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ePaper created 2016-09-08, 09:45:46 | version 1.38.0
Thursday, 8 September 2016 Czwartek, 8września2016 Science & Practice Nauka&Praktyka 6 www.fdiworldental.org A materials scientist from Lon- don, Prof. John Nicholson, has conducted extensive research on glass ionomer cements and related materials over the last 30 years. In his presentation today at the FDI Annual World Dental Con- gress in Poznań, he will be discussing whether modern dental materials can meet the world’s oral health needs, among other things. Worlden- tal Daily spoke with him about the shortcomings of modern dental ma- terials, restorative dentistry becom- ing a two-class system, and atrau- matic restorative treatment. Worldental Daily: In your presenta- tion, you will argue that most mod- ern dental materials are character- ised by cosmetic rather than func- tional aspects. Where do they lack most in your opinion? Prof. John Nicholson: They lack ease of use. This applies especially to compositeresins.Beingnon-adhesive, composites have to be employed in association with bonding agents. The function of bonding agents is to alter the nature of the freshly cut tooth sur- face from hydrophilic to hydrophobic, and this requires careful deployment of sensitive materials in accordance with manufacturer’s instructions. Hav- ing created a surface for bonding, the composite itself must be placed. This typically requires placement in incre- ments, with sufficient application of the curing lamp to ensure depth of cure. All of this manipulation is difficult and requires a high level of skill on the part of the dentist. Done correctly, it works well and the resulting repair is durable and aesthetic. However, it is too complicated to be the basis of tooth repair in poorer countries, ow- ing to the high numbers of patients, unreliable electricity supplies and fewer skilled dentists. Most technologies seem to become cheaperovertime,exceptdentalma- terials. What are the reasons for this reverse trend? In dentistry, we have emphasised appearance over performance, a fea- ture that is not so much of a problem in countries with large numbers of dentists able to replace worn-out res- torations, that is in richer communities in the developed world. The dental market therefore does not favour cheaper solutions, or simpler ones. With state-of-the-art dental materi- als only affordable in rich countries and a select few in poor countries, has modern restorative dentistry be- come a two-class system? It has indeed, and that two-class system applies in richer countries too, where poorer individuals are less likely to be able to afford the best-looking repair materials. Specifically, this means amalgam repairs rather than composites. Atraumatic restorative treatment was originally developed to provide a cost-effective treatment for pa- tients in the world’s poorest coun- tries. What have been the experi- ences with the technique so far, and can it offer an alternative for a popu- lation with no access to modern den- tal materials? Reports over the last few years have shown it to be very successful. A variety of patient groups, including children, young adults and even older patients, are benefiting from what is effectively minimal intervention, low- cost dental treatment. Furthermore, the performance of the glass ionomer repair materials in the atraumatic re- storative treatment technique is prov- ing to be better than what might be expected on the basis of in vitro stud- ies of the materials’properties. Amalgamisstillwidelyused,particu- larly in poorer countries. Are we pre- pared for amalgam-free dentistry, and what should be done to ensure there are proper alternatives after the phase-down has been com- pleted? I think we need to maintain the use of glass ionomers and perhaps see how these materials can be improved for this large and important group of patients. We also need to recognise that acquiring a proper understand- ing of the clinical performance of any material is a time-consuming process and that it can take years to obtain a full picture of how materials really be- have in patients. Should there be greater emphasis on the issue of dental materials in oral health campaigns and agendas around the world? Yes, there should. We know that caries is the most widespread disease in humans, so we can a safely assume that damage to teeth is equally wide- spread. Consequently, in my opinion, we should emphasise the role of ap- propriate repair materials just as much as we currently emphasise preventa- tive steps. Thank you very much for the inter- view. Disclaimer: The opinions expressed in this interview do not necessarily reflect those of the FDI World Dental Federation. S pecjalista w dziedzinie badań materiałowych z Londynu, John Nicolson, przeprowadził szcze- gółowe badanie nad cementami glo- sjonomerowymiorazporównałjakość materiałów na przestrzeni trzydziestu lat. Podczas prezentacji, którą wygłosi na AWDC FDI w Poznaniu, opowie między innymi o tym, czy nowoczesne materiały stomatologiczne są odpo- wiedzią na współczesne potrzeby zdrowia jamy ustnej. Podczas wy- wiadu z Worldental Daily odpowie- działnapytaniadotyczącewadnowo- czesnych materiałów stomatologicz- nych, technice ART oraz dlaczego sto- matologia zachowawcza staje się systemem dwuklasowym. Worldental Daily: W prezentacji mówi Pan, że najnowocześniejsze materiały stomatologiczne charakteryzują się nie funkcjonalnością, a estetyką. Czego, Pana zdaniem, brakuje im naj- bardziej? John Nicolson: Materiały te, w szcze- gólności żywice kompozytowe, nie są ła- twe w użyciu. Ponieważ kompozyty są materiałaminieadhezyjnymi,należysto- sować do nich systemy łączące. Zada- niem tych systemów jest zmiana właści- wości powierzchni świeżo ściętego szkliwa–zhydrofilnychnahydrofobowe, cowymagarozprowadzeniawrażliwego materiału zgodnie z zaleceniami produ- centa. Po utworzeniu powierzchni łączą- cej należy położyć kompozyt, zazwyczaj warstwami, zapewniając odpowiedni czas utwardzania za pomocą lampy. Cała procedura jest trudna do prze- prowadzenia, co więcej, wymaga wyso- kiego poziomu umiejętności lekarza. Praca poprawnie wykonana służy pa- cjentowi długo, ciesząc się trwałością oraz dobrą estetyką. W krajach ubogich, gdzieliczbapacjentówjestduża,niewy- starcza energii elektrycznej, a umiejęt- ności dentystów są mniejsze, odbudowa zęba okazuje się zbyt skomplikowana. Restorative dentistry has become a two-class system Stomatologia zachowawcza wprowadza system dwuklasowy | An interview with FDI speaker Prof. John Nicholson, UK | Wywiad z prelegentem FDI – Johnem Nicolsonem, WB. |Prof. John Nicholson |Prof. John Nicholson © fiphoto/Shutterstock.com Dental Tribune International ESSENTIAL DENTAL MEDIA www.dental-tribune.com PLEASE VISIT US Pavilion 7 Booth 7A41–7A50 AD …acquiring a proper understanding of the clinical performance of any material is a time-consuming process…