Read
Lecture 4 Notes | Read Comments | Add Comments
Comments
for Lecture 4
I don't think anyone will disagree that it is more important to treat the disease than individual teeth. But unfortunately, at the school here, we are all mainly focused on fulfilling requirements and doing as much tooth cutting as possible. To us, a "good" patient is one who needs a lot of work done...not one that has a stable mouth.
David Gilmer <gilm0069@tc.umn.edu>
- Thursday, September 19, 2002 at 08:41:56 (CDT)
I think that we need much more exposure to composite before we get up to clinic. Currently it is sort of an afterthought in the curriculum. If good technique is the hallmark to placing successful composites, then we need further instruction in order to place the best composites in clinic.
Gary Hedin <hedingj@tc.umn.edu>
- Thursday, September 19, 2002 at 07:44:49 (CDT)
I don't think we did enough composite work in preclinic labs. The number of people who did not pass all their composite work was quite significant...more work is needed. Also...what's with the lecture notes?? they don't follow what we were lectured on!
Julie Smith <smit1631@tc.umn.edu>
- Thursday, September 19, 2002 at 07:42:16 (CDT)
There are many who are very loyal to GV Black and that seems to work fine but I am excited about THE FUTURE OF DENTISTRY and being a part of it. Composites are only getting better people!
Sarah (Laszcwski) Melstrom <slaszcws@tc.umn.edu>
- Thursday, September 19, 2002 at 07:39:51 (CDT)
I'm still waiting for a lecture comparing composite and amalgam. All we've had so far is lectures either for composite or for amalgam. They're both good materials, but for different situations.
Todd Miller <mill1154@umn.edu>
- Thursday, September 19, 2002 at 07:33:31 (CDT)
I was talking to dentist about the concept of "chasing" caries. The dentists point was, why leave undermined enamel and not be sure that you have removed all of the caries? Perhaps if you have an adequate seal, but because this is so technique sensitive is it really realistic?
Stephanie Miner <schw0438>
- Thursday, September 19, 2002 at 07:23:51 (CDT)
I think esthetic dentistry will be used on every patient in a few years. People love to look good, and as long as composites last they should be used over amalgams.
Jeremy Gross <gros0159@tc.umn.edu>
- Thursday, September 19, 2002 at 07:18:56 (CDT)
Esthetics is the wave of the future in dentistry. Tooth colored materials will be done more often.
Tom Tadysak <tady0005@tc.umn.edu>
- Thursday, September 19, 2002 at 07:05:26 (CDT)
A chart was shown in lecture which gave the reason for replacement of amalgam restorations. I would really like to see the same chart for composites. That way we would have a better idea about its weaknesses. For instance, I would rather replace a composite because of excessive wear than replace an amalgam with a bigger amalgam because one of the cusps fractured off. How often restorations fail is important, but how and why they fail I think is even more important. Also I would like to see some failure rates for composites which don't have margins on enamel all the way around. Like on root caries for instance.
Craig Spieker <spie0089@tc.umn.edu>
- Thursday, September 19, 2002 at 06:57:12 (CDT)
I think that in a matter of only ten years, amalgam will be phased out of practice. Composite restorations are continually getting better, therefore there is no need for the excessive destruction of tooth structure. Actually, there are quite of few practicing dentists that I know of that don't even use amalgam anymore. I think that this will be a common trend in the next couple of years.
Mike Henrickson <henr0193@tc.umn.edu>
- Thursday, September 19, 2002 at 06:50:28 (CDT)
I have heard many complaints about composite relating to microleakage, but according to the studies presented that is clearly operator error. Maybe we should be doing more composite work the preclinical area to perfect our techniques.
Josh Campbell <camp0385@tc.umn.edu>
- Thursday, September 19, 2002 at 06:49:05 (CDT)
Evidence-based model and traditional-based model are somewhat related, therefore the combination of the two models would give us a better definition of the reason for operative treatment. ie. The goal as a dentist is to eliminate the disease and infection in the oral cavity (Evidence-based model), so if a lesion is present, then the restoration of the damaged tooth structure is required(Traditional-based model).
