DentaltownUK August 2017 - 27

The patient/parent experience can be measured only qualitatively, but clinical
success of the appointment can be measured quantitatively. Both the patient
and parent experience and clinical success are affected by many factors: size
and location of the carious lesion, risk factors, dental age, patient compliance
and, of course, operator skill and technique.
With so many variables to consider and manage to achieve success, it's
imperative to use excellent technique and quality materials.

"Treating children can lead to unique challenges.
More than any other aspect of dentistry, when we
work with children we must create a balance."
Use of resin-based composite in paediatric dentistry
Restorative material choices for paediatric patients are vast and varied, and
we use professional judgement and experience to determine which materials to
use in which clinical situations.
Resin-based composites are popular and widely used in North America for
restorative dentistry.3 The most recent Pediatric Restorative Dentistry Consensus
Conference, in 2015, updated the recommendations for the use of resin-based
composites in children.4,5
The final documents for use of resin-based composites in primary teeth
advises: Use in an adequately isolated environment in small pits and fissures;
occlusal surfaces; Class II lesions that do not extend beyond the line angles;
Class III, IV and V lesions; and strip crowns.6 Lesions that are to be restored with
resin-based composites require a dry field and must be prepared conservatively
to expect long-term success.

Adhesive systems: Total-etch versus self-etch
Resin-based composites are used in conjunction with adhesives. Dental
adhesives have evolved over the years from multiple-bottle total-etch systems
to current self-etch systems. Older total-etch generations of adhesives require
pre-etching with phosphoric acid and are more technique-sensitive than
self-etch systems.
Total-etch challenges are sensitive to postoperative discomfort and technique.
Phosphoric acid etching of dentin can lead to removal of the smear layer and
can lead to postoperative sensitivity. Additionally, in total-etch systems in which
technique sensitivity is high, the tooth must be dried so that the enamel appears
frosty, yet the dentin must remain moist. On any patient, child or adult, how
can we determine accurately how truly wet or dry the tooth is?
Self-etch adhesives are reported to have challenges with staining and
marginal leakage because of enamel that hasn't been etched with phosphoric
acid. This can be remedied easily by using a selective-etch technique, which
etches only the enamel surface with phosphoric acid, then proceeds with the

dentaltownuk.com \\ AUGUST 2017

27



http://www.dentaltownuk.com

Table of Contents for the Digital Edition of DentaltownUK August 2017

Cover
On Dentaltown.com
Editorial with Mike Gow
Meet the Team
Howard Speaks: Drive-Thrus and Dentistry
Endodontic Reboot: Part One
Classified Listings
Brand Advertising
A United Voice
Adhesion in Primary Dentition Restorative Dentistry
Additive Dentistry
Zero Moment of Truth
Through the Keyhole
Message Boards: Re-treats question
Due Diligence—A Vendor's Perspective
Message Boards: Antibiotics after Surgical Extraction
Adding Value to the Patient Experience
Lifestyle
Poll: General Dentistry
CE Update
Students Section
Wishlist
DentaltownUK August 2017 - Cover
DentaltownUK August 2017 - Cover2
DentaltownUK August 2017 - 3
DentaltownUK August 2017 - 4
DentaltownUK August 2017 - On Dentaltown.com
DentaltownUK August 2017 - Editorial with Mike Gow
DentaltownUK August 2017 - 7
DentaltownUK August 2017 - Meet the Team
DentaltownUK August 2017 - 9
DentaltownUK August 2017 - Howard Speaks: Drive-Thrus and Dentistry
DentaltownUK August 2017 - 11
DentaltownUK August 2017 - Endodontic Reboot: Part One
DentaltownUK August 2017 - 13
DentaltownUK August 2017 - 14
DentaltownUK August 2017 - Classified Listings
DentaltownUK August 2017 - 16
DentaltownUK August 2017 - 17
DentaltownUK August 2017 - 18
DentaltownUK August 2017 - 19
DentaltownUK August 2017 - 20
DentaltownUK August 2017 - 21
DentaltownUK August 2017 - 22
DentaltownUK August 2017 - Brand Advertising
DentaltownUK August 2017 - 24
DentaltownUK August 2017 - A United Voice
DentaltownUK August 2017 - Adhesion in Primary Dentition Restorative Dentistry
DentaltownUK August 2017 - 27
DentaltownUK August 2017 - 28
DentaltownUK August 2017 - 29
DentaltownUK August 2017 - 30
DentaltownUK August 2017 - 31
DentaltownUK August 2017 - Additive Dentistry
DentaltownUK August 2017 - 33
DentaltownUK August 2017 - Zero Moment of Truth
DentaltownUK August 2017 - 35
DentaltownUK August 2017 - 36
DentaltownUK August 2017 - Through the Keyhole
DentaltownUK August 2017 - 38
DentaltownUK August 2017 - 39
DentaltownUK August 2017 - 40
DentaltownUK August 2017 - 41
DentaltownUK August 2017 - Message Boards: Re-treats question
DentaltownUK August 2017 - 43
DentaltownUK August 2017 - 44
DentaltownUK August 2017 - 45
DentaltownUK August 2017 - 46
DentaltownUK August 2017 - 47
DentaltownUK August 2017 - 48
DentaltownUK August 2017 - 49
DentaltownUK August 2017 - 50
DentaltownUK August 2017 - 51
DentaltownUK August 2017 - Due Diligence—A Vendor's Perspective
DentaltownUK August 2017 - 53
DentaltownUK August 2017 - 54
DentaltownUK August 2017 - 55
DentaltownUK August 2017 - Message Boards: Antibiotics after Surgical Extraction
DentaltownUK August 2017 - 57
DentaltownUK August 2017 - 58
DentaltownUK August 2017 - 59
DentaltownUK August 2017 - Adding Value to the Patient Experience
DentaltownUK August 2017 - 61
DentaltownUK August 2017 - Lifestyle
DentaltownUK August 2017 - 63
DentaltownUK August 2017 - 64
DentaltownUK August 2017 - 65
DentaltownUK August 2017 - 66
DentaltownUK August 2017 - 67
DentaltownUK August 2017 - 68
DentaltownUK August 2017 - 69
DentaltownUK August 2017 - 70
DentaltownUK August 2017 - 71
DentaltownUK August 2017 - 72
DentaltownUK August 2017 - 73
DentaltownUK August 2017 - Poll: General Dentistry
DentaltownUK August 2017 - 75
DentaltownUK August 2017 - CE Update
DentaltownUK August 2017 - 77
DentaltownUK August 2017 - Students Section
DentaltownUK August 2017 - 79
DentaltownUK August 2017 - 80
DentaltownUK August 2017 - 81
DentaltownUK August 2017 - 82
DentaltownUK August 2017 - 83
DentaltownUK August 2017 - 84
DentaltownUK August 2017 - 85
DentaltownUK August 2017 - 86
DentaltownUK August 2017 - 87
DentaltownUK August 2017 - Cover4
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