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Fibre Reinforced Dental Composites

Fibre Technology turns impossible to possible

Written by Dr JJ Jansen van Rensburg - February 2005       Read more about Dr JJ Jansen van Rensburg   

Dental technology is rapidly progressing and the dental surgeon is expected to make use of it by choosing the most appropriate treatment option to suit every patient’s unique circumstances. Fibre technology has been helpful in my practice providing quick, easy and acceptable results in difficult situations.

 In the world of implantology many clinicians prefer extractions of first premolars to extensive and time consuming treatments involving root canal therapy, core build up and crown preparations. Due to the anatomy of these premolars (in many cases two thin roots) post preparation often ended up in root fractures or perforation of the roots. Many post-retained-crowned premolars have been extracted because of vertical fractures of the roots.  The same arguments apply also to the upper lateral incisors with their small and often curved roots.  Implantology to replace these teeth is sometimes contra indicated due to financial reasons or a lack of sufficient bone for implant placement, in these areas.

Fibre reinforced technology might be the treatment of choice to be considered in the future.  Fibre Bond Bond products have been helpful in my practice providing quick, easy and acceptable results in difficult situations.  I am sure every dentist can recall the” Friday 5 o’clock- patient”, who has just fractured his upper lateral incisor, at gum level – with no root canal therapy.  Typically, this patient has an important dinner appointment the same evening.  Thanks to Fibre technology, these situations no longer present a problem.  Bonding a direct fibre reinforced composite to the adjacent tooth would be an ideal solution, resulting in a very satisfied patient.

When deciding on a treatment option, special attention should be given to the following:

1.     Financial cost

2.     Duration of the whole treatment plan

3.     All possible complications

4.     Durability of the restoration

5.     Reversibility of restorations

6.     Conservation of natural tooth structure – 

        This should always be of high concern.

With Fibre technology, most of these criteria can be fulfilled.  This technology, using glass fibres, is one of the most exciting new developments in dentistry.  Impregnated glass fibres combined with the use of acid etched resin composites is revolutionizing modern cosmetic dentistry.

INCREASING WORK SATISFACTION…….

For me, as a practicing dentist, one of the most important advantages of Fibre Bond technology is the work satisfaction, obtained when using these fibre reinforced composites.

Working with composites is the most rewarding aspect of my daily work and Fibre Bond technology has enhanced this sense of satisfaction and has considerably expanded my field of preferred treatment procedures.  It is now possible to provide a patient with a restoration to replace missing teeth, without major preparations of the abutment teeth, impression taking, a follow up appointment (to place the restoration) and a technician’s bill.  It is very satisfying to build up an entire tooth using different shades of composites including transparent incisal composite to give it the desired natural look.  With Fibre Bond technology it is now possible to place a more reliable, durable, predictable and direct restoration to replace a missing tooth.  You will find that previously impossible treatments now become possible.

……AND MAKING MY BUSINESS MORE PROFITABLE

Gradually I am transforming my dental practice into a more Fibre Bond orientated practice.  I am spending more time doing the work I love most – fibre reinforced composite restorations.  I am also doing more and more indirect fibre reinforced composite crowns and bridges.  This means spending more time in the laboratory working on models, instead of  live and anxious patients.  Transforming the practice in this way, the amount of patients seen per day is less, resulting in a less stressful day for both staff and dentist.  There is also a much smaller technician’s bill to pay at the end of the month.  This is what most dentists are all looking for:  more work satisfaction, fewer patients per day (resulting in stress reduction), lower practice expenses, affordable treatment options, predictable results as well as a new challenge in this profession!  Most importantly, you'll find that you have satisfied patients, some of whom  excitedly refer to the Fibre Bond fibre reinforcement treatment result as a miracle.  All these advantages lead to a more intimate and easy to manage dental practice.

Fibre technology has provoked in me a new interest in dentistry.  This technology has changed my practice into a more profitable business and a better work environment.  I am looking forward to new developments and new indications in Fibre- and Stick Tech products.

 Dr.JJ J Van Rensburg

Fibre Bond Ltd., February 2005                                                                                                       About the author
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Achieving new standards with post restorations in your practice  

Dr. Klaas Visser
The successful restoration of an endodontically treated tooth often presents a serious challenge to a dental clinician. Coronal destruction caused by dental caries and/or fractures are often further aggravated by the loss of tooth structure during endodontic treatment. The anatomy of the root also plays a significant role as we set out to restore the tooth to normal form and function. 

We know that the strength and resistance to root fracture of an endodontically treated tooth is directly related to the amount of residual radicular dentine. The post diameter thus needs to be controlled in order to preserve radicular dentine, reduce the potential for perforations and permit the tooth to resist fracture. However, endodontic treatment often leads to wide, flared canals as the clinician sets out to clean and shape the root. Adapting the post to the anatomy of the endodontically treated tooth not only preserves precious radicular dentine, it also allows for oval and/or curved roots. 

The introduction of the everStick Bond® fibre post system by Sticktech Ltd. from Finland now enables the clinician to construct a custom made fibre post according to the anatomy of the post space. This is done directly in the mouth prior to cementation of the post. Due to the flexural strength of the everStick Bond fibres (1350 MPa) and the mode of elasticity being very close to that of human bone and dentine, it is now possible to provide the patient with a post that will not fracture the root, as is often occurs when stainless steel or titanium metal posts are used.

The method is easy and quick: The root filling (gutta percha) is removed with a Gates Glidden drill, following the "red eye". Virtually no radicular dentine is removed, but the clinician must ensure that all the old cement is removed, especially if the gutta percha was cemented with a cement containing eugenol as the post will be bonded into the root with a resin cement.

The post is then measured, cut and placed into the post space. In the case of widely-flared and oval canals a secondary post can be placed and laterally condensed, utilizing the whole post space. The coronal part of the post is now light-cured with a curing light for 15 seconds. The apical part will stay soft as the all the light will not travel down the root. The semi-cured post is now carefully removed and cured outside the mouth for a further 30 seconds. The post is then tried and the fit checked.

If the fit and the seating of the post is satisfactory, preparation for bonding the post to the radicular dentine can now take place. The first step is to create micro cavities in the post so that the inter-penetrating bonding network can be achieved. The post is coated with Stick Tech® Resin and protected from light for two to four minutes. 

While this is being done, the root is prepared by etching the radicular dentine, drying the post space and placing a suitable bonding agent. The bonding agent is light cured according to the manufacturer’s instruction. Often it is necessary to add a chemical cure converter to the bonding agent, or to use a dual cure resin cement. The post is then cemented with a resin cement according to the manufacturer’s instructions. Several peer reviewed articles, abstracts and results of clinical trials are available from Fibre Bond Bond Dental for those readers that want more information.

Klaas Visser
February 2005                                                                                                                                  

 

The two authors,Dr's JJ Jansen van Rensburg (Jansie) and Dr H. Visser (Klaas), have been nominated Best Dental Trainers for the Year 2005 by Stick Tech in Finland

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 Revised: 07 May 2007 18:29:27 +0100
   

 

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