Let the Patient Help Guide for Esthetic Restorations
ST. LOUIS, Missouri?There are many different options for restorations today and clinicians must decide among them based on the clinical situation, according to Frank J. Milnar, DDS, AACD, a speaker at a recent Updates in Contemporary Dentistry meeting.
"Our technical skills are secondary, in my opinion, to our ability to communicate with the patient," Dr. Milnar told the packed audience. "Discuss the prevention cycle, talk about biofilm, and make sure they get a return on their investment in coming to see you." He also urged clinicians to provide alternatives to expensive crown-and-bridge restorations.
The goal, he said, is to maximize communication with patients and the staff. He said that dentists should offer the least invasive treatment possible first.
Understanding the characteristics of the materials is key to choosing the best treatment, said Dr. Milnar. He said that adhesion dentistry allows dentists to plan treatment for each tooth with the potential to preserve both enamel and dentin.
In his slides, Dr. Milnar presented VOCO America's FuturaBond DC, an 8th generation, nano-reinforced, self-etch adhesive. Dr. Milnar said that the selective-etch technique provides dentists with the best of both worlds' preserving both enamel and dentin.
In selecting composite materials, Dr. Milnar mentioned that patients demand esthetics and long-lasting restorations while the dentists demand these properties plus, preferred handling, color match and polish, simple technique, and excellent physical properties. Nanotechnology has raised the bar on esthetics and physical properties, he said. He discussed the evolution of composites and discussed VOCO's nano hybrids.
Dr. Milnar made several suggestions for choosing materials. For dentists looking for an advanced direct restorative system, he suggested looking for a value-based universal composite. Such composites enable natural looking esthetic results in an efficient way because they combine nanoceramic technology with simplicity, he said.
In selecting a flowable, Dr. Milnar recommended that dentists examine handling capabilities, in addition to cost. According to Dr. Milnar, GC America has led the way in glass ionomer products. He also added that VOCO now makes them. "I can?t tell you which ones to use," he said, "You do the investigation."
Dr. Milnar also honed in on "pink esthetics" as an option for patients. He said that on anterior Class V's, dentists are using a lot of tooth-colored resins that can make a tooth appear larger than it should be. Pink esthetic integration allows dentists to select a highly esthetic option and mimic gum tissue. He said that products like Amaris Gingiva provide highly esthetic gingival pink replacements. GC America also offers GRADIA gum shades, a light-cured gum shade composite system. Dr. Milnar emphasized that in choosing the right product, it is not necessarily always the "bottle you buy, it?s what you do when go home with it."