St. Lawrence Dentistry is pleased to offer the latest advances in minimally invasive dentistry called ‘Biomimetic Dentistry’. This is the attempt of dentistry to mimic the biologic and elastic properties of a natural tooth.
Almost every dentist graduating over 5 years ago was taught that dental crowns have to end on solid tooth structure. Recent research suggests that this concept should be rethought. With today’s modern dental composites (white fillings) it often makes more sense to fill deeper areas of tooth decay with the white filling material and restore the more shallow areas with porcelain crowns. In doing so the dentist does not attempt to extend a dental crown preparation beyond a composite build-up of the tooth being worked on. This concept change can have tremendous benefits and on the longevity of dental work and in terms of how conservative dental work can be. The opinions of many dentists have been undergoing a paradigm shift about how teeth should be fixed and there is a movement away from doing full tooth crowns whenever possible. The concept of a combined dental composite and porcelain restoration is particularly useful in the treatment of decayed or fractured teeth.
Biomimetic tooth repairs take advantage of the tight seal of dental composite (white filling materials) to root dentin (second layer of tooth structure). The traditional way of using crowns was to do deep crown work and go several millimeters below the gumline. The departure from a deep crown has tremendous implications in simplifying fixing teeth. Dr. Hawryluk can create a more biologically acceptable restoration and can avoid periodontal (gum) surgery. It creates a ‘fail-safe’ design to dental work which can be more easily repaired in the future. If a crown is made unnecessarily deep initially, it more likely would be able to be repaired in the future should any issues arise.
Dental hard tissues each possess different flexibility quotients. There is hard enamel on top and softer dentin underneath. The result is a natural tooth that has both some flexibility and also some wear resistance. Dr. Hawryluk will try and mimic these natural tooth properties by careful consideration of the materials and techniques he uses. The difference between the stiffness of a cast metal crown relative to the more flexible underlying tooth can create an issue that can cause a tooth to fail. This can cause transfer forces to the ‘gingival margin’ (gumline) which is the weakest place of a tooth crown is located. A stiff crown under a more flexible tooth substrate can lead to a ‘push-pull’ action which can cause ‘cement washout’ at the gumline and opening of the ‘dentinal tubules’ causing sensitivity. Full crown treatment can sometimes result in sensitivity, recurrent cavities, weakened teeth, ‘pulp degeneration’, gum disease, and even eventual tooth loss. Dentistry can ‘biologically fail’ due to leaks in crowns, cracks in teeth, and are often not symptomatic until they are catastrophic to the tooth.
Dr. Hawryluk Jr. strives to create ‘fail-safe’ dental restorations. Such dental restorations have limited or no potential for recurrent cavities, protect the tooth from cracking, are easy to repair and maintain in the long run, and preserve the tooth.
Nothing in this world can be guaranteed forever and if dentistry breaks down we need it to fail in a friendly way which is easily repairable. If for example, if a porcelain restoration has a break hypothetically 15 years after is initial placement it is ideal if it can simply be repaired rather than having to do a new one and damaging the underlying tooth in the process. Dr. Hawryluk uses the biomimetic dentistry techniques to create such ‘fail-safe’ dental restorations. This type of dentistry mimics the biologic and mechanical properties of the underlying tooth.
This is in contrast to the potentially catastrophic failures of traditional dentistry.
The objective of the biomimetic strategy is to replicate the intact tooth mechanically and biologically. Dr. Hawryluk Jr. accomplishes this by replacing lost tooth structure using materials with similar properties with a predictable methodology based on science. The aim of this strategy is not necessary to use the strongest dental material but rather one which is compatible with the mechanical and biologic properties of the underlying tooth. In other words, it is not good to have a ‘rock hard’ dental crown only to have the tooth substrate underneath break.
Biomimetic dentistry eliminates cracks and infections in teeth. It’s protocol calls for bonding the tooth from all directions to lower the stress/strain on the teeth. The ultimately means these types of dental repairs are far more resistant to breakage than traditional methods. It also attempts to replicate the original tooth anatomy. Successful modern ‘adhesive dentistry’ can be expressed in an equation between bonds and stresses, where the bonds are able to withstand the stresses.
Some advantages of Biomimetic based porcelain dentistry are:
- Core buildups (filling foundations of dental crowns) can be done without tissue bleeding.
- Because tooth structure is conserved, tooth sensitivity is greatly reduced or eliminated. This vastly reduces the chances a tooth could need root canal treatment.
- Dental procedures are quicker and more comfortable.
- Gum Surgery or ‘Periodontal Crown Lengthening Surgery’ is usually not needed.
- Minimal adjustment of dentistry at insertion appointment.
- Preserves the tooth natural flexibility and creates a low-stress cleanable restoration.
One of the prime objectives of Biomimetic Dentistry is to maintain the vitality of the dental pulp and avoid root canal treatment. Dr. Hawryluk will eliminate infections in the dentin tissue of a tooth by removing and deactivating bacteria. He will create a ‘peripheral seal zone’ in your tooth to ensure long term success of your dental work.
Cracks are a common occurrence in teeth and these are removed in the biomimetic approach. Dr. Hawryluk will gently ‘chase; these cracks and seal them.
When discussing Biomimetic Dentistry the term ‘C-Factor’ often comes up. The C-Factor is also known as the ‘configuration factor’ and is the ratio of bonded surfaces to unbonded surfaces. Cavity preparations with a lot of walls around them are said to have a high C-Factor whereas those with single-bonded surfaces have a lower one. Each type of situation requires a different bonding protocol which Dr. Hawryluk Jr. is well versed in. If your interested in knowing more about this term please talk let us know when you come in.
Material selection for ideal Biomimetic Dentistry is of paramount importance. Many of the dental composites on the market today have problems or poor conversion of monomers into polymers, and addition shrinkage stress when they are setting. St. Lawrence Dentistry uses a dental composite made by GC America called ‘G-aenial injectable’ has an updated resin system that has lower shrinkage and high polymerization rate. This has lead to tremendous advances in the services we can offer.
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Biomimetic Dentistry has many benefits and is an integral part of what St. Lawrence Dentistry offers its valued clients. If you are looking for a new dentist and live in the Mississauga, Oakville, or Toronto area please give us a callclick here.
Reference: Viva Learning 2019: Biomimetic Dentistry