Specialist know-how on All-Ceramic restorations

Brisbane prosthodontists Michael Mandikos and Tony Rotondo promise a no hype, good and honest presentation in their All- Ceramic Crowns and Veneers course on the Gold Coast, March 18-19, 2005.

"This program is designed especially for the general dentist who is looking to start working with all-ceramic restorations or who simply wishes to improve their skills and handling of these restorations to get better results," Dr Mandikos said. "This will be a rare opportunity to attend a 'workshop-style' forum where the sole topic for two days will be all-ceramic crowns and veneers including plenty of practical tips and tricks to obtain excellent treatment outcomes.

"Some science and theory will also be presented to enable you to understand how these restorations function in the mouth and why they fail and of course, there will be a lot of step-by-step clinical examples to illustrate techniques.

"We will endeavour to cover everything in this course to a level of detail that will enable you to go back to your practice and produce quality, predictable, aesthetic crowns and veneers for your patients."

Dr Mandikos said that they were prompted to run this programme as they often receive phone calls from dentists enquiring about what the best type of all ceramic system to use is, what cement is the most appropriate or in what order to use etchants, primers, bonding agents, etc, when cementing.

"Dental Schools aren't able to include much in their curricula for all-ceramics and many dentists are confused about the various systems and how best to use them. Many dentists are also still concerned that these restorations are not strong enough and break easily. "All ceramic crowns are not all the same and choosing the wrong system can effect the aesthetic outcome of a case. Similarly, there are some situations where restoring in composites is more sensible and may avoid future problems. Veneers too are not all the same and some situations require reinforced systems, whilst other clinical situations are best treated with conventional feldspathic materials. Knowing how your ceramist makes your veneers may influence the types of cases you choose to apply them to. Recognising the amount and state of the remaining tooth structure will help determine whether veneers should be used at all or whether full veneer crowns or composites should be used instead.

"Preparation design and management of the remaining tooth structure are also vital in producing all ceramic restorations that will last in function. People wonder why all ceramic restorations fail and may blame the system used or their lab and may ultimately even shy away from all ceramics all together. Often, it is the preparation design that makes or breaks the case.

"The one over-riding factor in my opinion is an understanding of the material you plan to use. I believe that to do good, long-lasting restorations, you need to recognise the state of the remaining tooth structure and then have a good basic knowledge of the physical properties and method of manufacture of the restorations available to you to restore the case. If you understand this, then you are well placed to deliver quality restorations. Ignorance of a material or the condition of the remaining dentine and enamel is bound to lead to disaster."

Dr Mandikos said that all-ceramics, like all dental materials, were technique sensitive and a failure to understand their use and application could lead to failures in the mouth.

"Tony and I both received our specialist training in the USA and have attended many international meetings and symposia on dental ceramics. We know some of the great clinicians and educators in ceramics on a personal level and have had the opportunity to bounce questions off them over the years. We have 15 years of specialist experience in all-ceramics between us and all-ceramics make up a significant part of our daily practice. We enjoy the subject matter and look forward to presenting it to a likewise interested audience."