Phillip Zhan <phzhan@yahoo.com >
- Thursday, September 19, 2002 at 01:18:04 (CDT)
I have a patient who is on MA and is need of a removable partial denture. Teeth #2, #3, #14, and #15 are in need of therapy due to recurrent caries and broken cusps. She says that she can't afford crowns. This past lecture showed the value of adding bonding agent to amalgam to arrest caries, but would bonding of amalgam provide enough strength to support a RPD? I suspect that a RPD would still be contraindicated for this patient...does anyone have any other perspective on the matter?
Michael Nelson <nels1959@tc.umn.edu>
- Thursday, September 19, 2002 at 00:53:14 (CDT)
I also wonder why we haven't had more practice placing posterior composites in pre-clinical labs if this procedure is becoming mainstream in private practice, especially if evidence shows its strength rivals that of amalgam.
Alisa Nord <anord@tc.umn.edu>
- Thursday, September 19, 2002 at 00:11:40 (CDT)
The debate about posterior composites versus amalgam is very interesting. In preclinic we received such a one-sided view of the debate (favoring amalgam), it is nice to hear the other side (favoring composite). I have still to be convinced that one is without a doubt a better choice than the other because they both have their advantages.
James Sigaty <siga0004@tc.umn.edu>
- Wednesday, September 18, 2002 at 23:56:05 (CDT)
I have talked to a couple of dentists in private practice who are beginning to restore primarily with posterior composite opposed to amalgam. We have heard so much in the last year about why amalgam is superior in posterior restorations. After seeing the evidence presented in this lecture on the longevity of posterior composites, I can understand why a lot of dentists are using this restorative material more.
Brian Vieregge <vieregbl@umn.edu>
- Wednesday, September 18, 2002 at 23:43:43 (CDT)
I hope that with the addition of the Class II composite requirements, treatment planning faculty will be willing to use composites where they might not normally have done so. This will be a great learning tool for us as well as the faculty.
Aaron Johnson <john3097@tc.umn.edu>
- Wednesday, September 18, 2002 at 23:42:41 (CDT)
You provided us with a lot of practical knowledge on the subject of restorative materials, which will be extremely helpful for us while talking with patients about this subject. I am however, interested in knowing more about how stainless steel crowns work so well for pedo cases. I would assume that the bacteria associated with caries generally stays away from the gingival pockets? I'm interested in hearing more...
Nathan Mork <morknp@umn.edu>
- Wednesday, September 18, 2002 at 23:24:04 (CDT)
With all of the evidence that indicates composites are rapidly approaching the strength of amalgams and they bond to tooth structure, I am curious as to why so many faculty members and private dentists are against their use as a posterior restorative material?
Stephen Sawyer <sawy0071@umn.edu>
- Wednesday, September 18, 2002 at 23:17:55 (CDT)
I commented to an older/experienced instructor in clinic about the ability of composite bonded restorations to isolate caries when sealed over. They told me that this concept was unproven and unusual. This response proved your theory about the stratification of knowledge that is associated with the amount of time in clinical practice. Also, it made me wonder if as we progress in our practice if we will gradually stray away from Evidence Based dentistry, to one that we have simply mastered over the years of experience. And eventually become resistant to change...
Russ Dylla <rdylla@tc.umn.edu>
- Wednesday, September 18, 2002 at 23:03:45 (CDT)
I found the lecture on post. composites to be very interesting. I was suprised to learn about the comparisons between amalgams and composites. It was very contradictory to what we've been taught in the past, but I look forward to working with the material in the future.
Kara Lobaugh <loba0008@tc.umn.edu>
- Wednesday, September 18, 2002 at 23:03:16 (CDT)
We learned in Biomaterials that shrinkage in composites is inevitable, especially in larger restorations. How does shrinkage affect the longevity of a particular restoration? Are there situations where the amount of shrinkage will eliminate composite as a choice of material?
Jason Johnson <john4525@umn.edu>
- Wednesday, September 18, 2002 at 22:28:54 (CDT)
I also thought that the evidence presented on posterior composites was very convincing. We definitely should have spent more time doing them in preclinic.
