Advances in Composite Restorative Dentistry: A Blend of Artistry, Materials, and Technique
MELVILLE, NY, June 14, 2013?At the recent Updates in Contemporary Dentistry event in Melville, NY, Dr. Robert Lowe shared valuable insights into the world of restorative dentistry. His hour-long lecture focused on composite restorative dentistry, which blends artistry, materials, and techniques together for an esthetic outcome.
Artistry in Restorative Dentistry
In his lecture, Dr. Lowe compared artistry to dentistry by saying, "The best way to learn something is in the context of another discipline." He said that dentists should think creatively, visually, stylistically, morphologically, and most of all artistically when creating restorations for patients.
Techniques for Restorative Dentistry
Talking to a packed room of clinicians, Dr. Lowe shared several techniques for restorative dentistry, including the Class II direct composite restoration using the GIC/composite "Sandwich Technique." He also shared the benefits of using glass ionomer cements as a dentin replacement in deeply excavated lesions. Benefits include more tubules exposed, less peritubular dentin to bond to, formation of a "chemically fused seal" and high fluoride release for internal remineralization.
Materials in Restorative Dentistry
Dr. Lowe focused on important composite materials needed for successful restorations. "We?ve come a long way with these materials. We can do a good service for our patients." He continued, "Our adhesives are improving as well."
Dr. Lowe shared his thoughts on what makes a good restorative material. He said that optimal restorative filling material should behave like natural tooth substrate. Dr. Lowe said the following characteristics are important: strength, elastic behavior, thermal behavior, esthetics (opacity, fluorescence, opalescence, and gloss), surface roughness, and wear properties.
Dr. Lowe then discussed flowables. He said there are many benefits with high viscosity flowables, including: more stability after application; controlled dosage/application; and thixotropic properties make for ease of placement in undercuts, gingival, or subgingival locations. He also shared that flowables can serve as an excellent "base matrix" for fiber reinforcement materials.
In an interview with Dental Learning staff, Dr. Lowe shared what he uses for direct Class II posterior composite cases. He uses VOCO's GrandioSO and GrandioSO Heavy Flow because he feels they address key parameters to give a natural tooth substrate. For the additive technique for posterior composite placement, Dr. Lowe uses VOCO's Futurabond DC, as well as VOCO?s Dimanto and Easy Glaze. For a desensitizer, Dr. Lowe uses AcquaSeal from AcQuaMed Technologies.
Dr. Lowe also said he uses Triodent's V3 Sectional Matrix System for Class II slot preparation/direct composite restorations. He said the V3 Sectional Matrix System has a narrow band, and the top of the band is curved, which gives him ease of handling and placement. He also uses Isolite for isolation.
Dr. Lowe noted that he uses VOCO's x-tra base for bulk fill cases. He also uses VOCO's x-tra fil in other cases because it has thixotropic properties that can flow into nooks.
As for additional products used during restorations, Dr. Lowe said he uses Fissurotomy burs from SS White and uses KaVo's Diagnodent routinely on every patient.