bio enhancing restorative materials ? treating teeth as though-2
TRANSCRIPT
Treating teeth as though they are a vital and functioning part of the human body
Joseph A Marino DDS, FAGDLTC, USA DC
We Are Not Mouth MechanicsIt is not “just a filling”.Need to pay attention to the anatomy,
biology, and biochemistry of the teeth we are restoring
As a mechanicWe could be over-stressed
Our prof. could be going to the dogs
Most of the Biochemistry is happening at the dentin layer. Enhance the function by first treating the Dentin.
AKA Bio-enhancing MaterialsFirst material featured… Was FluorideTaken for grantedIt has not always been
thereReduced caries rateMore important – reduced
severity of cariesSlowed down the rate of
growth but did not eliminate caries
Most important effect is topical
Created a more “tricky” diagnostic conditionTopical effect leads to a…
Selective remineralization
From Previously Done PPT- Fl. And the New Caries (J. Marino)Creation of “fluoride”… Aka “hidden” caries
We want to get the fluoride…From here… To here..
Development of bioactive restorativesTransporting fluoride Enhancing the dentin
Dentin Bonding relies on intact Collagen Fibrils
Relies on a true chemical bond Sharing ions Sure bond to dentin
If failure, it is cohesive. Dentin remains protected
The workhorse of bio-active materials
Properties improve over time (days/weeks/months)
Greatly enhanced properties from R&D
Most important is coefficient of thermal expansion
BioactivityFluoride deposition Remineralization
If the material is exposed to a source of fluoride such as in an open sandwich.
Foundation is Mineral Trioxide Aggregate (MTA)Older version was known as Portland Cement
– one of the early examples of bio-active glass (BAG)
Takes the material inter-action with tooth to the next level…Acts to remineralize tooth structureAlso stimulates both Dentinogenesis and
Osteogenesis Original use in medicine for bone regenerationDental uses include repair of perforations,
apexification, as a liner on implants to aid in osteo-integration
Improvements in ease of handling and setting time have led to use as a restorative material (Biodentine – Septodont)
Tri Calcium SilicateStimulate Odontoblasts Into renewed
Dentinogenesis
Tri Calcium Silicate
Composite Resin – Bioactive?No YesMost composites Giomers
Hybridization of Glass Ionomers and Composite Resins (1)
Release fluoride and are re-chargable (1)
Improvement over compomers (1)
Composite Resin – BioEnhancing? Yes YesMost compositesGood bond strengths,
especially enamel, enhance overall strength of tooth
A kind of “fusing” effect
GiomersGood bond strengths,
especially enamel, enhance overall strength of tooth
A kind of “fusing” effectResist plaque formation
by forming material film layer (aluminum, silica, strontium, other ions)
Biological/Biomimetic Restorative DentistryCan be minimally invasive..
Post OP
Biological/Biomimetic Restorative DentistryCan involve deep or “hidden” caries
Post Op
Tri Calcium Silicate (Biodentine)
Highly Filled Glass Ionomer (Fuji IX Extra)
Giomer (Beautiful)
