Full course description

Many clinicians continue to perform outdated procedures with modern restorative materials and then wonder why their patients continue to have microleakage, recurrent decay, and sensitivity. The effect of outdated procedures could be one of the reasons for this relatively short clinical service of adhesively placed direct and indirect restorations in the dental practice. Advances in materials science and adhesive technology require clinicians to modify their restorative techniques when placing adhesive restorations. This requirement is particularly true when one is considering diagnosis, biomaterial selection, preparation design, restorative placement techniques, pulp protection, light curing, finishing, and maintenance. The adhesive design concept requires the selection of adhesive, bioactive restorative materials; simplified modifications of preparation designs; and precise placement procedures and techniques. This design concept has been instrumental in the paradigm shift from the principle of extension for prevention to the ultraconservative principle of prevention to eliminate extension. The proper interrelation of these restorative parameters—biomaterial selection, adhesion, and technique—can result in an optimal restorative-tooth interface with improved clinical performance, whereas an improper interrelation of these parameters can lead to gap formation, microleakage, staining, sensitivity, caries, and partial or complete debonding of the restoration that can result in long-term clinical failure. This presentation will address some of these concerns and will illustrate how these clinical challenges can be addressed using this concept.