The Empirical Problem
As the materials we use to create implants advance faster and faster, so too do the procedures our clients can perform. All of this goes on to benefit the end user–the patient.
On the other side of the coin, the rate at which these materials are being developed presents a challenge for the dental lab industry. How do we collect empirical evidence of a material’s performance over time, when by the time we’ve collected our data, there are 10 newer, cheaper, better materials on the market?
The short answer: we can’t. Fortunately, however, there are methods of accurately estimating new materials’ long-term performances without the need for empirical data.
1) Comparing existing materials
While we may not have the luxury of time, what we DO have is a plethora of existing materials to base our assumptions on. Most of the new materials we see today are derived from older materials we’re already familiar with (and have been using for decades). Knowing what a particular ceramic is made of places it in certain categories of existing materials, and there are even classification schemes for new ceramics, which classify based on the new material’s matrix and filler particles (see below).
2) Choosing based on patient application
Each case presents its unique circumstances and challenges, effectively narrowing the list of possible materials to consider. For instance, in a posterior bridge, we wouldn’t use IPS e.max®, opting instead for a zirconia or lithium disilicate implant. However, in an aesthetic capacity as a low-stress anterior restoration, e.max® would be optimal.
3) Improved Guidelines by Manufacturers
When manufacturers come out with these new materials, they provide a handling protocols for labs and dentists to use when dealing with the material. These protocols come from a long trial and error process the manufacturer goes through when making the product. As time goes on, materials and processing techniques get inherently better, and if dental professionals stick to the guidelines, we can reliably anticipate how the material will perform.
4) Real-world “Testing”
Because of the ever-changing nature of our industry, it is often the case that we (the dentists, labs, and even patients) are doing most of the long-term application, and monitoring the results. While manufacturers, testing laboratories, and universities are doing as much as they can, there are simply too many variables in dentistry to reliably test them all. Even the most rigorous testing programs can produce huge discrepancies with real-world application. This is why, as a laboratory, it’s extremely important for us to use appropriate techniques for each material we work with. After years of working with these types of materials, you tend to learn what works and what doesn’t.
For a full article on the subject, click here.
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