Question: Does anyone know/have any relatively new data on crack and adhesive interfaces?
Quick question… does anyone know/have any relatively new data on crack and adhesive interfaces? are there any specific materials that aid in such scenarios better than others combined with cusp coverage… thanks
Salvatore Sauro: Massimo!!!!
Massimo Giovarruscio: I’m going to post something on it today Thomas. I’ll tag you!!
Loukas Giannis: tag me also
Jose Manuel Barria: Me too
Ehab Nabil: Me too please
Maybe Still Still: Tag all dentists …☺️
Misael Montero Garrido: Me too please Massimo Giovarruscio
Jason Smithson: that tooth is toast BTW
Jason Smithson: probe distally…there will be a pocket
Thomas Taha: first thing I do is probe… (you taught me that a while back! 😉) but the question is… if it was asymptomatic and your own tooth… would you go straight for XLA & implant or try something else first… ps the picture above is just to discuss the topic of cracks and adhesion lol
Jason Smithson: xla
Thomas Taha: Who would you ask to do your implant if you had to have one?! lol On a serious note do you have specific go to paper you like to use in reference to your crack management guidelines?
Jeff Davies: Thomas Tahahttps://www.ncbi.nlm.nih.gov/m/pubmed/22299120/
A systematic approach to deep caries removal end points: the…
ncbi.nlm.nih.gov
Jason Smithson: that article is about caries not cracks
Jeff Davies: Right. Same concept should and can be applied to both. It’s about stabilizing the cracks because if not they will propagate and get worse. I know you know the authors. They have, I have, been doing it for years with great results.
David Wetherington: Jeff Davies, that is a reasonabke assumption on the surface, but like most complex questions you cant make simple comparisons. As humans we struggle with not having clear answers to clear problems so we decide on a solution and then convince ourselve…See more
Jeff Davies: David Wetherington wow. Strongly disagree. How about years of clinical success? Talk to either of the authors and they will tell you the same. It’s not merely assuming. That’s reckless. Everything I do in practice is based off current science. Truth be told. Research is being gathered about cracks for a paper, which I’m involved in. ☺️😜
Jason Smithson: Jeff Davies paper is on caries
Jason Smithson: please show me paragraph on cracks
Jeff Davies: Jason Smithson you know what’s in the article. But as mentioned, this is where the new research is going. Based off these protocols. Everyone is right. There is a great deal of evidence that is lacking to prove these steps. But the claim is coming from numerous dentists following these and reporting success. It takes a lot to believe the words of other tho. I get that.
Jason Smithson: Jeff Davies why are you quoting a paper that doesn’t include any information on the subject in case? It is not scientific
Jeff Davies: Haha my bad. I’ll stop. Just wanted to spread the love about removing the cracks as much as possible without exposing the pulp. Crown it, onlay it, whatever you want. If you don’t remove them tho they ll always be there. And get worse.
Jason Smithson: BTW…It may also interest you to know that the concepts in that paper are not original
Jason Smithson: at all
Jeff Davies: Jason Smithson right. But who else is showing that? A lot of the articles coming are quoting that one. But truth be told, it’s not important to me who was first but rather if the science is sound.
Jeff Davies: Jason Smithson just for conversation, how are you handling cracks? What’s your protocol. This is a chance for learning
David Wetherington: FWIW i disagree with smithson that this tooth is necessarily toast. He is one of the clinicians i look up to most in this profession. His opinion is valid and His assessment of the evidence is spot on – there isn’t any. In the end These are opinions and nothing more. That’s just the reality of where we are in dentistry right now.
Vasile Cirimpei: Don’t chase the crack. Splinting cusps by crowning is the way, but yes, prognosis is, well, you know…
Mahdi Al Sukhon: f
Liviu Steier: Should an extensive diagnostic not have revealed any serious causes reinforcement and adeqaute occlusal relief build up could allow extension of life expectancy.
Liviu Steier: Thank you Massimo!
Massimo Giovarruscio: Totally agreed with you Liviu
Stefano Bottacchiari: Quintessence Inlay onlay composite Cap. VI
Liviu Steier: Solution is not as simple as suggested I am afraid!
Stefano Bottacchiari: Liviu Steier no problem!!! Clinique and follow up is ok😊
Jeff Davies: You have to remove it. If not it will keep going, you’ll want to stabilize it. However you can only remove it in certain areas. Check the Alleman / Magne article online (2012) about deep caries removal endpoint. It’s the same concept.
Jason Smithson: Thomas Taha …do you have a radiograph?
David Wetherington: No evidence on how to handle these and the prognosis is. Tell the patient exactly that, make your best judgement call, let them decide and move on.
Stefano Bottacchiari: Cap. VI….you can see evidence
David Wetherington: ?
