cdr juan k packer n.
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Biomimetics: Taking Dentistry in a New Direction

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Biomimetics: Taking Dentistry in a New Direction

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  1. CDR Juan K. Packer Biomimetics: Taking Dentistry in a New Direction

  2. Graduate of the Univ. of Mississippi School of Dentistry 1998 USAF 1998-2003(Little Rock AFB,AR and Sheppard AFB, TX) Inter-service transfer to USPHS 2003 Staff dental officer-Advanced Tahlequah, OK 2003-2005 AGPR Residency Tahlequah, OK 2005-2007 Northeast Wisconsin Technical College Public Dental Health Certificate 2009-2011 Implant Seminars Miami, FL 2010-2011 Chief Dental officer Seminole Tribe of Florida(Hollywood, FL) 2007-present CDR Juan Packer

  3. What is Biomimetics What materials are considered biomimetic How will this improve the quality of dental care that you provide Is biomimetic dentistry applicable in an IHS setting Learning Objectives

  4. Bio = life Mimetic = to mimic Termed coined by Otto Schmitt in the 1950’s Biomimetics

  5. A preferred treatment is one that attempts to replicate the stress distribution, energy absorption, and other characteristics of the intact natural tooth.(Randall G. Cohen, DDS | David Rudo, DDS ) Inside Dentistry November 2011, Volume 7, Issue 10 Published by AEGIS Communications Biomimetic quote

  6. The use of dental materials and technologies that mimic tooth structure and function Maintaining as much natural tooth structure as possible Materials should absorb and distribute stress like tooth structure Enamel like materials Dentin like materials Biomimetic dentistry

  7. Function of Dentin • Dentin is the most important part of the tooth • Supports the enamel • Protects the pulp • Made up of 70% hydroxyapatite • Gives color to the tooth(enamel is semi-translucent)

  8. Hardest substance in the human body Protects the dentin Gives shape to the tooth Aids in chewing Function of enamel

  9. Biomimetic Materials(Kuraray) • Adhesives • Clearfil SE Bond • Clearfil SE protect

  10. Can be used with all light curing restorations Contains MDP(methacryloyloxydodecylpyridiniumbromide) which creates a strong chemical bond with hydroxyapatite Regarded as the “Gold Standard” for self etching products Clearfil SE bond

  11. In a liquid state has antimicrobial properties After light polymerization forms a antibacterial copolymer that kills bacteria on contact(MDPB) Described as having a “bio-active function” that has a therapeutic effect on caries control Aids in preventing 2° caries Fluoride releasing Clearfil SE protect

  12. Zinc-dependent endopeptidases (endogenous enzymes) Capable of degrading extracellular matrix proteins Trapped within the mineralize dentin matrix during tooth development In the presence of water, can breakdown collagen fibrils that are not protected by intrafibrillar minerals. What are MMP’s

  13. MDPB (an antibacterial monomer used in a two-step, self-etching primer adhesive). The advantage of MDPB over Chlorhexidine and Benzalkonium Chloride is that it polymerizes with adhesive resins and cannot leach from the hybrid layer. This is an example of what can be termed a “Therapeutic adhesive system” that provides anti-MMP activity along with antibacterial qualities. MDPB

  14. MDPB is a polymerizable bactericide, and the antibacterial component in the molecule is immobilized after the resinous materials incorporating MDPB are cured(Dental Materials Journal 2009; 28(1): 11-19) MDPB continued

  15. Composite( Kuraray) • Majesty composites • Only composite with Vita approved shades • Uses Kuraray patented light diffusion(LD) technology • Does not compromise tooth elasticity • Flexes with the underlying dentin

  16. Resin-dentin bonds are not as durable as was previously thought. Microtensile bond strengths often fall 30% to 40% in 6 to 12 months. The cause of this poor durability is a combination of the activation of matrix metalloprotinases (MMP’s) by weak acids such as lactic acid released by caries-producing bacteria, and acid-etchants used in adhesive bonding systems. These acids uncover and activate matrix-bound MMP’s. The other contributing factor is incomplete resin infiltration. If all exposed collagen fibrils were enveloped by resin, the MMP’s would not have free access to water, an obligatory requirement of these enzymes. Recently, several inhibitors of MMP’s have been added to adhesive primers. Examples include chlorhexidine (CHX), benzalkonium chloride (BAC), and MDPB (David H. Pashley, DMD, PhD; Franklin R. Tay, BDSc (Hon), PhD; and Satoshi Imazato, DDS, PhD ) Resin-Dentin bond

  17. Minimally invasive dentistry Remove only infected tooth structure( no extension for prevention) Maintain tooth's structural integrity Choose proper restorative materials Materials should mimic tooth structure Improving dental Quality

  18. IS this you????

  19. YES!! More predictable outcome Materials that continue to fight against caries Budget friendly Cost of Majesty composite $87.00/box Cost of amalgam $89.00/box IHS Applicable????

  20. Questions