Biomimetic Dentistry: Tooth Restoration, Not Replacement

Biomimetic dentistry strives to conserve and preserve your natural teeth as opposed to restoring or replacing them. This minimalist approach not only saves patients and dentists time and expense, but it may also offer up far more long-term value to the patient. Your teeth are not dead things. They are living, anatomical structures connected to bone and tissues, and integrated into the body through blood vessels and nerves. Each tooth is composed of intricate layers, from the inner pulp to the outer enamel, that all work in tandem to create a perfect union of form and function. Why throw all that out if the tooth is damaged? Instead, it pays to do less and save or salvage more of the original tooth. In doing less, dentists may actually be doing far more for their patients.

In a biomimetic approach, longevity is everything. Biomimetic material substitutes, such as resin and ceramic, are designed to mimic the biomechanical and functional properties of dentin and enamel. Because a biomimetic approach seeks to retain much of the living natural tooth rather than replace it with a “dead” prosthetic, the tooth tends to last much longer. A living tooth that is integrated into the body’s various bodily systems, including the cardiovascular system and immune system, is much more resilient than an artificial replacement tooth. This natural resilience is exactly what biomimetic dentistry is trying to take advantage of. By retaining as much of a living tooth as possible, doctors hope that future re-treatments that are common with man-made prosthetics can be avoided. Saving more teeth saves money and time in the long run.

For a long time, the paradigm of successful cosmetic dentistry was the replacement of failing natural dentition with a set of perfectly formed and fitted prosthetics. In patients where a tooth absolutely cannot be salvaged or has been totally lost, this is still very much the case, and very much necessary. However, in the thousands of cases where a living tooth can still be saved, replacement or restoration with mechanical attachments is no longer the gold standard. In fact, there is a growing concern amongst dentists and dental professionals that many clinics are actually needlessly over-treating patients. Invasively extracting a natural tooth that is integrated into the body and replacing it with a foreign object that is not integrated at all can often create additional cascading issues. Implants, for example, can fail to become properly osseointegrated into the underlying bone leading to inevitable failure and retreatment. Improperly sealed root canals can become infected leading to failure and retreatment. An amalgam filling can break and leak leading to failure and retreatment. As it turns out, overtreatment is just as dangerous as undertreatment.

With a biomimetic approach, the entire mindset is different. Instead of focusing on mechanical solutions, the focus is on conservation. Key to this process of conserving a patient’s natural dentition is the idea of minimizing the impact of any dental intervention or treatments.

Conventional cosmetic dentistry is concerned with mechanical solutions to dental problems. It employs titanium, ceramics, screws, and adhesives to replace or at least cover up dental problems. The ultimate goal of conventional cosmetic dentistry is to replace natural structures with supposedly superior, man-made materials. However, more and more doctors and dentists alike are finding that the body’s natural structures can’t simply be replaced.

Take a natural tooth as an example. A natural tooth consists of an inner layer of living dental pulp, an intermediate layer of dentin, and an outer layer of hard enamel. The pulp provides the surrounding dental tissues with nutrition. It also functions to collect sensory information, such as temperature, pressure, and pain and send it back to the brain. Meanwhile, the dentin and enamel give a natural tooth structure an unparallelled functional strength. The dentin, while relatively soft, has excellent tensile strength characteristics. This prevents a tooth from simply fracturing when exposed to the slightest lateral force.

Esthetic integration is not obtained through a single procedure, final work, or comprehensive cosmetic treatment. Rather, it can only be achieved with a holistic approach that takes into account every aspect of an esthetic treatment from beginning to end, including financial and physical costs, maintenance, and future re-treatment needs. It is not purely concerned with esthetics, but also with the long-term physical and financial health and wellbeing of the patient which, ultimately, leads to long-term patient satisfaction.