The Difference Five Minutes Make: Decoupling with Time

Six Lessons Approach Podcast by Dr. David Alleman

Each lesson in the Six Lessons Approach to Biomimetic Dentistry (SLA) is essential to restoring a tooth in a way that stays bonded and symptom-free. These two failings of traditional techniques — debonded restoration and post-operative sensitivity — are addressed in each lesson, but when it came to the bonding stage of the restoration, Dr. David Alleman was able to reach a pivotal conclusion from the published research.

Different parts of the tooth form hybrid layers at different rates based on the amount of hydroxyapatite. Composite will shrink to the best possible bonding surface, potentially leaving gaps in areas that have weaker bond potential. Understanding how to overcome these two variables is key to creating a restoration that bonds the tooth side to side, front to back and top to bottom like a natural tooth. This biomimetic bond eliminates gaps under restorations that cause post-operative sensitivity, but it requires understanding how bonding systems, composite and dentin need to work together within the first five minutes of the polymerization process. Dr. David Alleman named this process decoupling with time.

Articles referenced in this episode:

• Brannstrom M. The hydrodynamic theory of dentinal pain: sensation in preparations, caries, and the dentinal crack syndrome. Journal of Endodontics. 1986;12(10)-453-457

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