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Author Archives: JCDA Oasis

How do you treat a portion of all porcelain crown that breaks off in esthetic zone?

This question was submitted by a general dentist: Portion of all porcelain crown breaks off in esthetic zone. Do you etch porcelain first with hydrofluoric acid and then enamel/dentin with phosphoric acid, then silane primer on porcelain, then bond on tooth, then restorative material? Is it a big concern, if a little of the hydrofluoric acid gets on tooth structure – could happen easily, especially with a smaller tooth like a lower incisor. Dr. Omar El-Mowafy, Professor and Head of Restorative Dentistry in the Faculty of Dentistry at the University of Toronto provided this quick initial response I am of the ...

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How can I use CBCT and barium markers when placing temporary implants?

On an experimental basis, we have asked a limited number of companies to provide us with practical “How To” answers to clinical questions. We were prompted to conduct this experiment when dental team members told us that they visit company websites and consult company representatives for practical clinical information. We look forward to receiving your feedback on this experiment. By Dr. Robert Waugh When it comes to the placement of temporary implants (TADs) in difficult areas, CBCT technology and radiopaque markers provide the diagnostic views necessary for 3D treatment planning and treatment sequencing in cases involving the temporary replacement of ...

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Do the newer amalgam non-corrosion alloys fill with corrosion products and seal better as they age?

This question was submitted by a general dentist: Do the newer amalgam non-corrosion alloys fill with corrosion products and seal better as they age? Dr. Anuradha Prakki, Restorative Dentistry Assistant Professor, in the Faculty of Dentistry at the University of Toronto, has provided this quick initial response Drafted by Alexandra Rabalski, JCDA Oasis Summer Intern This depends on the material used for the restoration and the size of the initial gap at the amalgam/tooth interface. High-copper, corrosion-resistant amalgam with a small initial interfacial gap between the amalgam and tooth structure seal as rapidly as the lower copper alloys.   Reference Mahler DB, ...

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What is the safest way to clean up the cement found inside a porcelain crown?

This question was submitted by a general dentist: A patient comes in with a full porcelain crown which has come off. The tooth is sound and there is resin cement inside the crown. What’s the safest way to clean up the cement from inside that crown?   Dr. Alan Kilistoff, from the  University of Alberta, provided the following initial response in an interview recorded with Dr. John. O’Keefe. A summary of the interview is provided followed by the complete audio interview (7 minutes)       Historically, the safest way would have been to sandblast out the interior of the crown; ...

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What are some indications for replacing old amalgam fillings?

This question was submitted by a general dentist: What are some indications for replacing old amalgam fillings? Dr. Anuradha Prakki, Restorative Dentistry Assistant Professor, in the Faculty of Dentistry at the University of Toronto, has provided this quick initial response Drafted by Alexandra Rabalski, JCDA Oasis Summer Intern Oftentimes, patients do consider changing their old amalgam fillings to the latest white composites. It is important to note that although an amalgam filling may be “old,” it does not necessarily indicate a need for replacement. As a restorative material amalgam has some properties that improve over time. For example, the corrosion products ...

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Opening the conversation: What is the best restorative material still in existence and use?

This question was submitted by a general dentist and is a conversation opener on the best restorative materials based on your experience.  Related questions include:  Is cast gold a long lost art? How many of us are still able to offer it to our patients? What would we as dentists put in our own mouths ? Dr. John Miner provided the following response:  Yes…fabricating well-fitting/occluding Gold Restorations is a lost art; I offer Gold Restorations to my patients; I would definitely advocate the use of Gold Restorations in my mouth. Let us know what you think. You can reply to ...

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Should amalgam fillings be changed to the latest white composites?

This question was submitted by a general dentist: As a practicing dentist I am often asked whether it is recommended to change amalgam fillings to the latest white composites. What information should I be giving patients in order for them to make a well-informed decision? Dr. Anuradha Prakki, Restorative Dentistry Assistant Professor, in the Faculty of Dentistry at the University of Toronto, has provided this quick initial response. Drafted by Alexandra Rabalski, JCDA Oasis Summer Intern It is important to inform patients about the benefits and drawbacks of both restorative materials. Amalgam generally tends to have a longer lifespan when compared ...

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Why are furcation areas important and how can they be treated?

This question was submitted by a general dentist: Why are furcation areas important and how can they be treated? Dr. Sayed Mirbod, representing the Canadian Academy of Periodontology (CAP), provided this initial quick response: The primary etiologic factor in periodontal disease is plaque. The outcome of periodontal therapy is in general good and predictable, if the clinician and the patient can adequately access root surfaces to remove the bacterial plaque. Access to the molars furcation areas is especially difficult for the patient and clinician alike due to the posterior location of molars, the dimension and position of furcation entrances, and the ...

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