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Restorative

restorations-banner
Restorative, as the name suggest means restoring the teeth to its previous glory that is function and aesthetics. Number of reasons can damage teeth. Top reason is caries or cavities; but trauma, wrong brushing habits, clenching, grinding of teeth, gastric reflux, etc., also damage the teeth. Restoring the teeth is commonly known as fillings or dental fillings.

What are dental fillings?

Teeth can be damaged by caries or trauma. It results in defect or loss of tooth structure that need to be restored for proper functioning, aesthetics and to prevent further damage. Dental fillings are the substances that are used to restore such teeth. 

 

Tooth had been filled since centuries as mummies had been found with gold in their teeth. Today we have a number of option to fill a tooth that are durable, tooth colour and more economical than gold. The material of filling is usually selected by the dentist depending on the type and location of the damage/cavity. There are two methods of restoring a tooth: the direct method and the indirect method. 

composites The picture besides shows the different places, where a cavity can form. Have you noticed the difference in the size, shape and spread of caries and also the tooth part involved. So, One material can not be used for each and every cavity. At DDCRC, we choose a method as per clinical requirement of the tooth; explain the method chosen to the patient and the reason for its selection.

 

The factors considered in choosing the method and material for dental filling are:
Clinical:
  • Size, shape and depth of the cavity.
  • Type and the Surface of the tooth to be restored.
  • Subjective, clinical and radiographic assessment of pulpal tissue.
  • History of previous dental treatment on the tooth and peripheral teeth.
  • Occlusion.
 
Subjective:
  • Age.
  • Habits as clenching, tobacco eating and brshing technique.
  • Time and cooperation during the treatment.
  • Patient’s personal preference for any material.
  • Cost.
 
DDCRC dentists are experienced in aiding the patient in making this choice, such that it benefits the patient over the long term.
 
What are the types of dental fillings?
Materials used for filling are Amalgam, Composite, Porcelain, Glass ionomer cement and also Gold alloys. Under most circumstances, one has to choose between amalgam fillings and composite fillings.
Amalgam Amalgam is a Silver alloy along with metals like copper, zinc,tin and mercury. Though stronger than composite, they are grey/ black in colour and need extensive cutting of tooth to retain them. A recent criticism of amalgam fillings involves the use of mercury that could lead to adverse long term effects due to constant exposure. The defenders of amalgam counteract this, as there is no free mercury in a completely set amalgam restoration.
Composite is basically a acrylic polymer that has been strengthened with different class of material to withstand the occlusal forces and these are also cosmetically superior than amalgam. Most preferred material as of today. These are tooth coloured, need minimum cutting of any sound tooth, has micromechanical retention and no space for micro leakage that would have caused secondary caries.
silver-filling-composites
Glass Ionomer Cement consists of silicate glass powder and polyalkenoic acid. We have very high strength GIC that can be used for long term temporary filling for stress bearing area and permanent filling in non stress bearing areas of permanent teeth and permanent filling for milk teeth. Main advantage is their chemical adhesion to natural tooth surface and constant release of fluoride that strengths the adjacent tooth surface.
 
Amalgam, composite and GIC are used in direct method of filling a tooth as these does not involve any laboratory procedure and can be filled in one sitting.
 
Porcelain and gold alloys are high strength and highly durable options of restoring a tooth. These involves a specialised dental laboratory to process these materials. As these can not be filled chairside directly in the tooth, We classify these material as Indirect method of restoring or filling of tooth. These laboratory processed fillings are known as Inlay, Onlay and overlay. These has been discussed in Inlay and Onlay section.
The following are the general restorative procedures: