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22 | CERECDOCTORS.COM | QUARTER 4 | 2014
| | | P U R I
by some adhesive systems on the market (see end of
previous question).
However, one of the main characteristic of the
DEJ that may (or may not) still be lacking in existing
dentin adhesives is the ability to prevent cracks
from enamel to propagate into dentin. It is known
that such a characteristic is provided by thick Type
1 collagen fiber bundles organized with several
levels of scalloping.8 Considering the DEJ as fibril-
reinforced bond which is mineralized to a moderate
degree8 should help refine the next generation of
dentin adhesives.
WITH THE NEWER BONDING SYSTEMS, THE TREND
OVER THE YEARS HAS BEEN TO REDUCE THE NUMBER
OF BOTTLES AND TRY TO SIMPLIFY THE SYSTEMS.
IS THIS THE PROPER DIRECTION THAT THE
MANUFACTURERS SHOULD BE HEADING IN?
Ironically, those adhesives alluded to in the previous
question, and which are almost able to match the
DEJ or DEC, are from earlier generations, such as
total-etch-and-rinse, three-steps adhesives. Based
on my experience and research, I would person-
ally favor such a system with filled adhesive resin.
Everybody’s legitimate dream and quest has been
to simplify the application process into one step,
which has not proven successful so far, according
most of the scientific data.
WHERE DO YOU SEE THE STATE OF CAD/CAMFOR
CLINICIANS IN FIVE YEARS? IN 10 YEARS?
I see much simpler systems, wireless intraoral
cameras interacting with a tablet computer, which
will be much easier for mobility and hardware
upgrading, etc. I also see new manufacturing
options such as 3-D printers allowing for much
more anatomical detail and layering of the restora-
tions. Above all, opening of the platforms in order to
allow global access to the data.
WHAT FEATURES DO YOU FEEL THAT THE CAD/CAM
SYSTEMS ARE LACKING THAT YOUWOULD LIKE TO SEE?
First and foremost, to be more affordable! This is a
serious limitation for some countries that I visited
(not the United States, obviously). There are many
other technical features that I would like to see,
as outlined in the previous answer, but I would have
to have you sign a confidentiality agreement before
further answering this question ;-)
CAD/CAM IS A HOT ITEM IN DENTISTRY TODAY.
IN YOUR OPINION, WHAT IS THE “NEXT BIG THING”
IN DENTISTRY?
I believe in the extension of the digital technology to
globalize the concept of the Virtual Dental Patient
(merging of all data, CT scan, intraoral, dynamic
occlusion, etc.), a patient that could travel over elec-
tronic pathways in order to access the best clini-
cians for consulting and refining of the treatment
plan and for virtual simulation of the treatment. As
stated earlier, this would require a major effort to
establish an open platform and standardization to
share the data.
WHAT DOES THE FUTURE HOLD FOR
DR. PASCALMAGNE?
My wish is to continue having the same love and
passion for research, teaching and patient care,
wherever it leads me in the world. I would love to
expand and continue to propagate the knowledge of
“biomimetic restorative dentistry” while becoming
a more active partner to the industry in order to
achieve all the goals mentioned in this interview.
REFERENCES
1 Schlichting LH, Schlichting KK, Stanley K, Magne M, Magne P.
An approach to biomimetics: the natural CAD/CAM restoration:
a clinical report. J Prosthet Dent. 2014;111:107-15.
2 Magne P, Schlichting LH, Paranhos MP. Risk of onlay fracture
during pre-cementation functional occlusal tapping. Dent Mater.
2011;27:942-7.
3 Batalha-Silva S, de Andrada MA, Maia HP, Magne P. Fatigue
resistance and crack propensity of large MOD composite resin
restorations: direct versus CAD/CAM inlays. Dent Mater.
2013;29:324-31.
4 Edelhoff D, Sorensen JA. Tooth structure removal associated with
various preparation designs for anterior teeth. J Prosthet Dent.
2002;87:503-9 and Int J Periodontics Restorative Dent. 2002;22:241-9.
5 Smales RJ, Berekally TL. Long-term survival of direct and indirect
restorations placed for the treatment of advanced tooth wear.
Eur J Prosthodont Restor Dent. 2007;15:2-6.
6 Magne P, Schlichting LH, Maia HP, Baratieri LN. In vitro fatigue
resistance of CAD/CAM composite resin and ceramic posterior
occlusal veneers. J Prosthet Dent. 2010;104:149-57.
7 Magne P, Knezevic A. Simulated fatigue resistance of composite resin
versus porcelain CAD/CAM overlay restorations on endodontically
treated molars. Quintessence Int. 2009;40:125-33.
8 Lin CP, Douglas WH, Erlandsen SL. Scanning electron microscopy
of type I collagen at the dentin-enamel junction of human teeth.
J Histochem Cytochem. 1993;41:381-8.