Frank G. Landry, DDS, FAGD, FACD
Denville, N.J.
My observation is that both Dr. Steven and Dr. Dickerson are guilty of overstatements, not an unusual occurrence in this sort of public discussion. Interestingly, neither one addresses the problem basic to failures of either material.
Since retiring and working as a temporary dentist in various practices, I`ve become acutely aware of a general disregard for basic protocol. Directions are not read and essential steps are shortened or eliminated entirely. The facts are, of course, that each step must be done and must be done exactly, no matter how behind one may be. Composites are especially technique-sensitive and, contrary to what many dentists seem to think, they all need mechanical retention if they are to last. After 27 years of amalgams and 17 years of composites only, I know this is the secret to successful restorations. Not done well, neither material is worth the time and effort to place it
I guess one gets a bit cynical after years of exposure to "proofs" and "evidence." Those quoted studies fail to fully impress me. They just don`t match my experience. Moreover, to make a big thing about seven-year crowns is ridiculous. Most of the colleagues I know would be ashamed of such a poor record. We tell our patients that we cannot guarantee anything, but that we expect, and often get, 20 to 30 years` longevity assuming regular maintenance appointments and proper home care.
