tips and tricks

I was thinking about this question in the car yesterday. Many of our guarantees about dentistry lasting for a number of years or giving warranties comes from our own insecurities about our work. The truth is we don't really know. It lasts as long as it lasts. We can identify risk factors associated with early failure such as wear facets, large masseters, plaque accumulation, erosive wear etc and we can take steps to mitigate these risks. Despite this, dentistry lasts only as long as it lasts and we won't know when it will fail until it finally does. The question can be reversed though to: How long are teeth meant to last? The truth is that patients who require complex dentistry have ruined their natural teeth and their dentistry will fail one day too. It begs the question as to why we are designed with such fatal flaws and why we are in need of repair. The truth is that no design is perfect. Our teeth are only one of many things that wear and breakdown over time. Disease is...

Class 1 occlusions are the ideal occlusions discussed in the textbooks but they aren't always present. In fact, the majority of people in the community will be class 2. The occlusal contacts represented as dots and lines in the diagram of the previous part is based on a class 1 occlusion. Class 2 and class 3 occlusions will show different relationships and achieving a class 1 occlusion post treatment is not always possible or desirable when considering the goals of the patient. It is important to know why we do what we do and why the goals of treatment is what they are so that we can bend the rules as needed. The main change with Class 2 and 3 occlusions is the anterior guidance component of the occlusion. distribution of occlusal contacts is possible in any occlusion as the reason why we aim to do this is to reduce the non axial loads through teeth when the muscles are at their highest force. The position of these contacts may change with different positions on the occlusal sur...

Occlusion can be studied to try and improve success or reduce failures. Occlusion isn't a goal but it is a tool that we can use to achieve our goal. Everything fails if given enough time but we are aiming to slow the progress of this down so that the failure occurs as far away as possible. Patients need to understand this risk before agreeing to any treatment. Dental materials excepting fracture from trauma tend to break after repeated cyclic fatigue. The management of occlusion aims to reduce the force on teeth and restorations to reduce cyclic fatigue failure. This aim is independent of the materials used. Be it LiSi, zirconia, gold, base metal, composite, amalgam, enamel or dentine they will all fail if loaded enough for enough time. Materials that claim extrordinary strength such as some zirconias have the trade off of being very brittle. On the other hand, materials that are softer such as gold will burnish under high load, adapt to the conditions and therefore is less likel...