GC America Minimally Invasive Dentistry for Maximum Results

Author : Dental Product Shopper
Published Date 08/27/2010
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One of the things I hear when talking to dentists from around the country about materials technique and technology is that dentists generally feel hindered in their ability to preserve tooth structure due to an incomplete understanding of the caries process and deficiencies in the available restorative materials. Because of these perceived limitations, dentists are abandoning the idea of minimally invasive dentistry in favor of a more aggressive approach.

One of the things I hear when talking to dentists from around the country about materials technique and technology is that dentists generally feel hindered in their ability to preserve tooth structure due to an incomplete understanding of the caries process and deficiencies in the available restorative materials. Because of these perceived limitations, dentists are abandoning the idea of minimally invasive dentistry in favor of a more aggressive approach.

The good news is that advances in material science are affording us the opportunity to regain our focus on minimally invasive dentistry by giving us access to materials that overcome issues that have plagued us for years. Issues like microleakage, shrinkage stress, recurring decay, sensitivity, and longevity are just a few. We can now confidently place composites in posterior and anterior teeth, using the proper technique and materials in patients with a high incidence of caries and expect predictable long-term results. Some strategies and materials that can help with this include low-shrink composite technology, glass ionomer base, and remineralization of enamel.

Low-Shrink Composite Technology

Most conventional composites shrink between 3% and 5% during initial cure when volumetric shrinkage is measured. The more shrinkage that a resin has at initial cure, the more stress is created within the tooth over the life of the composite. This causes clinical concern because it introduces residual stresses in restored teeth. These stresses can, among other things, propagate enamel cracks, bring about microleakage, and cause postoperative sensitivity.

Stresses within a tooth after a direct resin restoration has been placed can never be eliminated completely, although decreasing stresses within a direct resin restoration is thought to be a critical factor in reducing the amount of microleakage over time. This increases the longevity of the restoration.

One of the most promising new low-shrink composites on the market today is KALORE from GC America. According to independent testing, KALORE has an initial volumetric shrinkage of 1.7% and a polymerization shrinkage stress of 2.0 MPa. Both of these results are among the best of all composites. It also handles beautifully, allowing the clinician to sculpt and blend the composite invisibly into both anterior and posterior teeth all while having tactile control over the composite.

Glass Ionomer Base

Adhesive dental materials make it possible to conserve tooth structure using minimally invasive cavity preparations because adhesive materials do not require the incorporation of mechanical retention. There are several materials that can be used, but the ones that seem to have been forgotten in the American dentist?s armamentarium and show the most promise are the glass ionomer cements (GICs), using the lamination (or sandwich) technique. I prefer GC Fuji II LC simply because it is easy to place, is light cured, and is manufactured by GC America, the innovators of glass ionomer technology.

GICs have a number of advantages including adhesion to tooth and release of fluoride and other ions. They perform well in low stress areas and because of their ?rechargeable? nature they can have an anticariogenic effect.

The lamination technique takes advantage of the physical properties of both the GICs and the resin-based lowshrinkage composites like KALORE. The GIC is placed first because of its adhesion to dentin and fluoride release. Resinbased low shrinkage composite is then laminated over the GIC for the purpose of improved occlusal wear or esthetics.

Remineralization of Enamel

It is now well-recognized that it is possible to arrest and even reverse the mineral loss associated with caries at an early stage, before cavitation of enamel takes place. Enamel and dentin demineralization is not a continuous, irreversible process.

GC America?s MI Paste Plus facilitates remineralization of the enamel and dentin at an early stage. In addition, it is used successfully in helping to prevent demineralization in patients with moderate to high caries risk assessment.

Predictable Long-Term Results

Dental adhesives, restorative materials, and a new understanding of the caries process and remineralization have catalyzed the evolution in caries management to minimally invasive dentistry. Emerging technologies such as low-shrinkage composites like KALORE, and the consistent use of GICs like GC Fuji II LC, and reminerialization products like MI Paste Plus will facilitate primary prevention of caries, which translate to maximum predictable results for the clinician and beautiful long-term restorative solutions for the patient.

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