Jon Matthes <matt0428@tc.umn.edu>
- Wednesday, September 18, 2002 at 21:48:51 (CDT)
In pedo, I am contantly reminded of what a disservice it is to our patients to take away healthy tooth structure just to adhear to the GV Black concepts. These children are young, and so are their teeth. They have manly miles left on them. Thus, in the end these teeth will probably need crowns, RCTs, and possibly extractions. Would a composite restoration have served these patients better? According to insurance companies-no. Parents have a hard time seeing the benefits of a more expensive restorative material when their mouths are filled with silver fillings which they deam as adequate. Then there is the question of isolation. Will composite serve the needs of my patient if I can't gain the isolation necessary? Maybe amalgam is the way to go in these situations. These lectures have raised many questions. I look forward to futher discussions into these topics. Lectures like this one, remind me to think critically and look to the literature for answers.
kellee kattleman <katt0013@tc.umn.edu>
- Wednesday, September 18, 2002 at 21:40:29 (CDT)
Based on the information presented in lecture I have a new appreciation of composites. The studies presented had surprising data. I still feel that amalgam is superior in certain situations. How does composite compare in large posterior restorations? In situations where isolation is inadequate? Even from my minimal clinical experience isolation isn't always that easy.
Ben Knutzen <knutzebt@tc.umn.edu>
- Wednesday, September 18, 2002 at 21:00:40 (CDT)
It was very interesting to hear about the possibilities of locking in caries and "starving" caries with a proper seal in regards to composite restorations. I asked one of the "On Staff Dentists" in the ICC clinic about this last night and he told me I was crazy. I guess that this is an instance in which the future and the past ideologys of dentistry are in stark contrast with one another.
Ryan Tietz <tiet0020@tc.umn.edu>
- Wednesday, September 18, 2002 at 20:59:26 (CDT)
During the lecture, you referred to some studies that compared the survival times of amalgams vs. composites. If I recall correctly those studies showed composite to be superior. I was wondering if those different materials were compared in the same types of restorations i.e. the same number of surfaces, ant vs. post, etc.?
Melissa McCartney <mcca0326@tc.umn.edu>
- Wednesday, September 18, 2002 at 20:49:42 (CDT)
I know some people still swear by amalgam for posterior restorations, because they believe the corrosion products result in reduced microleakage. However, in a lot of cases we've seen in the pedo clinic, sealants are often placed over the top of the composite to reduce leakage. Is this technique applied to adult patients ever?
Eric Knaff <knaf0006@tc.umn.edu>
- Wednesday, September 18, 2002 at 20:31:03 (CDT)
With the over-whelming information presented in class regarding
amalgam and the need to replace it due to failure of the tooth or
restoration, it is uprising to me that dentistry as a whole is
not moving away from amalgam as a restorative material at a
faster pace.
derek gustafson <gust0222@tc.umn.edu>
- Wednesday, September 18, 2002 at 20:23:36 (CDT)
I am really interested in the concept of sealing decay under restorations. I believe that if you do starve the bacteria the decay will not progress. But I had sealants replaced at about 18 on all my post teeth. Two years ago I went into the dentist and had 3 places where I had major decay, almost to the pulp on two. The dentist told me that the sealants must have started leaking and in that semi- anerobic enviroment they went crazy! How often would leakage lead to problems like this?????
Jolene Welter <welt0081@tc.umn.edu>
- Wednesday, September 18, 2002 at 20:05:21 (CDT)
I, like most others who commented, found it interesting that the failure rates of amalgams and composites were so similar. I'd like to see some data showing the effect of not obtaining proper isolation (rubber dam) on each procedure. I'm willing to bet that in instances where complete isolation is not able to be obtained, amalgam has a lower failure rate.
Adam L. Forster <fors0174@umn.edu>
- Wednesday, September 18, 2002 at 19:46:32 (CDT)
I thought that the evidence presented on posterior composites was very convincing. I wish more of the operative faculty would recognize the value of these restorations and have us practice them in preclinical. It is clear to me that it is a very very common procedure out in practice so I don't see why it is not a larger part of our preclinic curriculum
Luke Eichmeyer <eich0092@tc.umn.edu>
- Wednesday, September 18, 2002 at 19:28:53 (CDT)
Similar to Krista, I too was intrigued by the analoguous reference of caries and diabetes. This can be yet another clinical tool to use in a case presentation for patients who are frustrated with their dental condition. On a different note, in terms of composite restorations, it is extremely interesting to hear about the study on ultraconservative and cariostatic sealed restorations. It is mildly baffling that approx. 90% of the sampled restorations displayed arrested caries from this type of approach. That bit of information should definitely be applied in our schools.
