Six Lessons Approach Podcast by Dr. David Alleman

Fiber placement in restorative dentistry: Does it stop cracks, improve bonds or just add time to your restorative process? Dr. David Alleman, DDS, dives into the history of dental fibers, including Ribbond, Everstick Net and Ever-x Posterior, their uses in different clinical settings, and the research that shows how they support the restoration long-term.  Articles referenced in this episode: Bell...

Cracks put teeth at risk of infection and fracture if left untreated, but treating cracks in teeth can create many challenges for practitioners. Removing cracks without good magnification, visibility and an understanding of crack propagation puts the nerve and critical tooth structure at risk. Once the crack is removed, the non-standard defect requires specific techniques to bond to deep areas of...

Dentists have been attempting to treat cracked teeth for decades, with the goal of alleviating patient pain and conserving teeth through restorative treatment. But as Dr. David Alleman, DDS, describes in this episode, “it’s a coin toss of success.” Methods such as retention to hold the crack together or bonding over the crack with adhesion are unpredictable. Sometimes the treatment works, and some...

The most minimally invasive dentistry is early diagnosis and treatment. Dr. David Alleman created the 1-2-3-4 risk assessment so he could better diagnose teeth that were at risk of fracture or decay to prevent large fractures or carious lesions under the restoration. In this episode, Dr. Alleman discusses research into the structural integrity of different preparations and how practitioners can us...

Treating cracks in teeth can still feel ambiguous for many dentists. Is it better to observe? Is it better to crown? Is there a less invasive treatment option? In this episode, Dr. David Alleman discusses a key piece of research that offers practitioners more insight into crack diagnosis and treatment: cracks that cause decay. Occlusal effect caries is a carious lesion that forms from cracks that...

With the invention of new materials for restorative dentistry, new techniques for application were needed. Research in bonding to dentin showed bond strengths that approached the cohesive strength of a tooth, but getting this research into the hands of practicing dentists was another process entirely.  As Dr. David Alleman was learning and researching new protocols in adhesive dentistry, his quest...

Dental research developments don’t happen overnight. The key players in dental research — university faculty, dental product manufacturers and the practitioners who adopt this research — work in varying capacities with the overall goal of improving dental outcomes for patients. Yet there is often a disconnect, slowing the lines of communication. In this episode Dr. David Alleman discusses leading...

Dr. Charley Cox was one of the early contributors to adhesive dental research, specifically in the field of histology. During the development of adhesive dentistry, Dr. Cox studied long-term pulp health in non-human primates, identified immune responses that confirmed Martin Brannstrom’s hydrodynamic theory of pain and connected internationally with adhesive dental researchers like Takao Fusayama,...

Referred dental pain can be difficult for practitioners to diagnose without an understanding of the cause of dental pain and how teeth respond to different pathologies. Referred dental pain is caused by real symptoms that need to be treated, and in this episode Dr. David Alleman discusses types of referred dental pain, tips for diagnosing cracks under restorations and procedures for eliminating po...

As new dental materials are developed, manufacturers and key opinion leaders play a role in how widely those products are adopted. Manufacturers market new products, but key opinion leaders and teachers also influence practitioners by comparing the benefits of various materials and lending their expertise. In this episode Dr. David Alleman discusses his early introduction to adhesive materials, ho...

Popular during the early years of adhesive dentistry, chemical-cure dentin bonding systems have since become less common with the rise of light-curing, but they still serve a purpose when restoring the pulp chambers of endodontically treated teeth. In this episode Dr. David Alleman discusses the polymerization dynamics of chemical-cure and light-cure adhesives and how that impacts their effectiven...

How does peer-reviewed literature make it into the hands of practicing dentists? Sometimes it doesn’t. Other times research can be misinterpreted and applied incorrectly. The process of analyzing and applying current research is time consuming for practitioners to the point where new dental findings often fail to be widely adopted in practice. Reminiscing on his first meetings with researchers Joh...

Evidence-based dentistry aims to bring current dental research into daily practice, but the process of adopting new findings and translating them into protocols is a complicated and time-consuming process. Dr. David Alleman discusses how dentists should approach literature and what to keep in mind when considering adopting findings into their own practice.  From his own experience of wading throug...

