A Willingness to Try and Quality Education
When it comes to dental materials, especially restoratives, product loyalty is high among dentists. And why shouldn't it be? When you've found a material that best suits your restorative protocol, repeated use allows you to perfect your technique and provide better outcomes for your patients. Although this mindset is perfectly logical, dentists shouldn't allow it to become a barrier that limits the potential of their treatment when, for certain cases, the use of an alternative material could further improve their results.
The willingness to try out new methods and materials is crucial to our ongoing success as modern dentistry continues to evolve. I was using the same adhesive for 25 years and getting great results when I decided to switch. Why? The manufacturer approached me and explained the benefits of their newer universal. I had already developed trust in their products and research, so I was willing to give it a try. This is an important point. When considering the adoption of a new product or method, it is imperative to begin with the evidence. Be aware of who is paying for the research and question its methodology. Talk with your colleagues who conduct research, and seek out reputable companies-many offer sampling programs to help you get started.
As restorative materials have become more nuanced, the importance of gaining an understanding of chemistry has increased. You don't need to become a chemist, but quality education is essential to understanding how these materials react with each other and the oral environment. Is isolation needed? Should you traditionally cement or is bonding required? Will that bond be exclusively chemical or also micromechanical? How does that affect your preparation?
For any case, your choice of materials must be informed by patient selection. Many dentists have expressed that, with the transition from microfills to nanofills, filler technology has reached a point of diminishing returns regarding reduction in particle size. Some of these clinicians may prefer the esthetics achieved by layering a microfill on top of a stronger material, but is that approach appropriate for every patient? Using multiple materials will reduce your profit margin, particularly for insurance-based patients, and many may be satisfied with the results achieved by a universal nanofill composite alone. Thus, your return on investment should be considered, not only when initially adopting a material, but also when considering its use on a case-by-case basis.
Undoubtedly, material selection involves many complex decisions. Our August 2018 Materials Guide looks at the current state of various dental materials and presents panels of expert contributors who offer insights on pertinent questions regarding their use. I'd like to graciously thank Drs. Poss, Bunek, Vargas, Fasbinder, Burgess, and Alex for helping to spearhead this effort as well as the panel contributors for their exceptional participation. They offer a lot of great information. Who knows? Their answers may even help you to arrive at some of your own.
Robert C. Margeas, DDS
Editor-in-Chief, Inside Dentistry
Private Practice, Des Moines, Iowa
Department of Operative Dentistry
University of Iowa, Iowa City, Iowa