UPDATE ON BONDING
Bonding is a question of interfaces, and is a mixture of chemical reactions and mechanics/physics: i.e. surface energy, microstructure or preparation resistance form. Within dentistry we have many complicating factors: biologic variability, application in a chemically and mechanically aggressive environment and unfortunately insufficient product documentation with intentional or perhaps only traditional selection of misleading and clinically irrelevant test protocols. A further complication (for me) is the almost frightening emphasis in research and product development on crowns. For an adhesive dentist, crowns are only rarely necessary and generally contraindicated. Adhesive confusion only contributes to the production of tooth dust and the promotion of endodontics.
These are my priorities for the critical interfaces, the fourth being almost irrelevant.
Considering present trends in sales and marketing, you may doubt my priorities. I remember a private conversation with Nobuko Nakabayashi in the mid-1980’s. Quoting (perhaps paraphrased): “As a chemist I only trust mechanics.” David Pashley at a dinner a few years later, also in the 80’s (and not paraphrased because I wrote it down): “Dentists are the only scientifically educated professional group who believe that chemical reactions are immediate and irreversible.” Should we try to understand the chemistry? Yes, but clearly it is not our first priority. Chemistry offers no salvation for the mechanically ignorant, but can improve the results for a good engineer.
This presentation will be an attempt at conflict resolution.
ROOT CANAL POSTS
Obviously, root canal posts are used primarily to achieve additional retention for the core build-up and ultimately the final restoration. The indications for posts are often debated. For teeth with little remaining coronal structure, especially cervically, posts also can help reduce the risk of horizontal fractures. It is clear that molars rarely require a post, and that posts are generally only required when a crown is planned as the final restoration. The desire to avoid placing posts when possible is predicated by the potential clinical problems, in particular perforations and the risk of vertical root fractures.
Perforation during post space preparation
The risk of perforation naturally increases with both the diameter and the length of a post. Since we need intimate contact with the post space walls, we have little control concerning post diameter. With adhesively cemented fibre posts, the traditional recommendation for length is not required. 5 mm or less may indeed be sufficient for a properly bonded post in relation to retention, but retention is not our only concern.
Vertical root fractures
Vertical root fractures have been observed most frequently with threaded posts, with custom cast gold posts in second place for this “fatal” complication. The risk of non-restorable root fracture is reduced with bonded FRC posts.
Loss of Retention
The most frequent failure is loss of retention (true for all posts). The risk of vertical root fracture and inevitable extraction reduces the attraction to use threaded posts to increase retention. The use of passive fibre posts with adhesive cementation appears to the the best choice, but is not without its own difficulties.
In the fairly common clinical situation with minimal or no ferrule effect interproximally, in-vitro studies show a clear advantage of adhesive FRC posts. The necessity of surgical crown lengthening or orthodontic extrusion is certainly reduced, although clinical failures with fibre posts have also been associated with the lack of a ferrule. Patients should still be informed of the risk and the alternatives discussed. (Extraction and an FPD or implant.) A metal post and conventional crown is clearly contraindicated if a ferrule cannot be achived.
In my opinion, one of the biggest problems with FRC posts are odd recommendations for adhesives and cements combined with idiotic instructions for use concerning the clini
Dr Gary Unterbrink has been in private practice in Germany and is the technical consultant for Vivadent as well as being the director of clinical research with Ivolcar Vivadent. He then went on to become the director of professional services, again with Ivoclar Vivadent. He now maintains a private practice in Liechtenstien. Gary has delivered lectures in more than 60 countries all over the world and has numerous publications to his credit.
Foredraget varer ca 2 timer alene og en demo vil vare ca 2 timer den også om den tas alene. Om jeg kombinerer disse to gjennom en 4 timers seanse ( forelesning - demo - forelesning - demo osv ). forelesningen fordyper seg i problematikk innenfor proselensestetikk og de fantastiske vektøy vi har i Fluoricens, opalicens og translucens
Dr. Ackermann, born in 1952, studied dentistry from 1971 until 1976 at the Johannes Gutenberg University, Mainz, Germany.
In 1976 he received the DDS degree and in 1978 he acquired the degree D.M.D. From 1978 until 1980 specialisation in oral surgery ( University Mainz, department oral surgery).
