Dr. David Alleman, an experienced dentist, delves into the root causes of dental failures, focusing on micromovements and infections. He emphasizes the importance of preventative measures in adhesive dentistry to avoid bacterial leakage and fractures, highlighting the significance of understanding dental anatomy and chemistry for successful restorations.
Addressing cracks at the submicron level is crucial for strengthening dental restorations.
Preventing bacterial entry at the nanometer level is key to successful biomimetic restorations.
Deep dives
The Concept of Sealing the Tooth in Adhesive Dentistry
In the podcast, the host discusses his journey in dentistry and the realization that traditional restorations were failing due to issues like decay caused by bacterial entry at micron levels. The introduction of adhesive dentistry from Japan with the concept of sealing the tooth to prevent bacterial infiltration provided a new perspective. This approach focused on creating a bond that could prevent infection and decay, leading to a significant shift in the host's understanding and practice.
Understanding Fracture Causes and Solutions
The podcast delves into the issue of fractures in dental restorations, a significant challenge faced by the host in his clinical practice. By visualizing cracks and using advanced techniques like C-Tectin dye and microscopy, the host identified the importance of addressing cracks at the submicron level. Insights from engineering principles on crack propagation and treatment highlighted the necessity of dissecting cracks to ensure effective bonding and strengthen the restoration.
Importance of Preventing Micro Leakage and Micro Movements
The podcast emphasizes the critical role of preventing micro leakage and micro movements in achieving successful dental restorations. By focusing on sealing out bacteria at the nanometer level and addressing microscopic movements within the tooth structure, dentists can establish a foundation that mimics natural teeth. This approach, known as Biometric Restorative Dentistry, aims to create biomimetic restorations that prioritize preventing failures related to decay and fractures.
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Exploring the Causes of Dental Failures and the Importance of Preventative Measures
Where do failures happen in dentistry? At the micron level. Bacteria create infections; micromovements initiate cracks; these are the root of failed restorations, infected pulps, and cracked teeth. Experiencing his own failures from traditional and early adhesive restorations, Dr. David Alleman discusses how thinking small led to significant advancements in restorative outcomes.
Articles referenced in this episode:
Intro-3 Magne P, Belser U. Rationalization of Shape and Related Stress Distribution in Posterior Teeth A finite Element Study Using Nonlinear contact Analysis. J Periodontics Restorative Dent. 2002;22-425-433
Magne P, Oganesyan T. CT scan based finite-element analysis of premolar cuspal deflection following operative procedures. J Periodontics Restorative Dent. Volume 29, Number 4, 2009:360-369.