Moving away from amalgam: New online tool helps dentists choose suitable restorative materials
LUCERNE, Switzerland: To support the dentists during the phasing down of dental amalgam, experts from Foundation Nakao’s management board have created an easy-to-use online educational tool that aims to guide clinicians in their selection of restorative materials. The Restorative Options Decision Tree draws consensus from experts and incorporates in the decision-making process key factors in restorative treatment, such as clinical situation, patient expectation and comfort.
Profs. Reinhard Hickel, Clark Stanford, Eric Reynolds, Marco Ferrari and Keiichi Sasaki of the Foundation Nakao management board joined forces to support dentists in selecting appropriate restorative materials, and the Restorative Options Decision Tree project was initiated.
A comparison table of restorative materials was created in order to address different direct and indirect restorative options. Several parameters were considered, including the site of the restoration, the condition of the remaining tooth structure, the depth and size of the lesion, the possibility to isolate, caries risk factors, economic considerations, and the physical and clinical properties of the different restorative options. The comparison table was later transformed into a decision tree, and after four further steps, the decision tree was finalised and approved.
The decision tree was adapted into a user-friendly online educational tool that aims to facilitate identification of the most suitable restorative materials for each situation. The advice based on the experts’ consensus guides clinicians step-by-step in identifying the appropriate restorative materials and procedures depending on the clinical situation, taking into account key treatment factors such as time and cost efficiency, aesthetics, patient comfort and expectations, and preservation of tooth structure.
“The phasing down of dental amalgam is happening in nearly all countries”
– Prof. Reinhard Hickel, Ludwig Maximillian University of Munich
According to Prof. Hickel, director of the Department of Operative Dentistry and Periodontology at Ludwig Maximillian University of Munich, the new tool will help dentists to consider the various conditions of patients and teeth involved in dental restorations, and to make decisions on which material to use as an alternative to amalgam.
“The phasing down of dental amalgam is happening in nearly all countries. In the European Union a termination may happen in the next 5 or 8 years, but it will happen eventually,” Hickel told Dental Tribune International. He said that a reduction in the use of dental amalgam was happening at different speeds around the world, and that it was taking place for different reasons. He explained: “In the US, aesthetics has played a role and patients are opting for a more aesthetic restoration. In Scandinavian countries, environmental factors have been a motivating factor in the phase down—for many other countries, toxicity has also been a concern.”
Hickel commented that younger clinicians will face fewer hurdles in adapting to the use of new restorative materials. “I would not describe the phase-down as being problematic, it will involve new techniques and education is the key. Dentists will have to learn about and gather new experience using a new generation of restorative materials,” he said.
The Restorative Options Decision Tree tool can be accessed here.