From compromises to ideal solutions

THE FUTURE IS NOW!

There is an ever-growing abundance of materials in today’s marketplace. Today, as in the past, it is incumbent upon the practitioner to be mindful of what products can be used to create a long lasting result in a manner that is cost-effective, durable, aesthetic and less invasive to natural tooth structure. We have already seen a surge in the focus on aesthetics in the new millennium. The amount of television shows and print media devoted to “cosmetic makeovers” has been at times overwhelming. However, in our chosen field of dentistry, we need to, as always, be mindful of the conservation of tooth structure, along with the need to satisfy the patient’s demand for highly aesthetic restorations.

In addition to aesthetics, the buzz phrase for the 21^st century is “Minimally Invasive Dentistry” (MID). These two wonderful concepts of tooth conservation and aesthetics have ramifications in all aspects of dentistry and can be married to a myriad of products and techniques that will allow you to afford patients with the most sophisticated, beautiful, and beneficial dentistry available today.

A perfect case in point is the use of fiber reinforced composites (FRC) in techniques to stabilize periodontally involved teeth. Through the years several methods have been employed for intra and extra coronal splinting. These included, braided wire, titanium bars, acrylic/resin bonding, composite bonding, and yes even paper clips. In many cases, full coverage crowns were splinted together to insure stability when less than adequate bone would allow for mobility of otherwise sound dentition. In most instances, this was the antithesis of MID by requiring tooth preparation and the removal of otherwise healthy tooth structure for the placement of un-aesthetic splints.

Undoubtedly, everStickPERIO has provided us with the perfect cost-effective material for satisfying the need for aesthetics and preservation of healthy tooth structure. We can now place an extra-coronal splint with adhesive techniques that requires no tooth preparation, is highly durable, minimally invasive to the oral environment, and extremely comfortable for the patient. With intra-coronal splinting, less tooth structure needs to be removed in order to provide for a strong and wear resistant splint. In an age where metal free restorations are the state-of-the-art, this is a wonderful way to use FRC’s to secure and stabilize teeth with more natural looking tooth colored material.

The use of FRC’s in periodontal splinting is not the only area in which fibers can be most helpful. In orthodontics, for example, similar techniques to periodontal splinting can be used for arch stabilization and retention. These orthodontic retainers would be more aesthetic and highly durable over a long period of time. In prosthetics, fibers can be used to create cost-effective bridges in single tooth replacement cases wherein a more invasive acid etched, resin bonded metal retainer might have otherwise been used in the past. Such a fixed retainer may be viewed as a short or long term temporary that can be “built” chairside.

Repairs of denture prosthesis can benefit from fiber products such as everStickNET. This will undoubtedly add to the strength of the repair over a longer period of time then simply using an acrylic resin and/or a potentially visible metal retentions device (such as a piece of metal meshwork as an internal  reinforcement). But more, important, the use of this same product intra-orally, for stabilization of traumatically involved teeth is extremely beneficial. In such instances where teeth have become hyper-mobile and are surrounded by fragile and/or friable tissue, we want to be able to stabilize these teeth without cutting them or tying them up with wires.

If the 60’s and 70’s were heralded as the “golden age of dentistry,” than surely this must now be considered the “platinum age of dentistry.” With the advent of products like FRC’s, the dentist can be more artistic and less invasive as he/she sets out to help the patient save and/or restore teeth to normal form and function.

Howard S. Glazer, DDS, FAGD, FACD, FICD, FASDA

Dr. Glazer is a fellow and past president of the Academy of General Dentistry and former assistant clinical professor in dentistry at the Albert Einstein College of Medicine (the Bronx, New York). Currently he holds the academic rank of adjunct assistant clinical professor at several universities around the United States. Dr.Glazer has lectured extensively in the US, Canada, Korea, India, and the United Kingdom on the subjects of aesthetic dentistry, patient management, and forensic dentistry.