Dr. Steve Bayne who was a professor in the School of Dentistry, University of Michigan and distinguished speaker at the recent IADR meeting in Seoul South Korea spoke with Dr. Chiraz Guessaier. Dr. Bayne’s presentation was titled “Current Challenges for Dental Materials Research: The Street Light Effect.”
Currently, there is too much product testing, with little understanding of causes and effects to properly interpret results. Although dental materials researchers do good research, their efforts could produce more significant results if:
- Focus was directed towards the important problems, and
- A more basic scientific approach was taken while using more sophisticated protocols
Dentistry has moved towards digital fabrication techniques and technologies since 1988 but more rapid progression has occurred since 2008. Most of these have involved scanning, CAD-CAM, and computer management. There are, now, very exciting new ways to produce all-ceramic restoration that include both subtractive approaches (e.g., milling an object out of a block) and additive techniques (e.g., forming a solid by curing powders or liquids into complex shapes). These are the laboratory technologies that will generate most of the new restorations that need to be manufactured outside of the mouth. There is a demand large numbers of these restorations and the fabrication techniques need to be fast, accurate, and inexpensive. As such, we need to focus on optimizing these techniques and exploring new technologies.
Additionally, several standard laboratory tests and simulations for screening materials and comparing existing products have been developed. However, the tests do not predict true clinical performance. Most of the tests exclude exposure to saliva which is an extremely important factor impacting clinical outcomes. Practitioners require provide fast and accurate predictions of potential clinical performance of these materials. Unfortunately, materials are not tested first and then issued, but rather issued and then, extensively tested. Often failures are 4-5 years in service, and products have already changed every 2-3 years.
Clinical research is valued as the gold standard for testing; however, it takes time, is expensive, and is not very predictive of potential failure events or times in the future. As such, new clinical research models are needed to predict success or failure for new materials quickly. Ideally, practitioners would like restorative materials to last 10-20 years in the mouth but, most of the current research is only 2-5 years in length. Also, clinical research protocols are narrowed down to ideal patient types, rather than including examples of the real challenges that wet-fingered dentists face.
Watch the video conversation