Stefano Bottacchiari: David Wetherington in my book of Quintessence…
David Wetherington: Ive been down this road many times, I’d be interested to read your book. Every time someone tells me there is evidence what they present are thinly veiled opinion articles, and some observational evidence with little to no clinical actionable evidence.
Jeff Davies: The book is solid. Everyone should read it. It would serve you well.
Duncan Grant: Antonis Chianiotis has something new from Japan that supposedly bonds cracks in root treated teeth !
Shaza Hamid: Thats super bond , they quote it can be used for stabilising cracked or fractured segment
Jason Smithson: 😱😱😱😂😂🙄😂
Shaza Hamid: https://www.ncbi.nlm.nih.gov/pubmed/11585144/
Periodontal healing after bonding treatment of vertical root fracture.…
ncbi.nlm.nih.gov
Duncan Grant: Getting the article and details from Antonis Chaniotis
Shaza Hamid: I haven’t personally used for crack!!Bit tricky to handle, but i loved the flexibility of material a lot. Started just couple of months back
Salvatore Sauro: Massimo and myself have been working on material and clinical approaches for the sealing of those gaps “when possible” ……… results in vivo and vitro will be presented in Milano at SIE 2018. Stay tuned!!!
Stefano Bottacchiari: Ciao Salvatore di che si tratta? Io ho molti casi di fratture con controlli a lungo termine e mi piacerebbe tanto fare qualcosa insieme 😊
Salvatore Sauro: Stefano Bottacchiari con molto piacere
Salvatore Sauro: A Pasqua sono in italia e vengo a trovarti così ne parliamo
Stefano Bottacchiari: Ok un abbraccio
Hasan Nammoura: ..
Raul Costa: i have restored many assymptomatic cases like this with 100% success, so far, with observation up to 5 years. the data i have is quite limited, though. my scarce observations suggest that if symptomatic, it’s hopeless. if assymptomatic, it can survive. it will be difficult even to explain the patient why you want to remove it. most if presented with the dilemma would probably want to do the least troublesome treatment for the moment, including myself. but maybe this is wrong.
Raul Costa: (as far as i know there isn’t much compelling data on this)
David Scott Alleman: How do engineers treat cracks and crack propagation?
Joe Norris: what were your camera settings to get such a great close up shot tom?
Giacomo Dallari: I remember there’s an in vitro paper of Krejci which demonstrate how a fiber reinforced buildup would deliver a better behavior on crack propagation. I will upload when I find it. Looking forward to see Massimo & Salvatore results
Meyer Jean: for me the problem is that we cannot bond really such cracks because forces on cusps open it , it s just a mechanical question that s why we want to cover it but may be in this case it s too late
Duncan Grant: Not every crack in a wall means your house is going to fall down !
Jordi P. Manauta: Domenico Ricucci is the boss in this matter!
Jose Manuel Barria: Thanls for the info ill find the literature or there is something you can share?
Duncan Grant: All teeth have cracks but some have fractures.
Giacomo Dallari: Some of them commit suicide too 😜
Salvatore Sauro:
Thomas Roberts: Dear oh Dear. Crack propagation is a n an enormous subject starting from Griffith Theory to Fracture Toughness.K1C. In a word (or two)its to do with ‘stored energy’ and will lead most scientist to doubt in a value for a Strength of a material as a physical property(physical constant if you prefer). There, I’ve said it, and it needed saying.
Thomas Roberts: If you have the time , memory or the inclination – go back to the solution of the Comet Aircraft tragedies and also the ‘crack stopper’ windows of the Caravelle aircraft. .One solution might be to use diffusion – i.e. put a ‘suitable very low viscosity adhesive on the crack and hope it rapidly diffuses by capillary reaction to the tip of crack and stop it propagating further. Problem is ‘that if the liquid adhesive lowers the propagation ‘energy’ then failure will be guaranteed. Its all in the literature folks.
Duncan Grant: What do these guys do that is so different?!
Thomas Roberts: Indeed…and light cured…they were/are well behind the curve…but ahead of Dental ‘materials scientists’ in academia. 😉
Duncan Grant: https://www.omicsonline.org/…/sealing-the-gap-of…
Sealing the Gap of Vertical Root Fracture through the Root Canal
omicsonline.org
Duncan Grant: Superbond from Sun Medical
Thomas Roberts: MMA and 4 META?
Duncan Grant: Just checked the Sun Medical Website and heard back from Antonis Chaniotis4-META/MMA
Shaza Hamid: Yes its the same stuff superbond
Eduardo Silva: Dear Thomas, although the current adhesive systems are capable of create reliable bonding between dentin and enamel, from the clinical point of view and based on a experience of 28 years, I think that cusp coverage still remains as the better choice in such situations.
Thomas Taha: Thanks but I was looking for some scientific evidence based dentistry regarding cracks