Associated as dentist and oral surgeon together with Dr. Axel Kirsch in private practice in Filderstadt, Germany.
Since 1980 clinical and experimental work in the field of perio-implant-prosthetic andro-maxillofacial implantology.
Specialisation in oral rehabilitation, periodontology, implant-prosthetic, preprosthetic surgery.
Board Member of the German Society of Implantology (DGI).
Approved specialist in periodontology of the EDA (European Dental Association)
Part-time lecturer for the Academy of Practice and Science (APW) with the German Society of Oral Medicine and Dentistry.
Periodical lectures in the students´ program "Implant-prosthetics and Perio-prosthetics" at the University Hospital Charité of the Humboldt-University Berlin
Guest lecturer since June 2000 in the University Hospital Ulm, Dept. for Oral Surgery
Visiting Professor at the Dental University Niigata, Japan since June 2004.
Guest lecturer since May 2005 at the Steinbeis University Berlin
Lecturing internationally and multiple publications in all fields of above specialisations.
The Minimally Invasive approach is widely accepted as an ethical and realistic treatment alternative to aggressive tooth preparation in most aesthetic cases.
This will often require some degree of tooth repositioning to align and resolve crowding in the anterior segment in order to reduce or eliminate the need for preparation of healthy tissues. As the late Dr. Vincent Kokich accurately summarised it: alter tooth position and restore with caution. This statement emphasises the need for all dentists to consider orthodontics as part of any aesthetic procedure. The lecture will present the different options available to the GDP and show through case studies how STO can be used as a stand alone treatment or as pre-treatment before composite bonding and veneers.
Lennart Jacobsen graduated from University of Aarhus in 2003 and works at the Colosseum Clinic in Copenhagen as well as clinical teacher at the University of Copenhagen. He is also director of LiteWire ApS, a company dedicated to the safe provision of simple orthodontics in general dental practice using fixed appliances and clear aligners.
Lennart has a special interest in Short Term Orthodontics (STO) and the integration of orthodontics in the functional and aesthetic rehabilitation of adult patients.
He has been providing these treatments for more than 8 years and has treated hundreds of adult patients with both removable and fixed appliances as stand alone treatment and pre-alignment in combination with other aesthetic procedures.
Lennart lived in London for six years, during which he worked with some of the best clinicians in the field, and had several articles published in both the UK and Denmark. Lennart now lectures intensively on the subject of STO and aesthetic dentistry at national and international level.
In daily practice, composites are the materials most commonly used for restorative dentistry. We use them for preventive seals, micro-invasive restorations, build ups and complex, direct and indirect restorations in the anterior and posterior sections.
Indeed, it is in the anterior sections that composites have traditionally been used to the greatest effect, enabling us to carry out quite complex restorations using direct techniques and with notable aesthetic and clinical results.
Recent product developments, combined with clinical research into stratification, now make it possible to utilise new evolved composites with excellent characteristics from mechanic and aesthetic point of wiew.
It is however, a common complaint among colleagues that the techniques of layering seem to be rather complex and it is difficult to make the right colour choice: paradoxically, they say that the appearance on the market of sophisticated materials, designed to give ever better results in the medium or long term, only makes it even more difficult to make the correct decision.
Indeed, many of these colleagues, after the first buzz of enthusiasm, give up on the layering technique and opt for materials which they say are more simple or “mimetic”(!)
In this lecture, the author would like to discuss these topics and make suggestions which aim to give high quality and predictable results every day, both from an aesthetic and clinical point of view with undeniable advantages for ourselves and for our patients.
Born in Chiavari 29/03/1965 graduated with honours in Dentistry and Dental Prothesis in 1991 at the University of Genoa
Dr Devoto has worked as a teacher and demonstrator at the University of Genoa in the undergraduate courses of Dentistry and Dental Prosthesis, teaching Pedodoncy and Conservative Dentistry. From 2000-2004 he taught Reconstructive Dentistry in a course of Laser refinement at the same University. From 2005-2006 lecturer at the University of Madrid, master of Esthetic Dentistry
At present he is lecturer at the University of studies in Siena, Course of Aesthetics and Restorative Dentistry, professorship of Conservative Dentistry, at the International University of Catalona, Barcelona, for a post graduate course in Aesthetic Dentistry, Visiting professor at the “Universitè de la Mediterranee, Marseille” in the course of Refinement of Aesthetic Reconstructive Dentistry.
The objectives of the lecture is to discuss modern esthetic materials in the context of the technologies that we use to produce them and how to use them clinically. Porcelain, glass ceramics and oxide ceramics including the highly intresting translucent zirconium-dioxide with clinical procedures and cemetation techniques. From intraoral scanning to highly esthetic and durable restorations. The lecture will be based on clinical cases.
Dr Per Vult von Steyern is Doctor of Odontology and head of the Department of Materials Science and Technology, Faculty of Odontology, Malmö University, Sweden. He is a licensed specialist in Prosthodontics and researcher with Dental ceramics as his main research field. He is an internationally recognized lecturer and was 2013 awarded the Swedish Dental Association price for "outstanding lecturer". He has published several scientific papers in international scientific journals and different textbook chapters.
Graduated at the University of Bergen, Norway, in 1979. He started working with paediatric dentistry in Denmark. His interest in prosthetic dentistry brought him back to Norway and a position within dental health care for the elderly and handicapped. Since 1988 he has been responsible for oral and maxillofacial prosthetics at the outpatient clinic for maxillofacial surgery, Haukeland University Hospital in Bergen, Norway. He lectures in topics related to dental prosthetics with a special focus on implant dentistry.
Koray qualified in 1989 from Guy’s Dental Hospital, winning the Final Year Prize for overall excellence and the S.J. Kaye Prize in Oral Medicine and Pathology. He remained at Guy’s for two separate House Surgeon appointments in Prosthetic Dentistry and then Oral and Maxillofacial surgery till 1991 when he went into general practice in North London.
Between 1991 and 1993 he completed the Master of Science degree in Periodontology from Guy’s Hospital and at the end of 1993 passed examinations to obtain a (Restorative Dentistry) Fellowship in Dental Surgery from the Royal College of Surgeons of England.
He has since been in practice dedicated to quality dental care, having a special interest in multi-disciplinary cases that require detailed planning and co-ordination of several specialist branches of dentistry. Between 1996 and 1999 he provided surgical services in periodontics and implant dentistry to three prestigious practices in the Knightsbridge and South Kensington areas, prior to establishing his own practice near Baker Street in the West End of London where he remained until 2005.
In 2005 he expanded his practice and founded The London Centre for Implant and Aesthetic Dentistry (now LCIAD Ltd.) alongside specialist colleagues in Wimpole Street at the heart of London’s dental and medical community. In October 2010, he expanded the practice into new larger premises Clinical Director of LCIAD accompanied by several associate dental surgeons at 28 Wimpole Street London W1.
Koray has undergone and continues to undergo extensive postgraduate education in several countries with world leaders in several fields of dentistry and dental technology as well as being a sought-after lecturer in his own right. He currently holds the following posts:
President of the British Academy of Aesthetic Dentistry. (Treasurer and Executive and Executive Committee member 2006-present).
London Committee Member for Association of Dental Implantology UK (2009-) and ADI Mentor for dental implantology.
Editorial team of Dental Implant Summaries (2007-2010) and Implant Dentistry (2007-)
Member of the European Association of Osseointegration
Associate member of the Academy of Osseointegration, USA.
Secretary to the London Dental Fellowship (2006-2009) and President (2010-11).
Guest Lecturer Multi-System Implant Course, Trafford General Hospital, Manchester 2006-2010
Master Speaker in UK and Europe for the Ankylos Dental Implant System (Dentsply Friadent, Hanau, Germany (2005-)
Lecturer and mentor Simply Excellence Implant Year Course with Dr Phil Bennett Past President of ADI (between 2004 and 2008) and Dr Sanjay Sethi (2010- )
Affiliate member European Academy of Esthetic Dentistry (EAED) 2007-
Co-presenter Advanced Cadaver Maxillary Sinus and Bone Graft course with Prof. Cemal Ucer President of ADI at the Royal College of Surgeons of England in conjunction with Geistlich Biomaterials
Lecturer for Implant Programme, Salford University Implant Masters Degree (2008-)
Tutor and co-author for Association of Dental Implantology UK e-learning course (ARK) on treatment planning launched in October 2010