today I am attending a seminar in IDEA facility, with Pascal Magne and Michael Magne. Love it! Eye opener. If you ever have a chance, take it!

http://www.ideausa.net/

What is it all about? if you have not heard about Pascal Magne, it is all about Biomimetic principles, copying the nature, saving every bit of tissue as possible. Some of concepts are contradicting to what I learned in school ( not that I am that old), and to what majority of dentist believe in.

Just to illustrate:
-immediate dentin sealing after prep, prior to impression taking. 

- margin elevation technique. if there is a subgingival margin, elevate it with composite and then place margin of indirect restoration on the equi or supra-gingival area.

-preservation of pulp (vital, normal response)at all cost. Do not kill the pulp, it starts what he calls the "circle of death" for tooth: RCT tooth, crown, crown with post, fracture or failed tooth, extraction. Even with deep caries removal, create a absolute healthy tooth structure periphery, and at the pink deepest part, leave it undisturbed.

-bilaminar approach to treat teeth when there is need for facial and lingual restoration, e.g. erosion and wear cases: ultraconservative veneer on facial, composite on palatal to restore wear facet. Do not make a full crown prep.

-never cut for full crown, even with a pre-existing crown replacement, sometimes we can get away from full crown. Onlays, inlays, veneers, whatever it takes to not remove more than needed. we don't need full crowns for tooth after RCT, we don't need full crowns after a big amalgam to "wrap and protect" the tooth.

-CAD/CAM composite onlays: very conservative, it can be 1mm thin on occlusal. use it to restore posterior may be better than emax or zirconia. harder is not always better. how much do we have to cut for porcelain, emax or zirconia? much deeper than 1mm, they are not kind to opposing dentition, bonding is harder ( talk about bonding to zirconia!).

-there is a on going research for CAD/CAM composite abutment for implants, and results are very promising. bonds well, can be prepped at chairside ( veneer prep), it absorbs and flex like dentin.

I wish I can spread, intrigue and convert as many dentist so we can all think being minimally invasive... to conserve and appreciate what nature gave us, and not to be " serial tooth killer".