Six Lessons Approach Podcast by Dr. David Alleman

The Difference Five Minutes Make: Decoupling with Time

Jul 11, 2024

The podcast discusses the importance of creating a biomimetic bond in dentistry to prevent post-operative sensitivity. Dr. David Alleman introduces the concept of decoupling with time to ensure optimal bonding surface. Topics include hybrid layers, composite shrinkage, and bonding systems within the first five minutes of the polymerization process.

18:48

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Quick takeaways

Hybrid layers form at different rates based on hydroxyapatite levels, crucial for bonding surfaces.

Bonding tooth restoration within 5 minutes is vital to eliminate gaps and post-operative sensitivity.

Deep dives

Understanding the 6 Lessons in Dentistry

The podcast delves into the concept of the 6 Lessons in Dentistry, emphasizing that addressing all aspects is crucial to prevent potential oral pain. It explains how failure to connect a restoration side to side, front to back, and top to bottom can lead to tooth pain, highlighting the importance of maintaining the hybrid layer in restorations. The discussion mentions that disruption of the hybrid layer can result in pulpal fluid filling gaps under restorations, causing hydrodynamic pain during chewing. Strengthening the hybrid layer is presented as essential for comfortable dentistry.

Decoupling with Time in Dentistry: Exploring the Six Essential Lessons for Dental Health

12min

Creating Hybrid Layers in Deep Cavities and Decoupling with Time for Optimal Bond Strength

6min

Each lesson in the Six Lessons Approach to Biomimetic Dentistry (SLA) is essential to restoring a tooth in a way that stays bonded and symptom-free. These two failings of traditional techniques — debonded restoration and post-operative sensitivity — are addressed in each lesson, but when it came to the bonding stage of the restoration, Dr. David Alleman was able to reach a pivotal conclusion from the published research.

Different parts of the tooth form hybrid layers at different rates based on the amount of hydroxyapatite. Composite will shrink to the best possible bonding surface, potentially leaving gaps in areas that have weaker bond potential. Understanding how to overcome these two variables is key to creating a restoration that bonds the tooth side to side, front to back and top to bottom like a natural tooth. This biomimetic bond eliminates gaps under restorations that cause post-operative sensitivity, but it requires understanding how bonding systems, composite and dentin need to work together within the first five minutes of the polymerization process. Dr. David Alleman named this process decoupling with time.

Articles referenced in this episode:

Brannstrom M. The hydrodynamic theory of dentinal pain: sensation in preparations, caries, and the dentinal crack syndrome. Journal of Endodontics. 1986;12(10)-453-457

Send us a text

New 2025 training programs announced:
Biomimetic Mastership - class starts February 10. Learn more and register at allemancenter.com/mastership

In-Person SLA Workshop Dates:

April 25-26
August 8-9
October 24-25
December 12-13

Learn more and register at allemancenter.com/training

Learn more about Dr. Alleman's work at training programs at allemancenter.com.

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