Good morning ya MMP killas!
Before we get to the literature, a public service announcement: Dentists are apparently falling victim to new phone scams which include calls from cops, subpoenas, and fake court fines. Be aware out there.
Here’s today’s better news
🧌The Trolls Ruining Your Composites. The literature of MMPs and how to kill the guys killing your bonding
☕Coffee Break. A frustrating dental school physics lecture and a 3D printed jaw
🤵Bond. Zirconia, Bond. Bonding zirconia and looking forward to 2024!
Killing the Guys, Killing Your Bonding.
So 6 months ago, you finished a simple #13-DO restoration. No complications. No follow-up. It was beautiful.
But your patient is back…
That’s right. These are the matrix metalloproteinasis…or MMPs for short. And these guys are killing your dentin bonding.
So…
If not…let us explain why you should…
These MMPS…well, they’re losers, a$$hol3s, or whatever other cuss word ya wanna call them.
And they love two things:
And there are two important things to remember about bonding to dentin
1️⃣We want dentin with “fluffy” collagen (without a slime layer)
2️⃣ Dentin bonding sucks….like really sucks…and at least some of that suckiness has to do with MMPs!
I mean, look at these numbers 👇
Yes, that’s a 30 to 40% failure in 6 to 12 months. Not great!
So this is how the MMPs contribute to that failure…
Usually they are secured by the apatite minerals within the dentin’s collagen
But remember when we said that these MMPs LOVE etch? This is why.
When we go to etch that #13-DO something bad happens…
That’s right…the apatite mineral security guard is dissolved and the MMPs are allowed to run rampant- shaving all those cute little sheep in the process.
And over time, they mess with that nice hybrid layer of your restoration.
Which make your little sheep collagen friends feel like this…
But all of this is why dentists are adding one more extra step to their bonding protocol
…which includes placing materials that make these MMPs melt and run away…
Some common MMP killas include:
Chlrohexidine…like Consepsis
Gluma (Glutaraldehyde)
Now there is A LOT of debate on protocol for killing the MMPs, but at least one study has shown
And as far as time of Gluma/CHX treatment….there’s also a lot of debate.
But treating the prepared tooth for at least 60 seconds seems to be the starting point to killing those MMPS.
But!…
One very smart dentist out there (some call him the Michael Jordan of dentistry) says to scrub your preparations for 2 minutes (!!) with Gluma to completely kill the MMPs.
(…Which coming from personal experience…feels like an absolute eternity.)
In any case,
🧌Place your CHX or Gluma after etching, and before bonding.
⌛Scrub for at least 60 seconds (more to kill the last 14% of MMPs)
💨Don’t completely rinse off
Do you have a different protocol to take care of MMPs?
In any case, it’s all about making our little sheep friends happy…
Coffee Break
☕A literal coffee break. A simple trick that will improve your coffee…according to coffee literature. Did you know there was literature for coffee?
🐶Looking for a four-legged Christmas gift? The most and least expensive dog breeds.
🦐This guy deserve jail. TSA outlines (with pictures) how an airline passenger cooked shrimp in an airplane’s restroom.
💸Physics…in dental school? A dental student’s frustration over a very not applicable physics lectures(lol).
💀Very cool OMFS. A 3D printed jaw one week...graduation two weeks later.
You Can Bond…Zirconia?!
A programing note…
You won’t see us until 2024! We’re taking next week off and gearing up for a BIG new year…starting with zirconia bonding.
Have a great holiday season and can’t wait to send ya more tipsy literature in the new year.
luv u,
tipsy dentistry😘😘
How did you like today's edition of tipsy dentistry?
