Clinicians and technicians are caught in an endless debate regarding who is in the better position to make the selection of appropriate restorative materials for final restorations. This came to fruition again, as it has time and time again, in this month's feature "Guiding Material Selection in All-on-X Cases." To be clear, I have lectured on both sides of the aisle and have been accused many times of teaching more clinical than laboratory focused. As clinicians will tell you, they hold the accountability for the patient responsibility. Yet, in my experience, they often lack some critical knowledge in this process and the technician's knowledge of materials tends to surpass that of the clinician. To be fair, this information is not typical of the curriculum found in most dental schools, nor technician continuing education courses for that matter, and is more often an education process that occurs while working in the field.
The bigger question remains as to who is held accountable when the material fails. Yes, materials do fail for many reasons-faulty manufacturing, poor diagnostic choices, inaccurate preparation/impressions, managing occlusal stresses, and yes, simply choosing the wrong material. In the ideal setting of a good clinician/technician relationship, materials are selected not based on marketing, price, hardness, or quickness. Materials are, and should always be, selected by both sides of the clinical/technical team based upon the esthetic and functional parameters, the biological principles, and most importantly, to protect the patient's remaining tooth structure, implant, or bone.
Remember, we are healthcare workers and our job on both sides is to manage the health of our patients. In conclusion, as a team, rather than individually, we do this by having a complete understanding of the etiology of failure in one's oral environment, understanding all material pros and cons, and by carefully selecting the best restoration option to support all aspects of the patient's dental and medical heath.
Peter Pizzi, MDT, CDT
Editor-in-Chief
peter.pizzi@conexiant.com
