200. Marco Gresnigt DMD, PhD - Deep Margin Elevation
Nov 25, 2023
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Marco Gresnigt, a dentist and lecturer, discusses immediate dentin sealing and bonding techniques in restorative dentistry. Topics include the benefits of IDS, successful bonding tips, evaluating existing composite restorations, bonding to old composite, preservation of tooth structure, and deep marginal elevation technique.
Immediate Dentin Sealing (IDS) is essential in adhesive dentistry to improve bond strength and achieve long-term success.
Deep Marginal Elevation (DME) facilitates isolation and impression making for restorations, emphasizing the importance of maintaining an appropriate emergence profile and oral hygiene for post-DME success.
Deep dives
Overview of IDS and its importance in adhesive dentistry
In this podcast episode, the speaker discusses the concept and significance of Immediate Dentin Sealing (IDS) in adhesive dentistry. IDS involves applying a resin coating layer to dentin to improve the bond strength and longevity of restorations. The speaker emphasizes the importance of IDS in preserving tooth structure and achieving long-term success. They highlight the research and clinical studies supporting the effectiveness of IDS and recommend using specific adhesive systems for optimal results. Additionally, the speaker shares tips and techniques for provisionalizing and delivering restorations after IDS.
Silica Coating for Sandblasting and Silanization
The podcast delves into the technique of silica coating for sandblasting the IDS layer. Silica coated aluminum oxide particles are used to roughen the composite restoration surface and enhance adhesion. The speaker explains the steps involved, including rinsing, silanization, and applying adhesive. They also caution against using phosphoric acid on the silica coated IDS layer, as it may remove the silica and compromise bonding. Additionally, the podcast highlights the use of silica coating in bonding restorations to existing composite restorations.
Deep Marginal Elevation as an Alternative to Crown Lengthening
The episode explores the concept of deep marginal elevation (DME) in restorative dentistry. DME involves raising the margin of deep cavities above the biological width to facilitate isolation and impression making. The speaker discusses the benefits and case selection considerations of DME, recommending proper isolation techniques and the use of matrices. They highlight the importance of maintaining an appropriate emergence profile and emphasize the role of oral hygiene in the success of restorations post-DME. The podcast also touches on the clinical study and long-term survival rates of restorations with DME.
Contamination Management in Restorative Dentistry
The speaker addresses the issue of contamination during restorative procedures and provides recommendations for managing it. They suggest different approaches depending on when the contamination occurs. If contamination happens after etching or priming but before bonding and light curing, the process needs to be repeated. However, if contamination occurs after bonding and light curing, the restoration is safe and no further steps are required. The podcast concludes with a reminder of the importance of adhesive dentistry in preserving tooth structure and promoting long-term oral health.
Marco Gresnigt graduated summa Cum Laude in 2005 at the university of Groningen, the Netherlands. In January 2012 he obtained his PhD on clinical and laboratory evaluation of laminate veneers. Besides working at the university, he works as a dentist in a center for special care. Marco lectures at the Center for Dentistry and Oral Hygiene, and teaches masters students in a specialized program on esthetics and prosthetic dentistry. Besides writing scientific articles, he has published several articles on minimally invasive and adhesive dentistry in dental journals, and teaches post-graduate courses. He obtained several awards like: the NVGPT publication prize, Boering prize and Cavex prize. Since 2014 Marco became a member of the international Bio-EmulationTM group.
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