INTRODUCTION: THE GOALS OF DENTISTRY
We have many problems in composite dentistry. Most DDSs are placing composites without continuity in conceptual integrity, scientific justification, or full awareness of the breadth of relevant parameters in product selection. This is not their fault. It is almost impossible to do otherwise.
I did not set out to be a study club mentor. I wanted to join an existing group. But I could not find an operating study club in my home province of British Columbia, Canada, nor in the adjacent province of Alberta, in fact nowhere in Canada was there a vigorous network of study clubs. British Columbia has a very diverse network of over 75 study clubs but none confined their interest to composite resin technique. I looked all the way south through the USA states Washington, Idaho, Oregon and California, all my inquiries terminating in dead ends.
So, in the face of this frustration, I began a study club in 2003 toopen the discussion and explore the current practices in resin restoration, and subscribing to the prominent published product review organizations, Reality Research, Clinican’s Report, and The Dental Advisor. Soon I began building a website, which eventually grew to 400 pages, supporting my teaching, publishing spreadsheets and warehousing scientific references. I took my procedural conclusions to my local dental school, the Canadian lecture circuit, joined CARDP, went online as a mentor, and published articles, and invented procedures, concepts, approaches to treatment and products which you now see on this site.
Nothing much has changed over the past 15 years in the shortcomings and difficulties of the composite resin field. Standard of care remains inconsistent, scientific underpinnings lack continuity, products are over-marketed with frequent unsubstantiated claims, academia remains in turmoil, and clinicians practice in cottage-industry style with little consistency from practice to practice.
LOOKING FOR REDEMPTION
I have taken an extraordinary amount of time and effort to find effectiveness in the composite realm, mentoring for 15 years, presenting to over 4000 dentists in this period. In doing live clinics, demonstrations, inventing devices, originating techniques, and assembling a large website and putting in the hours necessary for mastery, I have found it a rewarding but unrequited pastime. Little has changed within the system in the past decade to alter the playing field. Yes, today our resins are better, lights are stronger, curing times have reduced, adhesives are more comfortable postoperatively, matrixes and other adjuncts have improved.
In the Handbook of Composite Excellence I have revised all the GV Black procedures explicitly for composite resin, and I also present a method for a new class of treatment for worn or eroded incisors, Incisal Attrition.This handbook aims to collect all the expertise leading to restorations that are a source of pride, which meet the expectations of the public and government overseers, which deliver lifespan comparable to amalgam, which restore the strength of the tooth to a far higher level than amalgam.
These can be attractive, unlike amalgam, and are less destructive and invasive than most laboratory procedures, and which meet both the traditional goals of restorative dental treatment and new goals that are within reach when using the composite paradigm..
TRADITIONAL GOALS OF DENTISTRY
- To conserve tooth structure
- To maintain the occlusion
- To prevent further breakdown of the clinical crown
- To protect the periodontal tissue
- To preserve the comfort and vitality of the pulp
ATTAINABLE NEW GOALS OF COMPOSITE DENTISTRY
- To preserve and promote the appearance of the patient
- To avoid systemic ill-health
- To deliver treatment without emotional or physical trauma
- To respect the economic well-being of the patient
It is a tall order, but it is do-able, I’ve done it, as have many others when following the same principles, so let’s get going.