Ryan Francis <fran0540@tc.umn.edu>
- Wednesday, September 18, 2002 at 18:34:08 (CDT)
I think that the charging for our intellect comment was very interesting. Many people just see us as people that drill, fill and bill, instead of seeing us for doctors who diagnose and control disease
Aaron D. Imdieke <imdi0012@tc.umn.edu>
- Wednesday, September 18, 2002 at 18:34:07 (CDT)
It was good to see how the trends have changed from the traditional thinking to the evidence based thinking. In the future will amalgam restorations be completely obsolete? and how long are the new composite restorations expected to last?
Grant Raykowski <rayk0002@tc.umn.edu>
- Wednesday, September 18, 2002 at 18:31:05 (CDT)
I feel that to successfully treat a disease, the clinician needs to consider all disease parameters. In this case, patient diet, oral hygiene, occlusion, motivation, etc. The timing and inclusion of treatment modalities really needs to become part of the dental mentality.
Brian Barsness <bars0020@umn.edu>
- Wednesday, September 18, 2002 at 18:03:29 (CDT)
I am a little confused. Evidence-based dentistry is based upon the availability of evidence within the literature, however, due to the shear volume of experiments, trials and such, it seems that you would feasible be able to find literature support for any procedure you would like to do. For instance, there have been countless articles on the benefits of amalgams, beginning many years ago.However, there are also articles supporting posterior composites. If you can find back-up for both procedures, wouldn't the dentist then have to decide on a treatment based upon his/her experiences and comfort level?
Leslie Spangler <span0072@umn.edu>
- Wednesday, September 18, 2002 at 17:02:10 (CDT)
I came away from this lecture with the idea that our thought process has to change. Whether or not you are only composite or also use amalgam isn't as important as when you finally decide to treat and the thought process behind, ie risk assessment.
Alyssa Hedstrom <lind0617@tc.umn.edu>
- Wednesday, September 18, 2002 at 17:01:30 (CDT)
Can you confirm the idea of sealing in decay? I would think sealing it in, might not always really be a seal at all. Is it now being taught to seal in decay rather than taking away extra tooth structure in selected cases based on the study presented to us in class and/or others. Or are you just stating that the bacteria are starved if sealed in? Are we expected to practice sealing in decay?
peter miskovich <misk0020@umn.edu>
- Wednesday, September 18, 2002 at 16:42:46 (CDT)
The lecture was very interesting. Everything we have been taught so far seems to be the absolute opposite. I would like to talk to dentists that practice everyday and see what their views are. I really don't think using composite all the time is always correct. Saying that it's the dentist's technique that causes the failure is to easy. Patient compliance and difficult isolation might have something to do with composite failure.
Bryan Johnson <john2819@umn.edu>
- Wednesday, September 18, 2002 at 16:35:07 (CDT)
I agree with the idea of not removing too much tooth structure, but it is hard to argue with faculty when they tell you to use amalgam in a certain tooth instead of composite.
Stephen Moore <moor0461>
- Wednesday, September 18, 2002 at 16:22:28 (CDT)
I found the slide describing treatment options (the one showing the spectrum from X-sound tooth to Y-loss of said tooth) to be of great interest. Especially when you only use sealants to "restore" a tooth. I ran into a case this week in which one instuctor thought there should be an occlusal composite placed in #30, but another instructor argued that the tooth would recieve the same benefit from just a sealant because there was no real evidence of an active caries process. Both ideas sound good and have reason behind them. I think these topics require more conversation and we should devote more of our time to discuss treatment options so that when we are finished with school we have the knowledge base to make such decisions.
