Correct choice of dental restorative materials. Lecture Restorative Davangere.pdf · 2018-02-02 · Information from producers Rule 1. Manufacturers’ role in this world is to generate

· .................... ,', .. , .. , .. Academy of Continuing Education

and Department of Prosthodontics

College 0' Dental Sciences Davangere

cordially Invite you to the

Inaugural Cerenloni of the

MILLENNIUM LECTURE SERIES Chief Guest

Or. M. S. Goud President, Indian Prosthodontlc Society

Guest of Honour

Shrl 1. P. Vlshwaradhya Chairman, College of Dental Sdences oavangere

Seedal Inyltm

Dr. Asbjom Jokstad AssocIate Professor Faculty of Prosthodontics Oslo University, Norway

Dr. M. L. Kulkaml Professor & Head

Dept. of Pedlab1cs JJM Medical College

Dr. S. M. lashl Prosthodntlst

Pune

Friday, 9th March 2001, 09.30 am Seminar Hall, College of Dental Sciences

Dr. V. V. Su~ Reddy President, ACE-COOS

Brlg.(or) K. Xavler Mathew Organizing Secretary

44444444444444444444444444444444 I •

Choice of restorative

material

Asbjørn Jokstad

Institute of Clinical Dentistry

University of Oslo

Http://www.odont.uio.no/prosthodont/india

•Choice of restorative material

•Is there such thing as a correct

therapy in prosthodontics?

•Bridging the gap. Dr A.K. Ray

LUNCH

•Clinical cases

•Cost considerations in prosthetic therapy

•Randomised Controlled Trials

and Oral Implants

•Clinical studies on GTR techniques,

are they science-based?

Strategy for choice

• Patient wishes

Example: posterior composite resins

Patienl Demand ~I =====================:::;_-J '~proved Appearanee ~I::::::::==========~ ______ ~ Reading Seienllllc I I Papers "

Visit by Sales Represenlatlv ..

AfI .. ndanc .. al Poslgraduale Meellng

Co<Tlpany A 'dverllslng M.I.rla.

RecommendAtion by ColI.agu.

Undergraduat .. Us ..

Sta It U ... In Dental Hosplt .. 1

*' Other Factors

o D

o

I

10

I I

20 30 40

Nu~b .. r 01 Aespons ....

50 60

FIG 2 Factors influencing respondents decision to start using posterior composite materials .. • "'()ther factors" included: Curiosity; Anticipated strength of the (composite) material; Clinical preference for using composite materials.

Patient wishes….

Doctor of Dental Surgery?

or

Delivery of Dental Services?

D.D.S.=

Strategy for choice

• Patient wishes

• Advertisement

Advertisement- can

we believe in it?

•

N.Den",t",a!..1 _______ -"Miissnyheter Dental Scandinavia 99

Biokompatibla fyllnlngar, tandvardens framtid

DEFINITE Den innovafiva keramlkfyllnlngen I dlre"t appJlcerbara "apslar

av "ORMOCER" = ORganically CERamic. Fiirsta och enda biokompatlbla alternatlvf.

• Ilur kan keramikens hiigsta esletik uppnas rned DEfiNITE?

Kombinera ~ .

och

DeguSS8 •

Advertisement for the

composite HL 72. J

Nor Dent Assoc 1973.

Advertisement- can

we believe in it?

Advertisement- can we believe in it?

Adaptic. J

Nor Dent

Assoc 1974.

Information from producers

Rule 1. Manufacturers’ role in this world is to generate profits - not to improve dental health.

Rule 2. The marketing departments decide which information should be given to the dental community - not the research and development departments.

Be sceptical towards information highlighting:– Physical properties versus clinical performance

• Relevance

• Relationship?

– Referal to “data on file”

– Use of obscure dental terminology

– Graphical misuse of data

Inverted transverse elasticity

modulus*

50

55

60

Fantastic Product A Product B Product C Product D* Data on file

Solubility properties*

* according to o.o.t

0

0,5

1

Fantastic Product B Product B Product C Product D

Inverted transversal elastisticy

modulus*

0

10

20

30

40

50

60

Fantastic Product A Product B Product C Product D

This test

does not

exist

Value of axis

Clinical

relevance?

SD negate differences

Illusions

Value y-axis begins at 0?

