Restorations real rivals today enamel wear and keep it as low as three micrometers per year
Dr. Samuel Waknine interviews New York, Dentistry Cosmetics Dr. Judy Johnson, Chief Medical Officer, visits to the dentist in Midtown Manhattan New York Center for Cosmetic Dentistry, the importance and benefits of using optimal restorative materials in modern dentistry. Dr. Waknine is chairman of the DRM Research Laboratories, which is mainly involved in research and development. He lectures at the university and the private sector, providing the technology or instruction manual for physicians and technologists worldwide.
(Question) New York Cosmetic Dentist Dr. Judy Johnson: Do you think the Central and Eastern Europe or the U.S. markets are ready for products high aesthetic quality and state of-the art materials?
(Answer) Samuel DDS Waknine: I think so! I had extensive experience in conferences around the world and interact both in industry and in clinical and academic sector technologists of many teachers and doctors to know if it is in Lithuania, the Czech Republic, Poland and Russia. In fact, these materials are increasingly popular in these places due to the fact that firstly, they are easier to use, secondly, that require less machinery and laboratory equipment and, thirdly, the president in time secondary education is significantly reduced.
The main disadvantages of this equipment is more sophisticated requires a dry field of operation during the installation procedure of the moment, however, I think the advantages outweigh the disadvantages due to the fact that this was a case that is functional, aesthetic, matches the color of the teeth, which is biocompatible and is used in better general health compared with fillings amalgam and crown bridge traditional standard cobalt, chromium and nickel, chromium and silver-palladium products.
Traditional materials are needed two or three days and a host of equipment, instruments and equipment, booster before a crown or bridge is made, only one of our material is capable of producing a food large enough or large, less than an hour. Thus, in time, effort and perspective of the teams is the preferred method for the laboratory.
(Question) New York Cosmetic Dentist Dr. Judy Johnson: Are the benefits others of modern restorative materials?
(Answer) Samuel Waknine DDS: Yes Looking at the dental restoration in a chronological order, from infancy to adulthood, from pediatric dentistry, geriatric dentistry, start with a small surface cavity that escalates to a two-surface filling, then possibly leaks and should be repaired and becomes a pin-retentive three - Or four silver amalgam filling undermine the enamel surface around, and then a crown (usually poorly adapted or seal), followed by root canal treatment and a post / buildup encapsulated by a prosthesis of the crown and possibly a collection, even a bridge, not normally an ally (porcelain fused to metal), after alveolar bone absorption, and possibly a denture or partial denture followed maximum increase and possibly an implant.
Due the amalgamation of money are very limited, usually must be repaired in line somewhere. As should be repaired, the site of the carious lesion has generally grown as broadly as it invariably becomes a three-quarter crown or a crown. Sometimes even the use of crowns and bridges.
The approach poly-Ceram modern restorative materials is that if you can get a very good seal to the tooth restoration interface, which is really the center or area of concentration in technology, and then you can reduce the possibility of having to rebuild and restore the flow of the road very difficult and complicated. This is not the case of advanced materials restoration. If there is a failure tends to be relatively minor and require very rapid review and repair at the interface of adhesive and if the incidence caries, remakes or repairs is significantly less than the potential costs and loss of teeth. That is a big advantage if you are in Prague, London or New York.
(Question) New York Cosmetic Dentist Dr. Judy Johnson: What about the issue of sustainability?
(Answer) Samuel Waknine DDS: It a very good point. There is a tendency to judge the restorers of poly-Class Ceram today by "the separation of them" in the 40 years, particularly among dentists who were familiar with these products there. However, composite materials or paste 40 years are far from what is available today. Since traveled about seven generations of products and probably tens of thousands of research projects documented in the form of manuscripts and patents, so there was much of the progress of innovation in this technology.
Therefore, there are now several products that are very reliable. From the standpoint of wear resistance, the restorations are now able to argue that usury is as low as three micrometers per year - which competes with real enamel. This compares with 40 years ago when it was 150 microns per year. According to statistical data collected from clinical restorations today have an average life of 17-22 years, which is very close to a restoration amalgam and / or metal-ceramic crown. Against a background of color stability of these products more residual oxide, which tend to be very stable and tend to maintain its anatomical shape, contour and texture and overall functional status physical and mechanical properties. So yes, there are still materials that today are not very reliable, and then there are some materials that are very advanced and can compete with any ancillary equipment, metallurgy and ceramics.
(Question) New York, Dentistry Cosmetics Dr. Judy Johnson: Would you say that, while these materials could perhaps be a little more expensive in the long run it saves much time for working more cheap?
(Answer) Samuel DDS Waknine: Well, cost is certainly a factor, but people in society today are more health conscious and aesthetically knowledge and are also factors to be considered. I believe that a restoration of money for a back molar is 50/50. Nobody looks down so that it can not be too important. However, a previous restoration there is really no choice in the matter, the thought of gold or silver which is a little awkward smile therefore more aesthetically nice materials become a matter of necessity. So for the Intra-oral anterior middle is a necessity. Moreover, since the coach is concerned, the materials modern are faster and easier to use and it is really no reason not to choose.
