Fundamentals of stress reduced direct composite (SRDC) restorations in the posterior area
CLASS SIZE limited to 10-12 people
Following 20 years of clinical experience and success with stress reduced direct composite (SRDC) restorations, this program is designed for dentists seeking for a true paradigm shift in restorative dentistry. The course will present the 100% tooth preservation philosophy based on 1-Occlusion, 2-Conservation, 3-Adhesion and 4-Stress reduction. Current evidence-based research supporting this technique will be presented.
The course will review the development of the SRDC protocol: from the Deliperi & Bardwell JADA 2002 to the Deliperi Operative Dentistry Journal 2012 paper. The 6-step protocol will be analyzed focusing on all the details of each step:
- cavity prep and caries removal endpoints
- structural analysis
- reliable adhesion to enamel and dentin (etch & rinse vs self-etch)
- stress reduction
- occlusal equilibration
Layering and Curing protocols to reduce the C-factor and the stress from polymerization shrinkage will be presented for both enamel and dentin. Participants will become familiar with the Selective Composite Technique: 1- the enamel shell, 2- the dentin replacement and 3- the successive cusp build-up layering techniques. The maturation of the dentin bond concept and the advantage of sculpting restorations before curing will be illustrated. This time saving technique can often result in minimal occlusal adjustment, contouring, and polishing!
This course will also include the direct restoration of structurally compromised teeth by using continuous woven polyethylene fibers. The “wall-papering” protocol will be introduced to reduce the stress, increase the bond and maintain the integrity of the tooth-restoration complex overtime (Deliperi S. wt al. Oper Dent 2017). The continuous fiber supported-stress reduced direct composite (CFS-SRDC) protocol will be reviewed starting from the Deliperi et al J Adhesive Dentistry 2005 to the Deliperi et al Operative Dentistry 2017 paper. Attendees will become familiar with the difference between an adhesive and a biomimetic stress reducing approach. The CMR (Cervical Margin Relocation) in a SRDC protocol will be presented: the one vs two appointment procedure will be discussed along with the issues related to isolation, tissue management and matrix system selection.
The level III of the course will be dedicated to the most advanced protocols in SRDC restorations which will include:
A) The ultra conservative approach for the highly structurally compromised teeth with the introduction of the cusp preservation vs “cusp protection” scenario
B) The continuous fiber supported-stress reduced semidirect composite (CFS-SRSC) restorationsfor the restoration of the “hopeless” teeth
C) The Full Mouth Rehabilitation via SRDC and CFS-SRDC protocols. This section will cover not only the rehabilitation of patients suffering from dental erosion, but also the rehabilitation of those patients with a structurally compromised dentition due to caries, failing existing restorations and tooth fracture via a 100% tooth preservation approach
- Understand a stress-reduced approach for the restoration of structurally compromised teeth with layering and curing protocols
- Compare a stress-reduced direct technique with traditional techniques available for the restoration of Class II restorations
- Understand how to replicate esthetic appearance and the creation of anatomical proximal contacts
- Learn a fiber lay down protocol to mimic the functional characteristic of the natural dentition
- Understand the ultra conservative approach for the highly structurally compromised teeth: cusp preservation vs “cusp protection”
- Become familiar with a SRDC protocol for the full-mouth rehabilitation in patients either suffering or not from TMD