexibility. The flexibility of the polishers was optimized for excellent adaptation to the tooth 

anatomy. 

• Good adhesion between the mandrel and the polisher. Avoids that the abrasive parts come off. 

• Hygienic. Possibility to sterilize before first use in order to preserve the hygienic – can be autoclaved 

at 134 °C. 

Material of Polisher: 

Gloss PLUS Polishers 

Flame 

Part. No. 2651 

Minipoint 


Cup 


Cup 


GlossP: sRa=0.26 µm 

Gloss Plus Polisher: 

HiLuster Plus Dia Polisher: 

Aluminium oxide particles embedded into a silicone elastomer. 

(mean particle size: 20 microns) 

Silicone carbide and diamond particles (5 microns) 

embedded into a silicon elastomer. 

HiLuster PLUS Dia Polishers 

Flame 


Minipoint 


Material of Mandrel: 

Golden coated mandrel 

Cup 


Cup 



39

Usage on different surfaces 

Comparison HiLuster Polishing System and Enhance+PoGo 

polishing system used on Herculite XRV Ultra 

Gloss Plus Polisher 

1: Reference surface 

OptiDisc coarse/medium 

OptiDisc sRa: 0.56 µm 

2: Polishing Enhance + PoGo HiLuster PLUS Polishing 

system 

Flame Minipoint Minipoint Cup 

Enhance sRa: 0.6 µm 

Gloss PLUS sRa: 0.27 µm 

HiLuster Plus Dia Polisher 

2: High Gloss PoGo HiLuster PLUS 

Polishing 

Polishing system 

Enhance sRa: 0.32 µm 

HiLuster PLUS Dia sRa: 0.14 µm 

Enhance is a very aggressive polisher, leaving high surface 

roughness. PoGo polisher has the ability to smooth the 

surface after Enhance but the final surface roughness 

sRa = 0.32 µm is not considered as high gloss surface. 

A much smoother and high gloss surface of sRa = 0.14 µm 

is achieved with 2-step HiLuster Polishing system. 

Flame Minipoint Minipoint Cup 

40 





OptiShine 

The first concave-shaped polishing brush 

Features 

• Efficient in practice. The concave shape of the brush is efficient on all tooth surfaces, 

also on less accessible surfaces like interproximal and occlusal fissures. 

• Universal use. Always produces excellent polishing results for all restorations due 

to the concave shape of the brush. 

Reduce the surface roughness without changing the anatomical shape and the micro surface texture. 

• Excellent polish. The polishing effect is created by polishing particles embedded in the bristles 

(silicone carbide), therefore no paste is necessary. 

• Durable for multiple use. Autoclavable at 134 °C, at least 3 min. 

No effect on the polishing performance. 

Good accessibility 

due to concave shape 

of OptiShine. 

Each bristle 

is a polishing 

instrument. 

Specialfibres with 

in-built silicon-carbide 

abrasive particles. 

OShine: sRa=0.25 µm 

Not liable to confusion. 

Easily recognisable 

by the golden shaft. 

Good accesses to the fissures and occlusal surfaces. 

41

Herculite XRV References 

1. Effect of delivering light in specific narrow bandwidths from 394 to 515nm on the micro-hardness of resin 

composites. Price RB, Felix CA. Dent Mater. 2009 Feb 23. 

2. Shear strength evaluation of composite-composite resin associations. Ribeiro JC, Gomes PN, Moysés MR, 

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42 



Authors Biographies 

in alphabetic order 

Prof. Martin Jung, DDS 

Policlinic for Conservative and Preventive Dentistry 

Faculty of Dentistry, Justus-Liebig University, Giessen, Germany 

martin.jung@dentist.med.uni-giessen.de 

Study of Dentistry at the Justus-Liebig-University, Giessen, Germany, 1979-1984. 

Approbation for Dentistry, 1984. 

Scientific Assistant in the Policlinic for Conservative and Preventive Dentistry at the Faculty 

of Dentistry, Justus-Liebig-University in Giessen, Germany, 1985. 

Promovation (thesis: “effects of rotary instrumentation on surface of human teeth”) 1989. 

Assistant Medical Director in the Policlinic for Conservative and Preventive Dentistry, 1992. 

Habilitation (“Finishing and polishing of indirect ceramic- and composite-inlays in-vitro and 

in-vivo”) at the Faculty of Dentistry, Justus-Liebig-University, 1999. 

Professor for Conservative Dentistry, 2005. 

