1. What are the best methods for detecting early and advanced dental caries (validity and feasibility of traditional methods; validity and feasibility of emerging methods)?
Observations and studies during the past two decades have indicated that diagnostic and treatment paradigms may differ significantly for large, cavitated lesions versus early, small lesions and demineralized areas on tooth surfaces. The essential anatomic-pathophysiologic problem is that the carious lesion occurs within a small, highly mineralized structure following penetration through the structure’s surface in a manner which may be difficult to detect using current methods. Additionally, carious lesions occur in a variety of anatomic locations, often adjacent to existing restorations, and have unique aspects of configuration and rate of spread. These differences make it unlikely that any one diagnostic modality will have adequate sensitivity and specificity of detection for all sites. The application of multiple diagnostic tests to the individual patient increases the overall efficacy of caries diagnosis. Existing diagnostic modalities require stronger validation, and new modalities with appropriate sensitivities and specificities for different caries sites, caries severities, and degrees of caries activity are needed. Continue reading →
Dental restorations are placed to restore the function, anatomy and integrity of tooth structure which can be lost due to various reasons such as dental caries, trauma and etc. They can be broadly classified into two categories: direct and indirect restorations. Direct filling materials are used for chair side restorations where as indirect restorations such as crowns, bridges, inlays are fabricated outside the patient’s mouth. Before we venture into the pros and cons of different types of restorative materials, let me explain to you the requirements of an ideal dental filling material. Continue reading →
Amalgam was first introduced in United States during 1833. It is then used widely as dental filling material over the years because of its strength, durability and low cost (especially for posterior teeth). It is now discontinued or banned in certain countries such as Norway, Sweden, Denmark because of its known biological effects on human body. Amalgam is made of metals such as Silver, Tin, Copper, Zinc and Mercury. 50% of amalgam is made of mercury and they are then mixed to form a hard material which has silvery grey appearance through a process which is known as amalgamation. Patients are exposed to high dose of mercury during the process of placing and removal of amalgam restoration. Continue reading →