(Question) New York Cosmetic Dentist Dr. Judy Johnson: Could you tell us a little more about the history of dental restorations and the progress made in recent years?
(Response) Samuel DDS Waknine: Traditionally, metallurgical materials were used for restorations. It was an established practice for most of the 150 years. In the case of fillings, silver amalgam have been used throughout the world greatly. These amalgams are 50 percent powder - made money, tin, copper and a tiny amount of zinc, liquids and 50 per cent - which is pure mercury - joined to form a paste that is placed in the cavity. Money Merge react with mercury, copper, while interacting with the bank to create a building complex copper-tin / hardening of the interface and zinc acts as a treasure to remove any residual oxide of unreacted metal. This material is not very sensitive, with almost zero handling and error handling features, it is advantageous to the clinician, as it can be placed in a moist environment, which forgives an acute isolation technique, rather than adverse effects teeth margin integrity of the interface. However, There are serious drawbacks to this type of material mix of silver, compared with the poly-Ceram modern composite fillings.
Silver amalgam is not color the tooth and is quite evident when placed in the pre-oral cavity. However, poly-modern ceramic composite can achieve almost perfect match tooth color. Also, if the amalgamation, the money is applied to more than one third of the slope of the cusps, tends to erode the enamel surrounding thin remaining wall leading to rupture of cusps and / or radial cracks threaten the conservation of the issues surrounding the tooth or restoration itself. The poly-Ceram is capable of forming chemical bonds, bonds of the underlying dentin organic and micro-mechanical bond to the honeycomb structure around the enamel prism with the help of modern technology of adhesive seventh generation.
This allows a more conservative approach to the criteria of the tooth preparation guidelines with greater emphasis on conservation of the lack of a healthy tooth structure decay. Instead, these advances in technology have enabled the accession of more substantial major restorations in place to hinder the structural strength of the remaining teeth, especially with the advent of image-was hired by oral onlay (three quarts) of the cemented crown cemented restorations.
The metal product of the amalgam is a conductor of electricity, is this not the most pleasant material to have in your mouth. In contrast, poly-ceramic composite fillings is not electrically conductive. Silver amalgam is also suffering from abrasion phenomenon that leads to degradation, allowing leaching of mercury content of some of the seals, which were known to affect the kidney and some liver enzymes and even penetrate the blood-brain barrier. Although salt is different from free mercuric mercury secreted form, this remains a controversial issue.
Whereas poly-ceramic composite of the decade 1960 due to increase of 150 microns is now a year (about 1993-2003) poly modern ceramic composites are able to maintain an attrition rate Clinical 3-35 microns per year, improved pivot. The corrosion product of dental amalgam by the possibility that seals the edge of the restoration of the tooth, instead of the chemical bond, also known as Gamma-called Phase II. To counteract the phenomenon of corrosion, both marginal deterioration, surface modes tray corrosion and tarnishing, the high-copper amalgam have been innovated, however, a clear disadvantage of the accentuation of the gamma-Phase I is that it takes more than fracture in large numbers and spread of mercury salt facilitated by the release of products.
The rules GV Black cavity preparation has innovated Protocol in 1898 and is still practiced today, the state of necessity "extension for prevention", in other words, extending the cavity preparation, excavation beyond the limits of the rotten area to prevent recurrent caries, therefore, consume more tooth structure. Moreover, given the fact that amalgams Money does not fit the chemical structure of the teeth, creating diatoric ways, roads, drainage and macro-mechanical retention areas during the cavity preparation is necessary for the sound of the amalgam and adverse sacrificing tooth structure stronger. In this during tooth preparation is committed to a large extent, the tendency is to use the gold to anchor bolts retaining and maintaining the silver-mercury invasive Admix also an unnecessary step.
Previous research has shown that silver amalgam mod '3 '- niche area, such as cavity preparation restored molar Class II argues that 50 per cent of its restored molar intercuspal flexion. In addition, a modern composite restoration poly Ceram strengthens tooth 2xfold intercuspal potential transverse force. Money amalgam restorations in Class II molar high, inevitably cause a large tattoo of permanent discoloration even violet-gray/green brown dye / color black is quite evident when a doctor has requested the removal, replacement or repair of an old not the silver amalgam restoration. This is not the case of poly-Ceram Modern composite fillings. Accordingly, such restorations in the last 20-25 years has become less popular alternative, also known as bonding or white fillings (known as composite or predominantly) are now available.
(Question) New York Cosmetic Dentist Dr. Judy Johnson: Could you tell us about your area of expertise?
(Answer) Samuel Waknine DDS: DRM Research Labs in our area of expertise meets these restorations replacing polymeric materials consisting of glass and ceramic fillers for the reinforcement. Restorations are used for a multitude trading of oral care, such as ships, cement, sealants, Class V cervical erosion sites, and direct restorations, class I, II, III and IV, the restoration of teeth before and after. They were initially available in self-healing (2-party system) in the 1950s-60s, then cure the UV photo initiated (200-400 nanometers). In the 1970s and late 1970s throughout the melting zone to cure blue picture or halogen curing light materials that are released by a blue light ranging from 400 to 700 nm wavelength radiated by 10-40 seconds. Light causes a reaction without radical addition to the material that converts a monomer (liquid) to a polymer (a solid) cured material.
