What is the Clinical Relevance of Bond Strength?
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Dr. Rick Carvalho is Professor in the Department of Biomaterials at the University of British Columbia. He joined me to speak about the relevance of laboratory research on bond strength and how it translates into clinical practice. Oftentimes, the durability of adhesive restorations is estimated from laboratory bond strength testing, and there is an equivocal assumption that higher bond strength indicates longer survival in the clinic. However, there are several and significant limitations to such association that need to be understood before relevant predictions can be made. I hope the interview sheds some light on questions that you might have been asking in your own clinical practice. You can always share your thoughts, questions, and suggestions with us through oasisdiscussions@cda-adc.ca Until next time! Chiraz Guessaier |
Full Video Presentation (15.50″)
Sorry it took me so long to view your post. I am Paul Belzycki, a dentist that has been posting my clinical experience of near 40 years, in a way as a mentor. I am in no way an academic…strictly wet fingered.
I am pleased and grateful beyond words that you took the time and effort to do this. It’s about time that the public be made aware of the short-comings of resin fillings.
I graduated in 1979 at the start of the bonding revolution. I hated resin from the start for Aesthetic reasons and here I use Aesthetic in a philosophical context. With amalgam, I could condense a solid mass and then “sculpt” some semblance of natural dental anatomy with hand instruments, trying to mimic what Mother Nature had intended. This, I submit, is the Art part of dentistry. I could never do this as effectively with resin. Forget for a moment the problems with shrinkage, wear, open contacts and recurrent decay. This handling characteristic was a turn-off for me. If the restoration is high, one must use a high-speed air-rotor; and this invariably causes damage to surrounding cusps. The reasons being it is difficult to control high speed; and ironically, when the colour match is good, it is more difficult to know what is tooth or resin. It left me with an Ugly result.
Then, there was a lecturer by the name of Dr Frank Wine, or Wein, can’t recall exact spelling, but he presented amalgam restorations that glistened like the finest silver jewelry. Polished with exacting technique. The shear artistry blew me away. And to do this, he booked a separate appointment 24 hours later to allow the material enough time to fully harden. There was a sequence of ever finer polishing materials, who’s names I also have forgotten. I cheat and use prophy paste in a rubber cup some 10 minutes after placement. Works well enough, but no where near the shine of Dr. Wine. They were truly aesthetic in terms of form and function.
My own mentor was Dr. Blake MacAdam (back then we did not call them mentors, nor did we let them know, we secretly respected their work). He too produced cast gold, gold foil and amalgam restorations that were more jewelry than restorations. Those clinicians took pride in craftsmanship that will not be matched by CAD/CAM.
Hearing the term Cosmetic or Aesthetic dentistry nowadays makes me nauseous. So, it is tooth-coloured…big deal. Today, it has become fashionable to stain one’s skin…tattooing…and pierce one’s face, lips and tongues with metal. So, for those patients that argue with me regarding amalgam restorations, I merely inform them that I am ahead of the fashion curve and now “Piercing Teeth” nor merely filling teeth.
And so it goes. Before even viewing your post, I knew resin is inferior, in every way. Clinical experience has taught that.
Thank you for taking the time to share your expertise.
Dr. Paul Belzycki, DDS