Nathan Pedersen <Pede0328@umn.edu>
- Wednesday, September 18, 2002 at 15:50:04 (CDT)
I found your statement very powerful that caries is like diabetes. You said, "Once you have it you have it for life." YOu can control it but you cannot cure it. This is a great way to explain caries to your patients. Thanks
Krista Miller <mill1021@tc.umn.edu>
- Wednesday, September 18, 2002 at 12:27:06 (CDT)
This evidence-based approach sounds great for new carious lesions, but how can we apply this mimimal intervention approach to our patients that have old restorations that are breaking down from wear and tear? (Especially now knowing that the restorations may have been placed in absence of disease, based only on an explorer that stuck in an occlusal fissure) Is not fixing, but rather watching, them an option?
Chris Wangen <wang0141@tc.umn.edu>
- Wednesday, September 18, 2002 at 12:07:12 (CDT)
Someone previously made a comment regarding the use of composite in posterior teeth and being laughed at for providing it as an option. I ran into this in tx. planning last week, a posterior tooth that needed a restoration (2 surface) and in talking with the instuctor I said composite could be used and he quickly replied "no we wouldn't use composite there." Dr. Zidan's analogy to grandparents and their music vs. us and our music was right on the money. People have different ways of thinking and sometimes no matter how much evidence is provided people are not willing to accept something new.
Sarah Como <scomo@umn.edu>
- Wednesday, September 18, 2002 at 11:42:56 (CDT)
The discussion about sealing in caries was interesting but a little distressing. I think that the study showing that caries progression stops if it is properly sealed in is all fine and good but I think it could lead to lazy dentistry. I would think that the dentin infected with caries is very weak and a sloppy dentist cound just bust through the enamel, through some composite on it and leave a very weak tooth. The caries may starve but the weak tooth structure is still there. Im sure the purpose of the article was not to let dentists know that they should do this but I will need to do more research to see where this application will be helpful in my daily practice life.
Dylan Ascheman <asch0013@tc.umn.edu>
- Wednesday, September 18, 2002 at 11:04:45 (CDT)
The lecture covered Tradition Based Model and how it is based on the restoration and not on the carious lesion. I thought that was a great point that dentists need to look at more often. For so many years dentists have been carelessly cutting away more tooth than necessary to accomodate the restoration. I also was enlightened about the reimbursement rates follow how much tooth structure is removed. It's nice to look at things from a different direction.
Jeremy Wehrman <wehr0018@tc.umn.edu>
- Wednesday, September 18, 2002 at 11:00:11 (CDT)
During the lecture, I learned that sealing in caries under a resoration would take away many things that are needed for growth and development of the bacteria. It was never made a point in our other classes.
Brent Deragisch <dera0008@tc.umn.edu>
- Wednesday, September 18, 2002 at 08:09:51 (CDT)
It is interesting to hear that amalgam and composite have similar success rates when placed posteriorly. Maybe now we will be able to place more posterior composites in the clinic without getting laughed at.
Matthew Berg <berg0522@tc.umn.edu>
- Wednesday, September 18, 2002 at 07:37:56 (CDT)
Yesterday's lecture exposed ideas that have sort of been pushed to the side by former lectures. I worked in a dental office that placed no amalgam, therefore relying heavily on composite and porcelain. At the time I didn't completly understand the reasoning he had, but I am beginning to see why composite is becoming the material of choice. As other people have commented...the materials have only improved and will continue to in the future. I think this is benficial for both the practicing dentist and the esthetically concerned patient. Approaching treatment with these materials will offer longevity and a pleasing appearance.
Heidi Nichols-Johnson <nichols@hotmail.com>
- Wednesday, September 18, 2002 at 07:37:24 (CDT)
I thought it was interesting that the failure rates for amalgam and composite were similiar. It seems in past lectures that amalgam was superior over composite in posterior teeth.
Jennifer LaBerge <luke0035@tc.umn.edu>
- Tuesday, September 17, 2002 at 23:33:44 (CDT)
Composite has been proven in many studies to be a superior restoration. In my recent experiences in pediatric dentistry, I have realized that the less tooth structure removed the better. For all people, kids especially, tooth structure is so important. Caries will remain in most caries prone patients, so the least amount of tooth removed the better because the bacteria will be removing the tooth not us.
steve graber <grab0054@umn.edu>
- Tuesday, September 17, 2002 at 23:14:55 (CDT)
It was interestign to see the data comparing the longevity of composites vs. amalgams and how similar they are in respect to survival time in the mouth. Is this "survival time" the ability to resist recurrent decay around the margins, or does it take into account the wear placed upon the restoration? All the infomation we have been presented in other classes stated that composites are significantly weaker under function in the posterior teeth (ideal gold, amalgam, then composites). Based upon this, shouldn't we be placing amalgams when needed to withstand the forces of occlusion, especially in the posterior? If composites can now match up to amalgams in wear resistance then they should be utilized more often due to conservation and esthetics.