Maximized differences

3D effects

Inverted transverse elasticity

modulus*

50

55

60

Fantastic Product A Product B Product C Product D* Data on file

Solubility properties*

* according to o.o.t

0

0,5

1

Fantastic Product B Product B Product C Product D

Value of axis

mg ?

Ppm?

Ppb?

= our own test

40% HCL?

Clinical relevance?

1997

1997

1998

Advertisement- can

we believe in it?

s The first t rue alternative to amalgam

Nytt polyglasS fyllingsmateriale

solita\re® Tall"leg Br/lgl-,{ke O,.,.cll JICI 51",r/l:,-/lor Il'lles III pl'O/llere ~en .\001 e" god k'#f,iker so'" ",er cun gjerne [(erer IH'''' \flU!

k"u"yktf~r ug /crdlgh(-'It'f'.

TlI""/t'~t' om" Illr'ill"r mt'" l'Or t:1I1lJS 1u ""t' uf SolJlaltV t'" f/tk..t a "d,JJtt' .. 't\ er "ft.'!:"h,,' klC'M.frl fig gll' gtXIr korlt...JcrptJII11I.'" K on SiJ/t.,,{(1I/iIlIU,Tll ...... .,. ... U •• ,,· nU/llwJllcl/t'H ~fot~ IL1/Cr

er J,,'(. 1If .. '" Itn d poI,-"-1.: ug haY ~rl;·\lelle plItV"II"'l(f.,.m~<r ~'1:NI</ciJp4'r ,~I)ftf s::Jnr Itll¥tl"'IOlc( ~""k'c, dlll!,dc.

Lcgl! opp matcrh\\C\ 1

lr.,a' HcltD ~ed hjclp 0'" tl plunnUlfumell\ cHef eT' :smalgal1tft"tul L~¥i ,,,nit matenalc\ t "Ppt'u,,\t1\J\~ rornmeuc (\ l~ 2\

.. onlk'1l~" "lalcrWlclll\O\

Ul"lCl ,'I!i\¥,cn tned hje\p '" eI P",send< "kood<ns<n"~'" _UtiU'UllleOl (I' I@. 3.4), "Vnnhgc- a'"~\g"n\_lUS.U'Ullltl\lCr

p,\ _~ortk",al mm med ham i {QI;bil'Ic/,'Is<

nU'd de ~\:Cl:r( j!mJl bordJ(.n1(m~lra~)QII4.U(. d

conl/)()"'(JOOf'HO/lfot1elkl' at lu," slckn hrukl S"II1uire, cl (.1\.' Je (am1l'r'1IU(lUn~'mllt4:r""t'IU.

\

pr«\usenten ol'lllyscC tlo\ygItP.s fy'hnb~tcriak ~'l\tCf1orc c~tcl''\\.;C I)," kOIl"wppby.wng 01l

2

Features& Properties

Strategy for choice

• Patient wishes

• Advertisement

• Use what others use

Metall Tooth colored

1963 Innes, Canada Dispersion amalgam (Dispersalloy)

1965 McLean, UK Al-porcelain

1969 Wilson & Smith, UK Glass-ionomer cem. (ASPA I)

1972 Mahler, USA Hi-Cu amalgam

1973 Asgar, USA Ternary amalgam (Tytin)

1976 Allen, USA Polymerisation with light

1978 McLean, England Cermet ionomer

1980 Lutz, Sveits Indirect inlays

1982 Nakabayashi, Japan Hybrid-layer in dentin (Clearfil)

1984 Mörmann, Sveits CAD-CAM concept (Cerec)

1987 Malament, USA Cast glass-ceram (Dicor)

1988 Sadoun, Frankrike Slip-infiltrate ceram (In-Ceram)

1989 Cast titanium

1990 Tokuriki, Japan Gallium-alloy

1990 G-C, Japan Resin modi. GIC (Fuji IILC)

1994 DeTrey, England Carboxylatemod.resin (Dyract)

1995 ADA/NIH, USA Colloid silver-alloy (Exp.)

1998 Degussa, Tyskland ”Ormocer”

1999 ”Ceromer” (Solitaire)

2000 ”Flowables”

Restorative materials in use

"Tooth colored materials"

1. Glassionomer: metall-reinforced / conventional

2. Glassionomer modified with resin (RMGIC)

3. Composite resin with glassionomer (“compomer”)

4. Composite resin: macro-, micro-, hybrid, "flowable”

5. Composite resin, inlay: clinic / laboratory

6. Ceramic, inlay: sintered / cast / CAD-CAM

7. Polyglass/ceromer/crystal polymer/polymer ceramic

8. Ormocer - "flowable ceramic”

9. Doxadent - “ The ceramic restoration that forms directly in the tooth”

Alternatives in Class II

0 %

20 %

40 %

60 %

80 %

100 %

Usa

1.

