TBU: #046 Visualize What We Bond To

 New Issue of The Biomimetic Uprising

Read Time:  2 min  

Caries removal is one of the most important things we do in biomimetic dentistry.  We've talked a lot about it in previous posts, like this one from February, and even briefly in last week's about how composite fillings are breaking down.

We should remember that the tensile strength of the DEJ is about 51.5 MPa.  This should always be the goal with biomimetic restorative dentistry.  This gives us the baseline of what we should be achieving, but also a reference to how close we are in deeper more compromised areas.  Its the deeper areas that gives us the most trouble and is most likely to the location of a future failure. 

The deeper areas of the tooth have a different makeup and have a high organic material makeup.  The high moisture area can lead to lower quality bonds if not done right, even more so if we have decay that we're navigating around.  

There's different techniques and materials that should be implored and if done correctly, there can actually be a high stable bond in these deep areas.  

Lets work our way down in tooth:

• Enamel can have bond strengths between 25 - 38 MPa with different bonding systems and surface treatments.  
• DEJ 52 MPa
• Dentin can have bond strengths between 37 - 60 MPa with different bonding systems and surface treatments. 
• Inner caries can be about 25 MPa with different bonding systems and surface treatments
• Outer caries can be about 15 MPa with different bonding systems and surface treatments

So when we we're bonding in deep areas, try to visualize :

1.  The location of the prep in the tooth and the potential bond strengths
2. The quality of the dentin that we have available to bond to
3. The surface texture that we are creating on the dentin floor with our caries removal
 

Self etching systems work well with a final coat with air abrasion on the dentin surface.  

Total etch systems can be used with a diamond as the final caries removal instrument. 

Knowing how to use our materials and the location of the tooth we are using them will give us a higher chance for success.

Whenever you're ready, here are the ways I can help you:

1.  If you're looking for better application in your practice, take a look at our online courses and guides 
   1. The Foundations Of Biomimetic Dentistry
   2. How To Do Biomimetic Posterior Direct Composites.
   3. Get our 53 page biomimetic protocols guide for posterior direct restorations. 
2. Join our ever growing community and get instant access to our group chat, shared resources, on-demand help, along with networking with the leaders in biomimetics. 
3. Work with me 1:1 to grow your biomimetic dental practice.