Maximizing Longevity

Our profession faces numerous challenges in today's environment. First, dental education is suffering from a shortage of well-rounded educators, clinicians, and researchers. Regarding the discipline of restorative dentistry, the lack of sufficient clinical trials to support certain procedures or materials, as well as the rapid introduction of materials with very limited evidence, has resulted in a significant disconnect between research, education, and clinical care. Many dental schools focus on direct restorations and indirect full-coverage crowns without addressing intermediate options. Part of acquiring a complete understanding of the available restorative materials and how to apply them involves mastering minimally invasive preparations, which allow us to conserve tooth structure and extend the life of teeth before they need to be extracted.

Traditionally, gold was the material of choice for partial-coverage restorations, and perhaps it still is. However, its use has declined for esthetic and financial reasons. As a substitute, ceramics were used, but because of the poor mechanical properties of early dental ceramics and weak adhesive systems back then, many failures occurred, leading to a loss of faith in ceramics as acceptable materials for partial-coverage restorations. More recently, ceramic materials with improved properties, excellent adhesive systems, and valuable clinical evidence have enabled partial-coverage restorations to be performed successfully with improved esthetics. These procedures necessitate knowledge regarding preparation guidelines; the properties of ceramic materials, including their ability to resist fracture and wear; and effective cementation/bonding and light curing protocols. Alternatively, the mechanical, physical, and wear resistance properties of composite resin materials have improved as well, enabling the successful placement of direct and indirect composite partial-coverage restorations, which can save time and money for patients.