ฝึกพูดภาษาอังกฤษด้วยเทคนิค Shadowing จากวิดีโอ: Pascal Magne Part #1

Pascal Magne

This is Pascal Magne talking from Los Angeles, California, at the University of Southern California School of Dentistry.

Today we are going to talk about the principle of biomimetics in restorative dentistry.

And I hope you will, after this hour and a half spent together, you will understand exactly what I mean when I say biomimetics.

And a couple words about my background as a word of introduction.

As you might know, I'm from the University of Geneva.

I was born in Switzerland and got my dental education there.

I was very much blessed to be under the guidance and leadership of Dr. Belzer in Geneva,

who I can really say is my clinical mentor.

The second person I want to mention at this stage is my second mentor I had in my career,

Dr. Bill Douglas at the University of Minnesota.

Bill Douglas was my, I can say, my research mentor.

He is definitely someone who opened my eyes on research

and I was so kind to host me for two years at the University of Minnesota

and you will see a little bit of the work

that I did when I was there in the freezing cold of the Midwest.

Finally I couldn't start this presentation without mentioning of course the University of Southern California.

This is one of the most recent chapters of my academic life and this is thanks to Dr. Hal Slavkin, the Dean here at USC,

a man with a vision, an amazing leader who inspired us to come

and actually as you know I didn't come alone at USC

I am here with my brother Michel who is one of

the most outstanding nail technician in the world I think it's not even needed to present him

and he's now in charge of the Center for dental technology here at USC.

And so we have now a Los Angeles Oral Design Center for those who know the oral design family.

Here is Michelle, you see on the screen, Michelle is very different physically than I am, right?

Especially at the top of our head.

However, if you look at our teeth, I don't have a picture here, but if you look at our teeth,

you will notice one day that we have quite a similar arrangement

and tooth form and because Michel is eight years older than me, he has much more incisal wear than I do.

Anyway, aesthetic dentistry, as you know, today is going to be about aesthetic dentistry.

And to be honest with you, I don't like too much the word aesthetic and even less the word cosmetic.

means aesthetic it is not a driving force in itself

and first of all we might have some disagreement on what means aesthetics

and that's why I want to give you my definition of aesthetic dentistry

and let's see what you think about it aesthetic dentistry is usually mentioned as being about the oral cavity,

the teeth, of course, the smile, the face of the individual.

And we hear that a lot in lectures.

And I agree with that.

However, I would like to say there is also a spiritual dimension in aesthetic dentistry,

which means that a lot of patients very often expect us to do extensive work and behind their expectations.

there is maybe a broken heart, maybe a personal problem.

And as you know, it is not by changing teeth

or by changing cars or by changing wife that you solve the root problems in your life.

And I think it's important to know that

because some patients have very high expectations and think that you can solve all their problems by making them a new smile.

And this is not what we want to promote here.

And I like this quote from Reverend John Murray in this book published in 1922, a long time ago.

As you can see, the realm of reality.

And what it says is so true.

The aesthetic is itself nothing more than a beautiful symbol of the spiritual, without which spiritual the aesthetic is a shadow without substance.

And I can't agree more with that.

Okay, with that in mind, I want to share some pictures here on so-called aesthetic cases.

And all these pictures you see now, these are patients with artificial teeth, all made in ceramics, veneers,

crowns, as is in the case, veneers again for this lady.

What does it mean really a successful aesthetic for these patients?

Can you judge on these slides?

Can you really judge from these slides if our treatment was successful or not?

And the answer is absolutely not

because you can make a very pretty shot of a pretty face and make you believe that the patient is happy.

But what will ultimately really make the patient happy is time and dynamic.

And this is impossible to judge on these pictures in these pictures, of course you would need to meet, to talk to this patient,

to know what is really aesthetic integration.

And this is what I want to share with you also during this lecture.

Aesthetic integration is not something you obtain with the final work.

It is something you obtain by the correct diagnostic approach and I will also try to share about this briefly.

