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Dental Materials

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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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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Comparing whitening agents: which is more effective?

This summary is based on the article published in the Dental News: Comparison of short-term effectiveness of four different tooth whitening systems (September 2012) Context Popular media has had an impact on swaying people’s opinion about teeth whitening. It is increasingly considered that whiter teeth are healthier and more pleasing. As a consequence, there has been large demand for such procedure accompanied by a proliferation of tooth-whitening materials and methods.   The study aims at: Reporting and comparing the short-term effectiveness and major side effects of four (4) different whitening systems (Opalescence 20%; BRITESMILE 2000; ZOOM; and ZOOM3 in combination ...

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Opening the Conversation: Temporization – What is the best material for veneer temps and what are the best techniques?

This question was submitted by a general dentist: Temporization – What is the best material for veneer temps and what are the best techniques? The following is a “discussion-opener” response by Dr. Dorothy Marko: After 33 years, you would have tried a lot of different things. A best practice starts with an excellent wax-up of what you want your case to look like. The lab fabricates a clear silicone template that is well adapted to the margins and gingiva. Any self or light cure temp material will work well, if the silicone matrix is well adapted and vented. There is very ...

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