Devin Croft <crof0017@tc.umn.edu>
- Tuesday, September 17, 2002 at 22:46:31 (CDT)
If there is data out there from composites that were placed over 10 years ago, then todays composites must be leaps and bounds ahead of what was placed in the mouth then. 3M and other dental product manufacturing companies are pumping these new materials out left and right, to the point that many of the tested materials are now obsolete.
Erick Hallie <ehallie@hotmail.com>
- Tuesday, September 17, 2002 at 22:36:59 (CDT)
I didn't realize that I needed to put a comment for lecture 2, now it is too late!
I had a patient today who had the db cusp fractured off of #15. Of course a gold onlay is best, but my consulting operative instructor said amalgam was the next choice, and not to consider composite, because it would just break off. I find this interesting, if amalgam has little retention in this situation, wouldn't composite work well? This is assuming no functional/nonfunctional contacts...I would like to have tried this to see just how long this restoration would last in composite.
Patrick J Capp <capp0021@tc.umn.edu>
- Tuesday, September 17, 2002 at 22:08:47 (CDT)
Like Adena, I to agree that it is not enough to treat just the symptoms of a disease such as caries, but that we must also treat the disease itself. Since we can never eliminate the three etiologic components entirely - teeth, bacteria, and food - how do we control it? Also, I was a bit confused about the statement that we should never replace restorations due to secondary caries. Any clarifications?
Jessica Inglis <ingl0011@umn.edu>
- Tuesday, September 17, 2002 at 21:58:28 (CDT)
It was interesting to me when the caries process was compared to diabetes- I had never heard that comparison before. I think the analogy would actually be very helpful when explaining caries to patients because it may help them understand caries as a disease process, and would also demonstrate the need for intervention/ control of the disease.
Polly LoCascio <loca0008@tc.umn.edu>
- Tuesday, September 17, 2002 at 20:44:09 (CDT)
Given the data that we were all shown in class today, and given that they were looking at rates over several years' time, obviously the data was compiled using "old" bonding agents and composite materials. One assumes that newer bonding agents and composite are ever-improving, so we have even more reason to make lesion-specific restorations than we did 10 years ago.
Karl Haemig <haem0002@tc.umn.edu>
- Tuesday, September 17, 2002 at 20:15:23 (CDT)
Dr. Zidan said in lecture today that 'caries is like diabetes, you can't treat diabetes, you can only control it'. So, how are we supposed to control the caries disease process in patients who are resistant to maintaining good oral hygiene, and who have no desire to cut down on sugar/soda? What are some methods of convincing them that this is the only way to prevent future decay?
Ann Thiele <thie0097@tc.umn.edu>
- Tuesday, September 17, 2002 at 20:03:20 (CDT)
Today you told us that we should use composites whenever possible, and this includes posterior tooth restorations. We have been told in other classes that posterior composites have lower strength than amalgam when placed in posterior teeth. I am wondering whether the studies giving the longevity of restorations placed, that we looked at today in class, were based on anterior or posterior composites, or a combination of the two. If the studies were based solely on posterior composite restorations, do you feel that the longevity of the restorations would decrease?
Erin Gannon <gann0033@tc.umn.edu>
- Tuesday, September 17, 2002 at 18:56:20 (CDT)
I understand the benefits of composite but know that many older dentists prefer amalgam for posterior restorations because it's "stronger." Is amalgam really stronger in posterior restorations and if so wouldn't that make it the material of choice. However if the strength of composite equals that of amalgam shouldn't composite be preferred do to it's esthetic qualities?
Stephanie Guy <guyx0015@tc.umn.edu>
- Tuesday, September 17, 2002 at 18:44:18 (CDT)
What are the clinical requirements for composite restorations? How many do we have to do and of what types?