Norw

ay n

ew 2

.

Norw

ay R

ev. 2

.

Sw

eden

UK 4

.

Publ H

lth n

ew 5

.

Publ H

lth rev

. 5.

Gold

GICMod

GIC

Composite

Amalgam

1. CRA , USA 1995

2. Mjör et al., 1999

3. TIA, Göteborg, 1992

4. Burke et al., 1999

5. Vestfold THT., 2000

Strategies for choice

• Patient wishes

• Advertisement


• Dental faculties, procedures

Restaurering-bilder

Product concepts 1/2

Produsent Adhesiv Sement Restaureringsmateriale

3M Scotchbond MPScotchbond 1

3M Polymer CementOpal CementVitremer

P-50

Bisco All bond 2AelitebondOne-step

C&B CementChoiceDuo-link

Coltene-Whaledent A.R.T. BondOne Coat Bond

Duo Cement Brilliant D.I

Den-Mat TenureTenure quick

InfinityUltraBond

CerinateTrueVitality

Dentsply Prime&BondPrime&Bond NTProbond

AdvanceColorlogicComspanMGC Lute CompositeEnforceDyract Cem

BiodentCaratCeramcoDicorFinesseMaxximPrisma AP.HTriad

ESPE EBS- multi CompoluteSono-CemKetac Cem

Pertac II

GC - G-Cera Porc.Ven.Bond.Syst.Fuji Plus

GC CosmotechG-Cera

Product concepts 2/2Produsent Adhesiv Sement RestaureringsmaterialeHereaus Kulzer Solid bond P & C 2bond2

TwinlookCharisma CSArtglass

Jeneric/Pentron Bond-1Conquest

Cement-It!Lute-It!Optec Universal Bond.System

OptecPreludeSynspar

Kerr Manufacturing Optibond FLOptibond solo

PorcelitePorcelite DCNexus

Herculite XRV Lab

Kuraray Clearfil Clearfil CR Inl.Cem.Panavia

Clearfil CR

Mirage (Chameleon) ABC EnhancedMirage Bond PlusWetbond

FLC VisionMirage Metal Resin Cement

FortressMirage

Shofu Imperva Bond Imperva Dual Resin Cement Vintage value

Ultradent Permagen Permalute -

Vivadent/Ivoclar SyntacSyntac sprint

Dual CementProTec CemVariolink IIVariolink Ultra

Empress IIIPS EmpressSR-Isosit (Concept)TetricTargis-Vectris

VOCO Solobond PlusSolobond M

AvantoBifixF-21

-

....................................................................................................................... ----~~~ ~&~~~---


• Patient wishes

• Advertisement



• Guidelines: e.g. from Health

authorities

Fissure sealants

Dental faculty, Oslo:

Delton

Tetric Flow

Helsedirektoratets veileder for bruk av tannrestaureringsmaterialer.

Tabellen er en anbefaling og utelukker ikke andre valg ved spesielle indikasjoner.

Standardmateriale representerer det materialet som det vil være mest ønskelig å bruke.

Lokalisasjon Standardmateriale Alternativer Kommentar

Fissurforsegling kompositt

Deciduous teeth





Klasse I

primære molarer resinmodifisert

glassionomersement

kompomer, kompositt Muligheten for fuktighets-

kontroll har betydning for

valget

Klasse II

primære molarer resinmodifisert

glassionomersement

kompomer, kompositt

Klasse III

primære insisiver resinmodifisert

glassionomersement

glassionomersement

Aproximal, anterior, small

1. choice

composite (microfill)

Silux Plus

Tetric Flow

Caries active patients:

Fuji IILC

Ketac Fil





Klasse III

permanente insisiver kompositt resinmodifisert glass-

ionomersement,

glassionomersement

Alternativene bør brukes

ved høy kariesaktivitet

1. choice: composite (hybrid)

Filtek Z250

Tetric Ceram

Z100


Fuji IILC

Ketac Fil

Aproximal, anterior, largeHelsedirektoratets veileder for bruk av tannrestaureringsmaterialer.




