Trends in materials science from the point of view of a practicing dentist

In the last 15 years remarkable changes in restorative dentistry occurred. The use of amalgam dropped dramatically, also the use of different types of alloys, The reasons were beside aesthetics the controversial discussion about amalgam and metal toxicity and environmental pollution. This shift did accelerate the development and use of composite resins and ceramic materials for dental restorations. Simultaneously to this development, new concepts in minimally invasive dentistry as well as in adhesive dentistry were introduced and improved. For small and medium sized cavities meanwhile composite resins are the first choice, whereas for large defects, crowns and bridges full ceramic restorations increased in number enormously. Most important questions in clinical practice are the handling of the material and the longevity of the restoration. Recent reviews show that composite resin restorations call compete with amalgam and indirect ceramic restorations but gold restorations are still the best in long-term performance. Main problems in clinical use are fractures, wear, gap formation and secondary caries, postoperative hypersensitivity and technique sensitivity. In contrary to earlier decades in the last 10 years the main reason for failure with composites is no longer secondary caries but nowadays fractures. Chipping of material and bulk fractures are also the most frequent reasons in ceramic restorations which limits the range of indication and there is still a need for improvement. But in general the patients are highly satisfied with these new adhesive and tooth coloured restorations. (C) 2008 Published by Elsevier Ltd.