Biomimetic dentistry can be defined by three main principles: preserve pulp vitality, conserve critical tooth structure and fully connect the tooth at 30 MPa or more. Mimicking nature (biomimetic) is about scientific analysis of how natural teeth function and replicating those principles during the restorative process. This isn’t art; this is science.  In this episode Dr. David Alleman discusses t...

Does biomimetic dentistry mean to mimic how teeth look? It can, but there is more to it than that. Dr. David Alleman discusses the evolution of cosmetic dentistry and its intersection with minimally invasive dentistry, adhesive dentistry and biomimetic dentistry. During his own research and teaching of biomimetic dentistry, Dr. Alleman met and taught a number of cosmetic dentists, including Joe Wi...

Adhesive dentistry has been taught in dental schools for decades and is widely used by dentists today. Bonding to a tooth offers increased adaptability of restorations, allowing for more minimally invasive treatment and preparation, but long-term success with adhesive dentistry is not a guarantee. Dr. David Alleman repeatedly saw failing composite restorations and realized that in order to improve...

Biomimetic restorative dentistry has been taught and practiced for over 20 years, with its roots linked to minimally invasive dentistry that started decades earlier. Minimally invasive dentistry sought to conserve tooth structure and restore only parts of the tooth affected by pathologies.  With the invention of adhesive materials, adhesive dentistry showed promise in advancing minimally invasive...

The wallpapering technique is a key protocol for extending the function of endodontically treated teeth. More brittle due to their reduced hydration, non-vital teeth are more prone to fracture, so using fiber in this way creates a fail-safe that prevents failure beneath the coronal portion of the tooth and reinfection of the root. Dr. David Alleman discusses how he helped pioneer this technique an...

Dr. David Alleman first created his Six Lessons Approach for vital teeth, but the same conservative principles can benefit endodontically treated teeth too. Compared to traditional techniques for retention and bonding, the advanced adhesive and stress-reducing techniques of biomimetic dentistry are better suited for treating non-vital teeth, which are more brittle and susceptible to cracking than...

Daily dentistry, the cases you see every day, usually involves minor occlusal adjustments that can be treated quickly and predictably using the Six Lessons Approach, but biomimetic techniques can benefit more advanced occlusal cases too. In this episode, Dr. David Alleman discusses the cause of abfractions, how complex temporaries are a thing of the past and options for doctors seeking more advanc...

Biomimetic dentistry aims to mimic a natural tooth throughout the restorative process. The last four decades of research has shown that mimicking and conserving a tooth’s natural connection to itself, its natural bond and resilience to occlusal forces and its natural defense mechanisms for infection benefits the tooth’s long-term health. This is also true for occlusion. In this episode, Dr. David...

What is the best material for enamel replacement? It depends! When selecting the material of an onlay or overlay, understanding how a natural tooth functions during occlusion is essential if your goal is biomimetic dentistry. Harder is not better, but rather mimicking a natural tooth’s bond to itself and its modulus of elasticity will aid in selecting your enamel replacement material. In this epis...

Air abrasion functions as a conditioning step when bonding, which means it prepares the dentin or composite molecules for bonding. Dr. David Alleman discusses the progression of bonding systems for dentin adhesion and how this conditioning step evolved along with the bonding system molecules. The latest studies from researchers independent from the bonding system manufacturers show that air abrasi...

Dr. David Alleman’s landmark paper written with Dr. Pascal Magne in 2012 gave practitioners predictable steps for deep caries, and now crack, treatment without exposing the pulp. But why is preventing pulp exposures so important? Dr. Alleman discusses research about the outcomes of pulp exposures and their effect on the tooth long-term in addition to proven treatment for teeth that have had expose...

Early diagnosis and treatment of dental pathologies allows for more conservative treatments while saving patients time and money. When developing the Six Lessons Approach to Biomimetic Dentistry, Dr. David Alleman created a risk assessment for determining if teeth were at risk of caries or cracks based on pathologies and treatment history. Drawing on research from how teeth experience pain, the pu...