Klasse III

permanente insisiver kompositt resinmodifisert glass-

ionomersement,

glassionomersement

Alternativene bør brukes

ved høy kariesaktivitet

1. choice: composite (hybrid):

Filtek Z250

Tetric Ceram

Z100

Can be combined with microfill composites

Alternative:

Silux Plus


Fuji IILC

Aproximal, edge





Klasse IV

kompositt skallfasett3)

, kroneterapi2)

2) Kroneterapi: Kroner lages av en støpelegering, støpelegering –keram (MK-krone), støpelegering-

polymermateriale (kombinasjonskrone) eller keram, og materialvalg gjøres ut fra estetikk og bittforhold.3)

Skalfasett lages i keram eller kompositt

Aproximal, posterior, small

1. choice: composite (hybrid)

Filtek Z250

Tetric Ceram

Z100





Klasse II

premolar, liten fylling kompositt

molar, liten fylling kompositt amalgam, innlegg1)

1) Innlegg lages av en støpelegering, i keramisk materiale eller polymermateriale, og materialvalg gjøres ut

fra estetikk og bittforhold.

Aproximal, premolar, large

1. choice: composite (Hybrid)

Filtek Z250

Tetric Ceram

Z100

Amalgam

Ardent Futura NG-2

Dispersalloy

Alternatives:

ceramic innlay

composite innlay

Tunnel prep w/ Fuji II/ Ketac Fil

and composite





Klasse II

premolar, stor fylling komposittamalgam, innlegg

1),

kroneterapi2)


fra estetikk og bittforhold.2)

Kroneterapi: Kroner lages av en støpelegering, støpelegering –keram (MK-krone), støpelegering-

polymermateriale (kombinasjonskrone) eller keram, og materialvalg gjøres ut fra estetikk og bittforhold.

Aproximal, molar, large

1. choice:

Amalgam

Ardent Futura NG-2

Dispersalloy

Alternativ:

Gold inlay

Ceramic inlay





Klasse II

molar, stor fylling innlegg1) kroneterapi

2), amalgam,

kompositt

Buccal/lingual, posterior

1. choice (kl. V):

Premolars: Glassionomer

Fuji II LC

Ketac Fil

molars: Glassionomer

Fuji II LC

Ketac Fil

Alternativ:

Premolars: composite (microfylt)

Tetrik Flow

Silux Plus

molars: Amalgam

Ardent Futura NG-2

Dispersalloy





Klasse V

resinmodifisert glass-

ionomersement

kompositt, glassionomer-

sement, kompomer

Occlusal, molar, large

1. choice: composite (hybrider)

Filtek Z250

Tetric Ceram

Z100





Klasse I

molar, stor fylling kompositt amalgam, innlegg1)


fra estetikk og bittforhold.

Alternativ 1: Amalgam

Ardent Futura NG-2

Dispersalloy

Alternativ 2&3:

ceramics inlay

Gull inlay


• Patient wishes

• Advertisement



• Guidelines: e.g. Health authorities– Hidden agendas?

– Non-evidence based policies?

Political decisions have been made in

Norway, Sweden and Denmark to reduce

the use of amalgam


• Patient wishes

• Advertisement



• Guidelines: e.g. Health authorities• Clinical experience - sound judgement• Minimum tissue removal - biologic costs• Clinical evidence

– Contraindication?– Consequences of choice of material?

Clinical factors influencing treatment decisions

Patient

OperatorMaterial

Strategies for choice• Patient wishes

• Advertisement



• Guidelines: e.g. Health authorities

• Clinical experience - sound judgement– Minimum tissue removal, biological costs

• Patient preference

–Informed consent

?• Esthetics - be young

and beautiful

The future of restorative dentistry

• Controlled release of anticariogenic or antibacterial components

• Synthetic enamel (recombinant DNA-technology)

??!!

Doctor of Dental Surgery or

Delivery of Dental Services?

D.D.S.

Patient confidenceProfession

You

Documents

Correct choice of dental restorative materials. Lecture Restorative Davangere.pdf · 2018-02-02 · Information from producers Rule 1. Manufacturers’ role in this world is to generate