cosmetic dentistry - beauty & science

14 I I research _ conservative dentistry cosmeticdentistry 3_2012 _A mere 20 years ago, fourth-generationadhesives revolutionised restorative dentistry by offering a pre- dictable technique for bond- ing to both enamel and dentine.1 Less than five years later, advances in ionomer and resin technologies pro- vided clinically successful dentine and enamel replace- ment. In 2003, the first se- lective preparation burs able to differentiate between healthy and unhealthy dentine were introduced.2 These were all revolu- tionary innovations that altered the practice of dentistry significantly. Within a decade, adhesive resin and composites had displaced amalgam as the mainstream restorative materials. The intervening years have seen the develop- ment of improved fifth- and seventh-generation adhesives,3, 4 micro-hybrid and nano-hybrid com- posites, LED curing lights, soft-tissue lasers,5–7 and a host of other adjunct technologies that make dental treatment better, easier, faster8 and more predictable.9, 10 These innovations have been evo- lutionary, rather than revolutionary, building upon the existing science through gradual improvement and facilitation. The three major clinical concerns encountered by practitioners in recent years have included: _the end-point of cavity preparation (how to dif- ferentiate between infected and affected dentine andhowmuchtoothstructuretoremovetoensure long-term operative success);11–13 _the disinfection of the prepared dentinal tissue (how to eliminate the re- maining bacteria to prevent re-decay);14, 15 and _the facilitation and simplifi- cationoftherestorativepro- tocol (how to reduce the nu- merous steps and technique sensitivities that arise in the restoration of function and form). Recent technological ad- vances have done much to allay these concerns and to move dental practice towards ever greater clinical predicta- bility. _Preparation end-point Second-generationSmart- Burs II (SS White) are self-lim- iting polymer burs developed to address the clinical prob- lem of the preparation end- point: the removal of infected Evolving conservative dentistry Author_Dr George Freedman, Canada Fig. 4 Fig. 5 Fig. 2 Fig. 3 Fig. 1