Dental Materials Compatibility
we all just get along?
by Louis Malcmacher, DDS
The title for this column may be an issue
that you rarely think about, but it directly affects the dentistry that
you do every day. The issue here is not communication with patients or
staff, joining organized dentistry, or handling social obligations. The
issue is dental materials compatibility. Are the materials that you use in
your patients' mouths compatible with each other — i.e., do they all get
We live in a confusing world of dentin bonding agents, composite resin
technologies, curing lights, resin-reinforced glass ionomers, compomers,
curing lights, cements, and ceramics. How do you know that all of the
components of the materials you use are actually working together
harmoniously? The answer is you don't, unless you have a restorative
failure and postoperative sensitivity.
When a restorative failure occurs, our natural inclination is to think
that the dental material failed. We blame it on the resin or the bonding
agent. Most dental manufacturers would like to believe that restorative
failures are a result of poor dental technique. The answer, like so many
other controversies, probably lies somewhere in the middle. A large part
of the answer to this problem, however, likely lies within the realm of
Let me give you an example. Most composite resins cure in a range between
350 and 600 nanometers. This is completely determined by the manufacturer;
it is an area that most dentists don't even think about when buying
Now, let's take a look at another crucial piece of composite resin bonding
— the curing light. Currently, there are three major types of curing
lights on the market — plasma arc, halogen, and light-emitting diode. A
quick scan of these three lights in terms of their curing range would put
them in this order: Plasma arc lights have the broadest range, meaning
these lights will cure a very wide nanometer range and will cure probably
close to 99 percent of all composite resins on the market. Halogen and
enhanced halogen curing lights have a medium to broad range of curing
composite resins, while light-emitting diode lights have a very short
curing range, typically between 450 and 550 nanometers.
This doesn't mean that LED lights don't work. As a matter of fact, they
have some advantages over other types of lights: They are typically
cordless, lightweight, easy to use, and they produce no heat. However,
because of their very short range of cure, these lights cannot be used
successfully with many composites, only with those that are compatible.
You may not realize this. Maybe you are curing composite resins that feel
hard to the touch on the outside but are very soft on the inside of the
restoration. To a certain extent, this is also true with bonding agents
and composite resins and some ceramic materials and composite resins.
You need to know about your dental materials and whether or not everything
is compatible. Sticking with one system from one manufacturer usually will
solve this problem, but I completely understand the need for different
materials in different situations. Do a little research; test these
materials and lights in your own hands to make sure they are compatible
with each other. This will significantly reduce restorative failures and
postoperative sensitivity, which makes happier patients and happier
dentists. Isn't it nice when we all get along?
Dr. Louis Malcmacher is an international lecturer and author, known for
his comprehensive and entertaining style. An evaluator for Clinical Research
Associates, Dr. Malcmacher is a consultant to the Council on Dental
Practice of the ADA. For close to two decades, Dr. Malcmacher has inspired
his audiences to truly enjoy practicing dentistry by providing the
knowledge necessary for excellent clinical and practice-management skills.
His group dental practice has maintained a 45 percent overhead since
1988.For details about his speaking schedule, Dr. Malcmacher can be
reached at (440) 892-1810 or via email at firstname.lastname@example.org.
This article was originally printed in Dental Economics May, 2003
Author(s) : Louis Malcmacher
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