207. Mark Latta, DMD, MS - Bonding to Old Composite
Jan 15, 2024
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Dr. Mark Latta discusses the success factors in a clinical situation, advancements in dentistry and composite technology, challenges faced by clinicians in material selection, clinical trial failure, bonding to old composite, and the effects of saliva contamination on dental adhesives.
The success of dental restorations is determined by the care, skill, and understanding of the provider, rather than the specific brand or type of material used.
Proper cavity preparation, managing polymerization stress, and balancing occlusion are crucial for successful composite placement in dental restorations.
Deep dives
The Importance of Clinical Skill and Judgment
The success of a clinical situation depends on the care, skill, and judgment of the provider and the appropriate application of materials. It is not solely determined by the specific brand or type of material used. The understanding, utility, and proper usage of materials play a crucial role in maximizing their performance.
Factors to Consider in Composite Selection
Composite materials for dental restorations do not significantly differ in physical characteristics, strength, or wearability. The choice of composite material depends more on factors such as handling, aesthetic properties, and translucency. Microfills may not be suitable in areas prone to extensive wear. Overall, the clinician's skill and understanding of the materials are key to achieving success.
Managing Stress and Marginal Integrity
Composite restorations generate stress at margins, which can lead to cracks or failure. Proper cavity preparation, eliminating unsupported enamel, and managing polymerization stress are all crucial for successful composite placement. Balancing occlusion and avoiding parafunctional habits are also important. Modern composites can withstand wear well, especially in a properly managed clinical environment.
The Importance of Isolation and Contamination
Meticulous isolation is crucial for successful bonding and composite placement. Salivary contamination can degrade the bonding ability of dental adhesives and compromise composite integrity. Hydrophobic materials like composites are particularly sensitive to moisture. Dental dams generally provide better isolation than alternatives like the Isolite device. Operator judgment and clinical situation assessment play a role in determining the necessity for isolation.
Mark A. Latta, D.M.D., M.S., professor of general dentistry,served as dean of the School of Dentistry from 2011 to 2021. Prior to the dean’s appointment, he served as the Associate Dean for Research at Creighton University School of Dentistry since 1995. He personally has been awarded more than 140 research grants on prosthetic dental restorative materials, adhesives and bonding and dental material clinical trials. A speaker and lecturer of international renown, he has published more than 85 manuscripts and more than 200 abstracts and presented at numerous state and national dental association meetings and throughout the world. Prior to joining Creighton, Latta served as director of Research and Development for the Trubyte Division of Dentsply International, York, PA. During his industrial career he contributed to or was responsible for more than 20 new dental product introductions and is an inventor or co-inventor of numerous patents. He earned his dental degree at the University of Pennsylvania School of Dental Medicine in 1983, and his master’s degree in oral biology from the University of Maryland Baltimore College of Dental Surgery in 1995. He also spent one year in hospital general practice residency at York Hospital, York, PA. Dr. Latta, a Fellow in the American College of Dentists and the International College of Dentists is also a member of Omicron Kappa Upsilon, the national honorary dental society. He has also served as president of the Dental Materials Group and the International Association for Dental Research.
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