Six Lessons Approach Podcast by Dr. David Alleman Dr. David Alleman

Dr. David Alleman is known today as an innovator in the dental field, but it didn’t start that way. Dr. Alleman recalls his early interest in science, his journey as a dental student, experiences in his early career and how all of this led to him wanting to leave dentistry.
Frustrated with sensitivity and failing restorations, he expectation that fillings would one day need crowns and then root canal therapy the next made his work feel worthless. He wondered: is this the best a dentist could do for their patients? 
In 1998 Dr. Alleman learned about advancements in adhesive dentistry, which offered the opportunity for improved results, but some of his mentors’ teaching left him with more questions than answers. So he took the research into his own hands.
Dr. Alleman’s literature review opened his eyes to techniques that would later be called biomimetic restorative dentistry, but at the time he was just looking for a better way to fix teeth. He sought solutions to post-operative sensitivity, failing and debonding restorations and cracked teeth. As Dr. Alleman incorporated the research into his work, the results were impressive. This research is the basis for his Six Lessons Approach to Biomimetic Restorative Dentistry, a system now used by doctors around the world.
Send us a Text Message.
Learn more about Dr. Alleman's work at training programs at allemancenter.com.

Instagram
@david.alleman.dds
@davey_alleman_dmd
@allemancenter.com

YouTube
@allemancenter

A long-lasting dental restoration comes down to molecules. Dr. David Alleman breaks down the research timeline of developing adhesives that can bond to dentin, and you don’t have to share his love of chemistry to appreciate how impactful that is to the field of dentistry.
These adhesives were available to dentists as early as 1951, but just using an adhesive containing a proven molecule does not guarantee success in a dental restoration. 
Understanding materials and how they interact with a natural tooth are part of Lessons 3 and 4 in Dr. David Alleman’s Six Lessons Approach to Biomimetic Restorative Dentistry. These lessons turn discussions about molecules’ interaction with dentin into actionable steps for practitioners.


Send us a Text Message.
Learn more about Dr. Alleman's work at training programs at allemancenter.com.

Instagram
@david.alleman.dds
@davey_alleman_dmd
@allemancenter.com

YouTube
@allemancenter

C-factor is more than the ratio of bonded to unbonded surfaces. Understanding C-factor, or Configuration Factor, is essential to understanding how composites behave in a tooth, but this topic was still being researched as manufacturers were trying to bond to dentin. Eventually, c-factor and its role in composite bonding showed the potential for a strong bond to dentin, but overcoming the c-factor stresses was the key element  that Dr. David Alleman studied in his search for predictable adhesive dentistry.
Articles referenced in this episode:
Cho BH. Effect of interfacial bond quality on the direction of polymerization shrinkage flow in resin composite restorations. Oper. Dent. 2002;27:297-304.Alleman DS. The protocols of biomimetic restorative dentistry: 2002 to 2017. Inside Dent. 2017;June 64-73.Nakajima M. Bonding to caries-affected dentin using self-etching primers. Am. J. Dent. 1999;12(6)309-314Nikaido T. Evaluation of thermal cycling and mechanical loading on bond strength of self-etching primer system to dentin. Dent. Mater. 2002;18 269-275.Fusayama  T. Clinical guide for removing caries using a caries-detecting solution. Quintessence Int. 1988;19(6)397-401.Deliperi S. An alternative method to reduce polymerization shrinkage in direct posterior composite restorations. J. Am. Dent. Assoc. 2002;133 1387-1398.Send us a Text Message.
Learn more about Dr. Alleman's work at training programs at allemancenter.com.

Instagram
@david.alleman.dds
@davey_alleman_dmd
@allemancenter.com

YouTube
@allemancenter

We are able to visualize how molecules move during polymerization thanks to the work of Carel L Davidson in the 1980s. Being able to visualize and then measure this movement, also known as flow, helps create more predictable bonds when working with different substrates in enamel, but Dr. David Alleman took years to systematize this concept into his practice as he was developing his concept of Decoupling with Time.
Articles referenced in this episode:
Alleman DS. Decoupling with time. A solution to the problem of the hierarchy of bondability. Inside Dent. 2021;August: 35-41Fusayama T. A Simple Pain-Free Adhesive Restorative System by Minimal Reduction and Total Etching. 2nd Edition. Ishiyaku EuroAmerica, Inc.; 1993Davidson CL, de Gee AJ. Relaxation of polymerization contraction stresses by flow in dental composites. J Dent Res. 1984: 146-148Davidson CL, de Gee AJ, Feilzer A. The competition between the composite-dentin bond strength and the polymerization contraction stress. J Dent Res. 1984;63(12): 1396-1399Feilzer A, de Gee AJ, Davidson CL. Setting stress in composite resin in relation to configuration of the restoration. J Dent Res. 1987;66(11): 1636-1639Kemp-Sholte CM, Davidson, CL. Complete marginal seal of Class V resin composite restorations effected by increased flexibility. J Dent Res. 1990 Jun;69(6):1240-3.Lu H, Stansbury JW, Bowman CN. Towards the elucidation of shrinkage stress development and relaxation in dental composites. Dent. Mater. 2004;20: 979-986Nikolaenko SA, Et al. Influence of c-factor and layering technique on microtensile bond strength to dentin. Dent. Mater. 2004;20-579-585Send us a Text Message.
Learn more about Dr. Alleman's work at training programs at allemancenter.com.

Instagram
@david.alleman.dds
@davey_alleman_dmd
@allemancenter.com

YouTube
@allemancenter

Early adhesive dentistry showed promise, but as Dr. David Alleman began implementing these new techniques into his practice, the success wasn’t immediate. Struggling with continued failures and wading through the sea of new bonding systems that were becoming available year after year,  he sought to eliminate the guesswork and go to the source of what was causing unpredictable restorations: the science.
Send us a Text Message.
Learn more about Dr. Alleman's work at training programs at allemancenter.com.

Instagram
@david.alleman.dds
@davey_alleman_dmd
@allemancenter.com

YouTube
@allemancenter

The tops of teeth don’t matter… as much as the bottoms. The key to any biomimetic restoration is the direct component, which is why I describe biomimetic dentistry as a bottom to top approach. When I first learned of Simone Deliperi’s work and we began working and then teaching together, we both understood how this direct component needed to be carefully managed for a successful restoration. Deliperi’s Stress Reduced Direct Composite technique, which we co-authored a publication on in 2009, is a necessary tool for any dentist who aims for conservative dentistry.

Article referenced in this episode:
Deliperi S, Alleman D. Stress-reducing protocol for direct composite restorations in minimally invasive cavity preparations. Pract Proced Aesthet Dent. 2009;21(2):E1-E6.Send us a Text Message.
Learn more about Dr. Alleman's work at training programs at allemancenter.com.

Instagram
@david.alleman.dds
@davey_alleman_dmd
@allemancenter.com

YouTube
@allemancenter