Restorations represent the bedrock of many general practices. Yet the materials, techniques, and technologies are always changing, meaning related seminars and workshops are always popular at shows like CDA Presents in Anaheim last week.
For example, Troy Schmedding, DDS, discussed principles in today’s restorative dentistry during Thursday’s lecture series. The practicing cosmetic and restorative dentist brought his 20 years of experience to a packed room eager for his insight. We spoke with Dr. Schmedding after his session.
Q: How has restorative dentistry evolved from the “drill and fill” days?
A: Now we’re moving to a more minimally invasive approach. We’re able to do a lot less aggressive preparation and still get predictable results for our patients.
Q: What role have new materials played in this evolution?
A: In the restorative department, we’ve obviously increased the strengths of our materials, the aesthetics of our materials, which in turn has given us the ability to do smaller restorations, so to speak, in the minimally invasive part. We can do smaller preparations, place thinner fillings, but still have adequate strength for those materials for the long term.
Q: What about older materials like the amalgams? Are you seeing a broader move away from them?
A: Absolutely. Amalgam still has a viable place in dentistry. But for the good or the bad, our patients are requesting more aesthetic-type things. Obviously there is some controversy over whether it’s for health reasons or not, but a lot of dentists have taken that out of their arsenal due to some of the pressures that come with it.
Q: What other benefits do newer materials provide?
A: Ultimately our goal is longer durability. We’ve got a situation where our restorations aren’t lasting as long as we’d like them to last, so hopefully these materials provide that long-term durability.
Q: What are some of the other technologies influencing restorative dentistry?
A: The digital world is taking a big place in dentistry in terms of how we’re processing our cases, even in taking impressions of patients and in turning them into one-day procedures.
Q: What role is preventive dentistry now playing in restorations?
A: Are we being more preventative on the earlier side of things? Absolutely, which may be minimizing some of the dentistry that may need to be done in the future. Also, we’re not getting ourselves into a situation where every case needs a crown. We can get away with minimally invasive ceramics being more durable in a minimal state. We may happen to not to need to do as much preparation on teeth. For instance, take a 20-year-old person who may need a crown. With a minimally invasive approach, we can prolong the life of that tooth. Once you’re into a full-coverage crown, it’s tough to get back out again. The less you can do to a tooth, the better in every appointment.
Q: Are you finding better case acceptance with the minimally invasive approach when you present it to patients?
A: I think case acceptance comes down to good communication from the dentist and the staff. You really have to give patients an understanding of the benefits behind it. If the doctor and staff are doing their job appropriately, then generally it shouldn’t be too big of an issue.
Q: Looking ahead, what do you see as the next step in restorative dentistry?
A: I think the next thing that we’ll probably see is bioactive work, more of the bioactive materials—maybe eventually replacing some of the composite restorations that we’re doing today.
Intraoral Repair of Multiple Substrates Using Silication
Preventative Plan Reduces Fillings By 50 Percent