Non-metallic biomaterials for tooth repair and replacement

P Vallittu ed., Woodhead Publishing Limited (2013)
Reviewed by M Tabak

Non-metallic biomaterials for tooth repair and replacement, 2013

P Vallittu eds.

Woodhead Publishing Limited 

ISBN 0857092448

 

In about 13 chapters the contributors of this excellent piece of literature have been able to create a clear overview on the use of “non-metallic” materials for tooth restoration and tooth replacement.

The restoration of dentin and enamel structures in relation to the amelogenesis protein and mineral interactions clearly forms the full subject-matter throughout chap. 2, called “Biomineralisation”. Whilst reading these particular pages, one can not ignore the basic concept of adhesion Buonocore [1955] where numerous micro-chemical interactions between enamel / dentin have been discussed [Chap. 3].

Dental Restoration also requires a healthy and functional periodontium. Chap. 4 describes the effect of “Enamel Matrix Proteins” EMP in periodontal regeneration and possible incidents in the application of various dental restorations.

Most parts of the book contain a classification of numerous “non-metallic materials” and their biomechanical characteristics. Within the group of “all-ceramic materials”, also “glass-ceramics” used in e.g. veneers and inlays, are discussed. As a substitute for aluminum bonded ceramic materials [feldspar, , K Al Si3 O8], various alumina bonded materials [alumina Al2 O3], zirconia [Zr O2] and Spinel ? [Mg Al2 O4] are used. These materials possess a flexural strength of more than 700 MPa.

By the specifically chosen publications, upon which the compiler has based his book, you will notice that he is clearly trying to use those publications as an extended plea for the use of zirconium Zr O2, as a highly biocompatible material, in combination with a porcelain coating and custom silanization [Bonding], to give a clear overview on what a high technical system that can respond to some natural aesthetic and biocompatible restoration of tooth structure, should be.

The comparison between the mechanical properties of alternatives such as Procera, All-Ceram and IPS Empress 2 allows the writer to evaluate his own experiences with the specific use of all-ceramics. Some ceramic materials, which are classified within the “bioactive glass” [sol-gel derived silica-based Si O2 – P2 O5 – Ca O], can be used next to other sol-gel applications to stimulate bone mineralization or restoration. It discusses the complexity of the networks and effects on osteoblasts of Sr2+ in the bone matrix.

The technique of “Sol-gel derived bioactive glass” is described as one of the numerous potentially successful applications in dental restoration and regeneration.

The book also contains a detailed description of adhesive restorative composite materials [Capt.8 and 9] as a replacement for the older amalgam, which has gradually fallen into disuse. We notice an augmentation in the use of dental composites, while, on the other hand, we are dealing with the higher risk for bacterial micro leakage. Nowadays, this forms the base for extensive research on the impact of significant remineralization and the development of protection of the emergence and development of biofilms.

In chap.10 the effects of particulate filler systems in direct relation to the mechanical properties such as modulus, fatigue, resistance and viscosity are compared to each other.

Negative aspects of polymerization shrinkage and water absorption will always have some influence on the clinical outcome. Since such materials can be used in both the assembly and / or fixing of “non-metallic” structures, as well as in the conventional protective structure of a tooth restorative, further research concerning the biological and physical properties will be the next great challenge in the nearby future.

Fiber-reinforced composites do offer an alternative for some of these negative traits we have to cope with. Possible applications and extension to implants and bone structures have been discussed by several authors. The effects of residual monomers such as bis-GMA-TEGDMA and potential allergic reactions in addition to the limitations of molecular conversion, are not much of a problem to the authors nor to the further development of tooth coloured dental implants and abutments.

The book offers an objective look, in a concise manner and with extensive references, at the dental use of “non-metallic” biomaterials for dental restoration and tooth replacement based upon evidence from publications in only 3 general parts. Dental professionals need to be prepared for scientific material and the trouble it might cause in their practice. If necessary, they can always fall back upon this overview of the latest trends, materials and references to complement their existing library.

 

M TABAK

March, 2013