So the main topic today will be about ceramics and composite

and I want to share new developments and their application in your practice.

I hope you have really a lot of take home message because I want to be very also very clinical for you.

It's going to be about adhesive technology and as I said something called the biomimetic principle.

Just again still as a very general comment the fixed prosthodontic is changing constantly

and I think like in the last decade the most important changes that we can mention

is around adhesive dentistry on one side and implant dentistry on the other.

And you have a good example on the screen of where we've gone from,

from the more invasive procedures like crown to more conservative occlusal coverage with like ceramic overlays that you see on the right.

And I think this is very important because it allows us to maintain more intact tooth substance.

It allows us to be more conservative.

It allows us to keep more teeth alive.

And I think this is very important.

The revolution is that, and this is the most extreme example of stabilization and retention form,

the use of pins.

That's an extreme, of course.

Stabilization and retention, you've heard these words when we prep crowns.

And I think this is the revolution stabilization and retention are not required anymore.

And from these very mechanical approaches of pins and crown preparations and screws and posts in the root,

etc., we are now shifting toward a more biomimetic approach.

And what is the driving force of biomimetics?

What is it that is really the base, the foundation of the concept?

It's very simple.

It starts with biology.

Biology is number one in the pyramid of priorities.

When a tooth is alive before we treat it, it should stay alive after the treatment.

There is one thing we cannot replace in a tooth, it is the living pulp.

Once it lasts, we will never recover it.

And I think that's every type of treatment that allows us to keep the pulp alive, we should buy that treatment.

We should support it.

And this is the foundation of biomimetics.

The next step is if we have a vital tooth

and we know that we play in the higher league every time we have a vital tooth,

then we have to emulate the mechanics and the function of this intact tooth, of the intact tooth.

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And to emulate the mechanics and function we need to know a little bit about enamel, dentin, as a material property.

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And I tell you, if we respect biology, if we emulate mechanics and function, aesthetics will be like a gift.

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It will be given because we would not have to think about it.

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Because to emulate mechanics and function, we need tooth-like materials, not only mechanically but also aesthetically.

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And so this is really the very strong foundation of what I call the biomimetic principle because as you might know, biomimetics is a more broader

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definition towards the fabrication of body parts the same way they are fabricated by the human body

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but in vitro in a lab.

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And we are not yet to the point when we can fabricate enamel

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and dentin as tooth parts to be used as a restoration.

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But people are working at This is part of Dr. Slavkin's, our dean's vision, and I think this is very important.

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Now for us, and for nowadays, let's say, we need to be inspired by the biomimetic principle.

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And as I said, we need to know dental materials, and we have to simulate enamel and dentin.

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And for that, we need to know the tooth.

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We need to know what is the constituent of the tooth.

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And as you know, most of the tooth volume is made out of dentin that you can see now on the screen.

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And dentin is very flexible and compliant.

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It gives a lot of elasticity to the tooth.

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And we know from these studies by Stokes and Hood that the stiffer the coronal restoration,

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the more we increase the risk of root fracture.

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And this is a typical example of altering the biomechanics of the tooth with a stiff element, a too stiff element.

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Then we transfer the stress to the more deformable part of the tooth, in this case the root, and we increase the risk of root fracture.

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So we have to remember that the tooth, the intact tooth, is a perfect balance between resilience and stiffness.

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The dentine is here as a flexible core to bend, to absorb the deformation.

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And the enamel is there to give enough function and cutting ability and stiffness for long-term function.

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And this is the perfect combination.

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This is really what makes it work.

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And if we can all agree on this principle, if we can all agree that the intact tooth is the reference for reconstruction,

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then I think we can really focus on developments that strive for emulating this.

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And you know what, with nowadays material it's not too complicated.

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We need to find an enamel substitute, a dentine substitute, and a dentine enamel junction substitute.

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Thank you.

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ฝึกพูดภาษาอังกฤษด้วยเทคนิค Shadowing จากวิดีโอ: Pascal Magne Part #1

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