Peter Walford Dentistry

An article in Oral health Journal written by Dr. Walford  is now posted online. See the online article

The title is “Anterior composite rehabilitation: a minimally invasive approach.”  . It details a method for augmenting worn anterior teeth from articulator-mounted models, using a stent to arrive at a pre-determined clinical outcome.

This article closely follows the content which will be organized in the upcoming Handbook of  Composite Prosthodontics

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At the Pacific Dental Conference  in Vancouver on March 8, 2019 , I demonstrated a lower-arch  molar MODL restoration on the Live Stage in the Exhibit hall. The Bandbender™ was an key part of the procedure. A large number of attendees “got it” and placed orders for Bandbenders with Sure Dental Innovations, our dealer for Bandbenders™.

Haven’t heard of the Bandbender? It’s the game-changing matrtix-shaper that makes large composites successful. Without it, don’t pass go, don’t collect $200.When sectionals become useless, bring out the Bandbender™.

You can’t talk about flight if you haven’t got wings. The Bandbender shaping system is a cornerstone to large composite success. It develops properly curved proximals from a flat  typical Tofflemire matrix. No broken contacts, no food traps, no expensive repairs. Win every time. Restore boxes of any size on teeth with any amount of missing tooth structure.

It could bring an enormous improvement in your restorative capability and your practice satisfaction. Stop doing it the hard way.

See THE BANDBENDER™

Other high points of the demonstration:

• Glass fibers- which are the best, and indications for placement
  
• Cusp shoe design principles –  bevels and the science behind them
• Outside-in gingival box preparation- protecting the adjacent tooth from iatrogenic damage
• Up-scaling gingival margins –  avoiding recurrent decay from enamel margin failure
• Isolate rubber dam- the best in the industry
• The Sippressor retromolar saliva ejector- an essential patient comfort and isolation device
• Custom wedge trimming- seal the gingival matrix and protect the curvature of the Bandbender™ matrix
• Contact Formers to guarantee proximal contact
• Etch- the most effective products
  
• Rinse- the most effective protocol
• Double-priming dentin, essential for postoperative comfort
  
• Caries detector for 100% certainty of caries removal and old composite removal
• Sandblasting for optimum margin adhesion
• Managing flash
  
• A sandblasting scavenging system to preserve operatory air quality
  
• Adhesive – a versatile DC MDP -based adhesive with a long success record
• Bulk-eze DC bulk fill, the only good bulk fill on the market with research to prove it
• Flowable first gingival increment  to prevent contraction damage to dentistry’s most  fragile margin
• Wet-pack placement- eliminating bubbles at cusp shoe margins
• Voco Grandioso, a very tough resin  with parameters to validate it
  
• Curing- deeply and powerfully to rapidly  increment large restorations
• Calibrating cure to the resin; joule requirement
  
• Proximal post-curing- to ensure maximum cross-linking at the heart of the restoration
• Occlusal shaping and polishing – a simplified, rapid  method
• Articulation – a rapid and exacting verification method  that meets best occlusal principles and delivers postoperative comfort

Perhaps you know these techniques, but if not, they are part of the Class II restoration method in the Handbook of Composite Technique, an online source book soon to be available from this site. Check back at the end of May for publication date.

After development in offshore markets, Tokuyama launched a new resin at the prestigious Chicago Midwinter Meeting in February 2019. It also hit the Pacific Dental Conference, March 2019 . The resin is Omnichroma

What’s new? Its singular claim is an ability to blend with very wide range of tooth shades using only a single shade. They manufacture a second to mask/opaque where needed.

See Cases restored using Omnichroma 

The Promising aspect of this product: Universal shade match promises to simplify  inventory for both dentists and suppliers. it also might improve cosmetics for the patient. Also, it might solve an unmet clinical problem-shade mismatch between restorations and teeth  if teeth are whitened (bleached) through a peroxide program, office-provided or OTC .

How good is it? Can we buy it, throw away our other shaded resins, and put it everywhere? We can evaluate esthetics because we can see that. Esthetics are not enough. We need to also evaluate any new resin for properties which we cannot see. Unless you feel like being reckless you will have to address the limitations highlighted in black below. take your own look at physical properties, which are housed in this product at Tokuyama’s Omnichroma Technical Bulletin

Check it out. You  will find  graphic comparisons with other well-known resins from several university research labs on:

• Gloss -pg 18= >90%,  rates very high compared to most resins
• Wear resistance – pg 20= negligible with negligible opposing tooth wear. Top in its class
• Polymerization Shrinkage – pg 21 1.5% a beneficially low number
• Radiopacity – pg 25 = average for posterior resins
• Contraction Stress – pg 29 =>2.5MPa, higher than most, a negative quality suggesting careful placement of small increments might be needed to avoid white line defects and crazing enamel in the host tooth
• Flexural Strength —pg 30- 110MP  weak– suitable for light function patients in Class II restorations
• Elastic Modulus- pg 30= 9.2 GPa- less than dentin, below median for posterior resins, limiting its application to light to light-medium function patients. See Resin Selection Sieve , Light function patients 
• Compressive strength -pg31- 310MPa = high, but not usually a significant clinical attribute
• Depth of cure – pg 32 –  consistent to 4 mm, indicating high curabiity, which should deliver on properties in real-life clinical application. Better than most resins
• Stain resistance -pg 22 = low, on par with best-rated resins
• Color Matching- repeatedly superior to most shade-matched resins

Want to go further? Have a look at how I evaluate resins?…See RESIN SELECTION