Fulfilling patients’ aesthetic expectations
Scientists are on the brink of creating an enamel which they say could be used to fill cavities. The team from the University of Washington School of Dentistry[i] have successfully created stem-cell-based organoids that secrete the proteins that form dental enamel. Described as a ‘critical first step’ in the development of stem-cell based treatments to regenerate and repair damaged teeth, they say that the laboratory-created enamel could even be used as a ‘living filling’ to grow into and repair cavities.[ii]
While that may be some time off, dental restorative materials have come a long way in the last few decades, with constant advancements being made to improve their strength, aesthetics and ease of use.
Move over amalgam
Amalgam, though still widely used in the UK, is being phased down due to the EU’s 2017 Regulation on Mercury which is now part of UK law.[iii] The measures are purely for environmental protection and do not reflect any evidence-based concerns about adverse effects of amalgam on human health. It remains a safe, durable and cost-effective material and has been used in dentistry for 150 years. Its popularity is also decreasing because its metallic colour does not blend with the natural tooth colour so both patients and dental professionals prefer tooth-coloured restorative materials for better aesthetics.[iv]
So, what’s taking amalgam’s place? One of the latest trends in dental restorative materials is the use of composite resins. Composite resins are a mixture of synthetic materials such as glass or quartz fillers and a resin matrix. They are popular among dentists due to their ability to blend seamlessly with the natural tooth colour, creating aesthetically pleasing restorations. Additionally, composite resins bond to the tooth structure, providing better support and reducing the risk of restoration failure. Dentists also appreciate the ease of use and versatility of composite resins, as they can be used for both direct and indirect restorations.[v]
Zirconia zip
Then there are zirconia-based ceramics. These are known for their excellent strength and durability. Dentists tend to favour zirconia-based ceramics for their ability to withstand heavy bite forces and resist chipping or cracking[vi], making them ideal for posterior restorations. Additionally, zirconia-based ceramics have excellent biocompatibility and are highly resistant to staining, ensuring long-term aesthetics.[vii]
The most important components of aesthetic tooth appearance are: colour, fluorescence, opalescence and translucency. One drawback of full contour zirconia restorations is their opacity, however coloured zirconia with improved translucency has now been developed to closely match the colours of human teeth.[viii]
Bioactive benefits
To improve the longevity and success of dental restorations, dentists are turning to bioactive materials. Bioactive materials, such as glass ionomer cements and calcium hydroxide cements, release ions that promote remineralisation and provide a protective barrier against bacteria and acid attack.[ix] These materials not only restore function and aesthetics but can also actively contribute to the overall health of the tooth structure.[x] Dentists appreciate the preventive benefits of bioactive materials, as they help reduce the risk of secondary decay and the need for additional treatments.
Advances in dental adhesive systems have also had a significant impact on the success of dental restorations. The development of universal adhesive systems has simplified the bonding process, reducing the steps required and improving bonding performance. Dentists now have access to adhesives that can be used with various restorative materials, eliminating the need for multiple adhesives and simplifying inventory management. Universal adhesive systems also offer improved bond strength.[xi]
When looking for a versatile composite that is suitable for both anterior and posterior restorations, dental professionals should consider COLTENE’s award-winning[xii] BRILLIANT Everglow™. This composite provides exceptional aesthetics, ensuring natural-looking restorations that blend seamlessly with the surrounding teeth. Its wide range of shades allows dental clinicians to achieve accurate colour matching, resulting in highly satisfied patients. It exhibits excellent handling characteristics, making it easy for dental professionals to sculpt and shape the material precisely. Its non-sticky consistency simplifies the placement process, reducing the chances of mistakes.
The field of dental restorative materials is constantly evolving, with new trends emerging to meet the needs of dentists and patients. Improved aesthetics, strength, durability, ease of use, and preventive benefits are just some of the advantages that dentists can expect when utilising these materials. By staying up to date with these trends, dentists can provide their patients with the best possible restorative solutions.