These materials have been many problems, most of which were resolved in recent years the technology has become more refined. Our area of concentration and innovation is the original semi-poly-crystalline nano-technology enhanced Ceram and assistant online, including the burden of this innovation is the key product line of diamond. There are a number of affiliates at this from DiamondBond Advanced sticker, shirt / concrete sealant, DiamondLink, filling, crown DiamondLite prosthetic and bridge system, DiamondCrown. It is the crystal morphology and oligomers Ceram specials features the interface of these materials certain physical, mechanical, optical and wear resistance properties that rival standard polymer composites amorphous.
This special technology has improved color stability, tooth-colored improve playability, the significantly higher resistance to force Last minute near zero leaching / solubility, resistance to wear huge, significant contraction forces of polymerization shrinkage, a significant improvement in marginal integrity of adhesive teeth due to advanced liaison mechanisms, the tenacity of the formulation biocompatible and remarkable, absorbing Shock of the characters, making this technology to exceed the level of restoration niche in the field of reconstruction materials, including prostheses and implants.
It is particularly interesting field of prostheses and implants, due to the fact that traditional infrastructure superstructure encapsulating or coating alloy metal on which they characterized as the dental porcelain surface very hard and brittle which is relatively inflexible and complex laboratory methods of application. The PFM (porcelain fused to metal) restoration, although very people is permeated by a range of disabilities related to:
i. The mechanical properties material witness porcelain dental particularly difficult, four times that of natural tooth structure, which is rather un-forgiveness, is opposed to the dentition, low tensile and bending mode (low resistance), and most important of the hardness reaches very low, therefore, unable to dissipate the energy of the chewing cycle. Therefore, it is prone to fracture, delamination of the basic structure of metal retention, often requiring complex intra / extra oral repair.
II. This situation is further complicated by the use of porcelain dental alloys as covers popular frameworks such as dental or palladium, nickel, chromium and silver, which have been documented to ensure responsiveness to cytotoxic intraoral epithelial membrane contact areas of the mucosa of the soft tissues, causing erosion of the cervix, pocket formation, degradation and loss of papillae interdentinal ligation periodontal attachment, the acceleration Mobility and threaten the overall stability of structural architectural ergonomics tooth.
III. Lack of an underlying metal substructure aesthetics or tooth color matching capability requires a commitment more tooth structure for immersing the metal neck of the restoration of the crown, giving a margin below line cervical gingival gum tissue under the gumline. This also led to bio-interaction within the fold of Perio-impaired and ligation maintenance of poor hygiene due to inaccessibility to brush their teeth and the activity of toothpaste.
IV. These factors are collectively large branches, When these materials, porcelain is used in dental implant prosthesis. Especially in a single implant and the most popular techniques of immediate loading, shock-absorbing, hardness, functional and maintenance, along with the breathtaking beauty of the semi-crystalline nano-reinforced Poly-Ceram DiamondCrown technology competes with any dental implant titanium porcelain superstructure. This is of great importance, particularly fragile transition osseo integration implant (crown) periods of burden that will dictate the success rate of the possible integration of implants and prosthesis maintenance.
Furthermore, in complex cases of joint disorders Temporomandibular is widespread and the potential of teeth clenching and jaw tension characteristic phenomena are clear, semi-crystalline DiamondCrown technology, serves its purpose as the final restoration to be used for occlusal rehabilitation. At the shock, cyclic energy dissipation micromorphology masticatory particular crystal plates leads to a micro-elastic behavior of poly strengthen interdendritic Ceram allows the stiffness and macro architecture despite the occlusal dispossession tormented. Furthermore, the strengthening of the ability to repair and maintain intra-oral versus the industry standard, gold tooth.
(Question) New York Cosmetic Dentist Dr. Judy Johnson: Would it be advisable to carry out special training before using new restorative materials?
(Answer) Samuel DDS Waknine: Yes, training and education is a key factor in the dissemination of methodologies and techniques proper operating affiliated with this new generation of materials. The learning curve associated with increased generation of materials metallurgical, an intra-oral in terms of investment of attention, is not very pronounced, and become more adept at this type of restorative dentistry is very important to conduct clinical workshops and meetings, or even chair of workshops for creating greater awareness about what is proper or surgery, or technical cooperation protocols cause a type of chair side success, their clinical indications for and ramifications.
(Question) New York Cosmetic Dentist Dr. Judy Johnson, who could conduct these workshops?
(Answer) Samuel DDS Waknine: Actually the conduct of these workshops with a team of technicians, medical and scientists. From one country to another and try to help generate greater awareness of appropriate methodologies associated with Advanced clinical engineering biomaterials chemistry. This makes the real success of this science of restoration - education.
About the Author
New York Cosmetic Dentist Dr. Judy Johnson and Dental Visits Midtown Manhattan NYC Cosmetic Dentistry Center now accepts dental insurance health plans for most dental care. Write New York City Cosmetic Dentist Judy Johnson DDS, for more information on cosmetic dentistry, dental implants, veneers or just dental visits topics. http://www.dentalvisits.com
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