The consideration of biomechanics in dentistry involves applying the principles of engineering and physics to better understand the dynamics of the forces of mastication. Among other benefits, this understanding helps dentists select the most appropriate materials for each indication, optimize the location of implants, and halt the progression of damage from parafunction, maximizing the longevity of restorations and occlusal stability. This month's cover story explores the concept of biomechanics and its relevance to all aspects of restoration.
Regarding the biomechanics of materials, stronger isn't always better. Selecting materials with the correct balance of strength and esthetics for their location in the mouth, as well as their relationship to surrounding restorations, not only increases the success of restorations long-term, but also allows us to control failures. The fracture of a restoration is more easily rectified than that of natural tooth structure or an implant. Catastrophic failures, especially those of iatrogenic origin, must be avoided at all costs. To improve dentists' understanding of the materials available for prosthodontics, this month's CE classifies dental ceramics and presents selection criteria.
When it comes to respecting biomechanics, as well as achieving longevity, no material can compete with cast gold. Although the cost-prohibitive nature of gold has led to its reduced emphasis in dental school, techniques for placing it are still taught in other venues. This month's inside restorative article presents a case that employs the Tucker technique to replace failing composite restorations with beautiful gold castings that could function for a lifetime. In my practice, I see patients with gold restorations that were placed by my partner more than 50 years ago that exhibit no signs of failure. I have gold restorations in my own mouth that are more than 30 years old. In terms of longevity, gold really is "the gold standard."
Robert C. Margeas, DDS
Editor-in-Chief, Inside Dentistry
Des Moines, Iowa
Department of Operative Dentistry
University of Iowa,
Iowa City, Iowa