For more on COLTENE, visit www.coltene.com,
email info.uk@coltene.com or call 0800 254 5115.
Author: Nicolas Coomber COLTENE National Account & Marketing Manager
[i] University of Washington School of Dentistry https://dental.washington.edu/
[ii] Alghadeer A, Hanson-Drury S, Patni AP, Ehnes DD, Zhao YT, Li Z, Phal A, Vincent T, Lim YC, O’Day D, Spurrell CH, Gogate AA, Zhang H, Devi A, Wang Y, Starita L, Doherty D, Glass IA, Shendure J, Freedman BS, Baker D, Regier MC, Mathieu J, Ruohola-Baker H. Single-cell census of human tooth development enables generation of human enamel. Dev Cell. 2023 Aug 11:S1534-5807(23)00360-X. doi: 10.1016/j.devcel.2023.07.013. Epub ahead of print. PMID: 37582367. [Accessed November 2023]
https://www.eurekalert.org/news-releases/998468
[iii] British Dental Association https://bda.org/about-the-bda/campaigns/amalgam/Pages/dental-amalgam-faqs.aspx [Accessed November 2023]
[iv] Rathore M, Singh A, Pant VA. The dental amalgam toxicity fear: a myth or actuality. Toxicol Int. 2012 May;19(2):81-8. doi: 10.4103/0971-6580.97191. PMID: 22778502; PMCID: PMC3388771. [Accessed November 2023]
[v] Azeem RA, Sureshbabu NM. Clinical performance of direct versus indirect composite restorations in posterior teeth: A systematic review. J Conserv Dent. 2018 Jan-Feb;21(1):2-9. doi: 10.4103/JCD.JCD_213_16. PMID: 29628639; PMCID: PMC5852929. [Accessed November 2023]
[vi] Daou EE. The zirconia ceramic: strengths and weaknesses. Open Dent J. 2014 Apr 18;8:33-42. doi: 10.2174/1874210601408010033. PMID: 24851138; PMCID: PMC4026739. [Accessed November 2023]
[vii] Ossama Saleh Abd El-Ghany, Ashraf Husein Sherief, Zirconia based ceramics, some clinical and biological aspects: Review, Future Dental Journal, Volume 2, Issue 2, 2016, Pages 55-64, ISSN 2314-7180, https://doi.org/10.1016/j.fdj.2016.10.002. (https://www.sciencedirect.com/science/article/pii/S2314718016300398) [Accessed November 2023]
[viii] Nistor L, Grădinaru M, Rîcă R, Mărășescu P, Stan M, Manolea H, Ionescu A, Moraru I. Zirconia Use in Dentistry – Manufacturing and Properties. Curr Health Sci J. 2019 Jan-Mar;45(1):28-35. doi: 10.12865/CHSJ.45.01.03. Epub 2019 Mar 31. PMID: 31297259; PMCID: PMC6592671.[Accessed November 2023]
[ix] Mutlu O, Roberti G, Maziero V, Bioactive Materials for Direct and Indirect Restorations: Concepts and Applications, Frontiers in Dental Medicine 2, 2021
https://www.frontiersin.org/articles/10.3389/fdmed.2021.647267 DOI=10.3389/fdmed.2021.647267
ISSN=2673-4915 [Accessed November 2023]
[x] Zhang OL, Niu JY, Yin IX, Yu OY, Mei ML, Chu CH. Bioactive Materials for Caries Management: A Literature Review. Dent J (Basel). 2023 Feb 23;11(3):59. doi: 10.3390/dj11030059. PMID: 36975556; PMCID: PMC10047026. [Accessed November 2023]
[xi] Isolan, C.P., Valente, L.L., Münchow, E.A. et al. Bond strength of a universal bonding agent and other contemporary dental adhesives applied on enamel, dentin, composite, and porcelain. Appl Adhes Sci 2, 25 (2014). https://doi.org/10.1186/s40563-014-0025-x [Accessed November 2023]
[xii] Editor’s Choice Dental Advisor and Dental Product Shopper Best Product