Brett Knutson <knut0283@hotmail.com>
- Tuesday, September 17, 2002 at 18:43:59 (CDT)
It would be great if we can get some review on the techniques about using composite, especially on achieving complete seal around the margin.
Lan Zhou <zhou0039@tc.umn.edu>
- Tuesday, September 17, 2002 at 17:09:51 (CDT)
I know a lot of dentists today in private practice have gone to doing basically only posterior composites unless there is extensive decay requiring a crown. Do you think that really the only time that an amalgam makes sense is for an MOD with extensive decay?
Thekla Olson <olso1118@tc.umn.edu>
- Tuesday, September 17, 2002 at 17:04:45 (CDT)
I agree with Kelly- it seems that every dentist has a different way of doing things. The two dentists that I observe back home both have entirely different philosophies on the correct way to place composites. Since it appears that dentistry is shifting away from amalgam and towards composite, I wish that we would have a lot more instruction on the correct technique for placing composites.
Katie Lantz <lant0025@tc.umn.edu>
- Tuesday, September 17, 2002 at 16:52:59 (CDT)
It is surprising how opinionated dentistry can be. I can see why dentists find their knitch and try to get comfortable there by gaining experience at performing particular procedures with particular materials. This way they can give their patients an honest and personal prognosis.
Kelly Reynolds <krol0068@umn.edu>
- Tuesday, September 17, 2002 at 16:49:46 (CDT)
I agree with your position about how we treat the symptoms of the disease, rather than the disease. I have been hearing this for a while, but what I have not been taught, is how to change my method of treating the patient that allows me to treat the disease. How do you do this? What does this mean? I am waiting for someone to help us solve our problem instead of continually pointing it out.
Adena Borodkin <boro0038@umn.edu>
- Tuesday, September 17, 2002 at 16:18:03 (CDT)
The use of composites in posterior restorations seems like the most ideal treatment after hearing the presentation today. It was interesting to see the success of composite restorations compared with amalgams in posterior teeth. Have there been any studies specifically done with class II composites? I have heard a few dentists say that they question the efficacy of class II composite restorations.
Brandon Owen <owen0133@umn.edu>
- Tuesday, September 17, 2002 at 15:33:25 (CDT)
I find it interesting that the vast majority of amalgams are replaced due to secondary caries. Maybe we should be taking a little more time to explain the importance of oral hygiene around restorations.
Roxane Huber <hube0079@tc.umn.edu>
- Tuesday, September 17, 2002 at 15:10:00 (CDT)
I found it interesting that amalgams and composites had such similar survival times. I had always hear that composites don't last as long as amalgams. I am wondering how often composites are replaced for "recurrent decay" or if they are often replaced because of staining???
Carrie Carlson <lebl0022@umn.edu>
- Tuesday, September 17, 2002 at 14:36:56 (CDT)
I am wondering...is there any data available on the longevity of composite resorations placed by students at the dental school? My dentist who works in St. Paul mentioned that he has to "re-do" many of the composites previously placed by students at the U of M, and he believes the composites fail because of water in the air spray, or something to do with our water lines. Has anyone heard this before?
Emily Vober <vobe0003@tc.umn.edu>
- Tuesday, September 17, 2002 at 14:30:02 (CDT)
I think that we as the next generation of dental professionals need to treat dental disease in a wholistic way according to the evidenced based model of dentistry. The material chosen to restore teeth does not put an individual in a group of traditionalists rather the attitude is what reflects the clinicians rationale for treatment. It is also imperative to not focus on the model to such an extent that one forgets to treat each individual with respect to their situation. For example should we treat an individual that presents with incipient decay if they are caries active and won't be able to come again for some time. I propose that we do in this case restore conservatively.
Will Manke <mank0027@umn.edu>
- Tuesday, September 17, 2002 at 13:06:40 (CDT)
I think that it is interesting that the survival rates for amalgam and composite are so similar. I suppose that there are instances where amalgams have lasted fifty years and could connote durability for that reason, but composite hasn't been used long enough to yield such results.
Jim Healy <heal0052@tc.umn.edu>
- Tuesday, September 17, 2002 at 13:02:33 (CDT)