Adhesive dentistry has become an important part in the domain of restorative dentistry. The two most common placed adhesive restorations in the posterior region are direct composite restorations and indirect bonded onlays/partial crowns/crowns. As adhesive restorative procedures are quite technique sensitive, it is required to follow effective and standardized protocols to make high quality adhesive restorations in the posterior region in daily practice. In addition, the dentist must be aware of the why and how of the different steps of the protocol. A detailed biomechanical analysis before and during cavity preparation is very important to determine what will be the most favorable adhesive restoration (direct, indirect). Direct composite restorations show a good clinical performance in the long term, when restoring medium size Class-1 and 2 lesions. Restoring a large defect in a posterior tooth with wide open boxes and cusp reduction with a direct composite restoration is time consuming and requires a skillful operator. The most optimal and durable restoration for moderately destructed posterior teeth with cusp reduction is a bonded ceramic overlay/partial crown/crown. In this lecture, the selection of the most favorable adhesive restoration will be discussed based on a profound biomechanical analysis. How far can the dentist go with each restoration type and what influence does it have on the clinical performance of the restoration? And when do we decide to restore the tooth with a conventional crown. Finally, the most important steps of the protocols to make the different types of adhesive restorations in the posterior region in daily practice will be highlighted.
Duo presentation with Marleen Peumans