My beloved college mentor often told me, “I’m pulling for you” (shameless dental pun intended). Then he would proceed to show me teeth in his mouth that were gold or silver. They were like his battle trophies, each with its own unique, unpleasant story. Boy, am I glad that times have changed! Current advances in ceramics & bonding have phased out the need for metals and amalgams, so we no longer have to compromise on material safety, esthetics, or strength. With biologically compatible materials, we are able to practice biomimetic dentistry
Biomimetic literally means “to mimic nature.” A biomimetic dentist is concerned with two things: (1) conserving as much tooth structure as possible and (2) mimicking the natural form and strength of teeth. How do we do this?
- Ceramic materials: Porcelains, zirconia, and ceramic hybrids are the core materials for biomimetic dentistry. They have properties that, when properly contoured & polished, closely resemble that of tooth enamel. Not only do metals and amalgams not have these properties, but they often require excessive cutting of healthy tooth structure.
- Bonding: Dentists used to place restorations with cement, zinc phosphate being the most popular. Today, we bond restorations, which creates a strong adhesion to the tooth and provides a seal that protects against the invasion of bacteria.
- Computer-aided design/Computer-aided milling (CAD/CAM): This technology allows us to not only create conservative restorations in our office, but to do so in just one appointment! Traditionally, teeth with large amounts of decay and/or broken fillings would require a full coverage restoration called a crown [see Figure 1], and a significant amount of tooth structure would be cut away. But, with CAD/CAM technology, we are able to fabricate inlays and onlays [see Figure 2] instead, providing us the best of both worlds—strength and preservation of tooth structure.
- Skilled practitioner: A dentist with adequate training and experience with biomimetic dentistry knows the importance of proper isolation from saliva and debris. Correct bonding sequence is also critical. So, if the practitioner has a mastery of the proper technique, there really is no reason to still use metals and amalgams when such variety and versatility of modern biocompatible materials exist.
Figure 1: Crown Restoration
Figure 2: Inlay Restorations
A. Before restorations
B. During removal of fillings and decay
C. Inlays made with CAD/CAM
D. Inlays bonded to teeth
What About Cosmetics?
The pioneer of Biomimetic Dentistry and professor of Esthetic Dentistry at USC, Dr. Pascal Magne, once said:
“The driving force is to mimic nature, not just the esthetics of nature, but to respect the biology, to emulate function and mechanics. Esthetics is a logical outcome.”
Although cosmetics is not the primary focus of biomimetic dentistry, we are able to provide great looking results simply by following the form of the natural tooth. So, just by following the principals of biomimetic dentistry, we are sure to get outcomes that are cosmetically pleasing.
“You can have it all; you just can’t have it all at once,” Oprah Winfrey once said. However, when it comes to biomimetic dentistry, you can have it all: biocompatible material, strength, function, esthetics, and preserved tooth structure. Work with a dentist that shares this philosophy, and the next time you share your dental experience, it’ll likely be a positive one.