Specialist for Clinical endodontics, 2006. 

Main scientific activities: dental materials, surface quality of restorative materials, oral 

hygiene products, endodontics. 

Dr. Nick Silikas, BSc, MPhil, PhD, FADM 

Lecturer in Dental Biomaterials Science 

University of Manchester, UK 

nick.silikas@manchester.ac.uk 

Dr. Nick Silikas is currently a Lecturer in Dental Biomaterials Science in the School of 

Dentistry at The University of Manchester. He was born in Greece but has completed all 

his Higher Education studies in Manchester where he obtained a BSc (Hons) in Chemistry, 

an MPhil in Pharmacy, and a PhD in Dental Biomaterials. 

He is an Editorial Advisor of Dental Materials-Journal for Oral and Craniofacial Biomaterials 

Sciences [Elsevier Science]. He is a Fellow of the Academy of Dental Materials (FADM) and 

a member of the International Association of Dental Research (IADR). 

His research interests lie in surface Imaging & Analysis. His expertises are in characterizing 

interfaces using several techniques like Atomic Force Microscopy (AFM), X-ray 

Photoelctron Spectroscopy (XPS), FEG-SEM, Fourier Transform Infra-Red Spectroscopy 

(FTIR) etc. He is also involved in studying mechanical properties of materials using nanoindentation 

and traditional mechanical testing (3-point bending, compression, flexure etc.). 

Prof. Angelo Putignano, MD, DDS 

Professor of Restorative Dentistry, Head of Endodontic and Operative Dentistry Dept., 

Dean School of Dental Hygienist 

Polytechnic University of Marche, Ancona, Italy 

aputi@tin.it; a.putignano@univpm.it 

M.D. degree and D.D.S. post graduate certificate from the University of Ancona, Italy. 

Full professor in Restorative Dentistry at School of Dentistry Polytechnic University of 

Marche, Ancona. 

Head of the Operative Dentistry and Endodontic department at School of Dentistry 

Polytechnic University of Marche, Ancona. 

Dean School of Dental Hygienist Polytechnic University of Marche, Ancona. 

Active Member of the Italian Society of Operative Dentistry (SIDOC), as well as of the 

European Academy of Esthetic Dentistry (EAED). 

Founding Member of the Academy of Minimally Invasive Dentistry (ACAMID). 

Private practice in Restorative Dentistry, in Ancona. 

Co-author of the book “Adhesive Dentistry: the Key to success” edited by Quintessence 

International. 

Prof. David Watts, DSc, PhD, FInstP, FRSC, FADM 

Head of Biomaterials/Biomechanics Research Group 

University of Manchester, UK 

david.watts@man.ac.uk 

Professor David Watts, PhD leads the internationally-reputed Biomaterials/Biomechanics 

Research Group in the University of Manchester, School of Dentistry, investigating basic 

hard-tissue structure/properties, biomimetic-composites, new scientific instruments, 

photon science and developments with dental/orthopaedic industries. He has successfully 

supervised 40 PhD Theses and has 250+ peer-reviewed research papers. Professor Watts 

holds Fellowships of the Royal Society of Chemistry, the Institute of Physics and the 

Academy of Dental Materials and is also Research Professor at Oregon Health and 

Sciences University, USA. He received a Doctorate of Science from the University of 

Athens and the 2003 IADR Distinguished Scientist [Souder] Award for research in dental 

biomaterials. He became Editor-in-Chief of Dental Materials – Journal for Oral and 

Craniofacial Biomaterials Sciences [Elsevier] in 1998. Since 1986 he has served as UK 

Principal Expert to International Standards Organization TC 106 (Dentistry), on ceramics, 

resin-composites and photo-polymerization. 

I wish to thank sincerely our eminent authors, Prof. Martin Jung, Prof. Angelo Putignano, 

Dr. Nick Silikas and Prof. David Watts for the valuable support, scientific contribution and 

guidance to the realization of the Kerr Restorative Clinical Booklet. 

Heartfelt thanks also to the Kerr Innovation and Product Management Teams for the 

significant input and collaboration. 

Manuela Brusoni 

Clinical Affairs Manager Europe 

manuela.brusoni@kerrhawe.com 

43

KerrHawe SA | Via Strecce 4 | P.O.Box 268 | CH-6934 Bioggio | Phone ++41 91 610 05 05 | Fax ++41 91 610 05 14 | www.KerrHawe.com 

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