Restorative Fillings
In the face of advanced materials and techniques in dental restoration, restorative fillings may appear as more traditional and rather out-dated means of restoring natural teeth. Still, their usefulness is acknowledged on account of their qualities like strength and durability. These qualities do count when filling back teeth, which have to exert the greatest chewing forces.
Some of the common restorative
materials used very often are:
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Factors
Involved in the Choice of Restorative Fillings
Following factors mainly determine
what kind of restorative fillings you need to choose:
- Oral and general health of the patient
- Composition of the filling material
- Place and mechanism of filling
- The chewing load on the tooth where filling is needed
- Duration and number of visits needed for restoration
Direct
and Indirect Dental Restorations
Direct restorative fillings require
a single visit in which the filling is placed immediately into a prepared
cavity. The dentist prepares the tooth and places the filling, followed by
adjusting the restorative and the job is finished. These fillings include:
- Dental amalgam
- Glass ionomers
- Resin ionomers
- Resin composite fillings
Indirect restoration requires at
least two visits. The first visit includes preparation of the tooth and making
an impression of the area that is to be restored. In the next visit, the
filling (coming from the dental lab) is placed and adjustment is made. Types of
fillings include:
- Gold alloys
- Base metal alloys
- Ceramics
- Indirect Composites
Composite
Fillings
Composite fillings, also called
filled resins, consist of a mixture of glass or quartz (silica) filler placed
in a resin medium. As a filling it appears as tooth-colour. Composite fillings
exhibit the following properties:
- Good durability
- Resistance to fracture
- Withstanding moderate chewing pressure
- Adhesively holding in cavity
- Making a smaller filling than amalgam
- Requiring longer to be placed than amalgam filling
Glass Ionomers
Glass ionomers are translucent
mixtures containing acrylic acids and fine glass powders. These are used in
cavity filling, especially cavities found on the root surfaces of teeth.
A little fluoride is released by
these fillings which is useful against tooth decay. Since their resistive power
is low, they are used in places where chewing load is not very high
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Resin
Ionomers
These are also made from glass
filler with acrylic acids and acrylic resin. They exhibit low to moderate
resistance to fracture. Like glass ionomers, they too are used for small,
less-load bearing fillings like those between the teeth.
Amalgam
Fillings
Amalgam fillings are the most
popular of all restoratives. It is an alloy containing mercury, copper, silver,
tin, and a few minor elements. Amalgam fillings can withstand great chewing
loads and are also useful in restoring deep fillings below gum line. Some
concern has been raised about the mercury content of these fillings but
authorities in health (FDA, WHO, and others) have found it to be safe. Their
greater popularity rests on several reasons like:
- Durability
- Ease of use
- Greater resistance to wear
- Relatively inexpensive in cost
Gold
Alloys
These alloys consist of gold, copper
and a few other metals. Together these form a strong and effective filling,
crown or a bridge. Their primary use lies in inlays, on lays, crowns and fixed
bridges. Gold alloys are known for:
- High resistance to corrosion and tarnishing
- High strength and toughness against wear and fracture
- Requiring the removal of minimum amount of healthy tooth structure
- Feeling gentle to opposing teeth
- A drawback to gold fillings is that their colour does not look like natural teeth.
Base
Metal Alloys
These are high strength and
toughness, non-noble metal alloys having a silver appearance. They show high
resistance to corrosion, tarnishing, fracture, and wear. Some people may have
allergic sensitivity to base metals. Also, some initial discomfort may be
encountered from hot and cold.
Ceramic
Materials
Ceramic fillings require a minimum
of two visits. These include porcelain, ceramic or glasslike fillings and
crowns. These are highly resistant to wear but prone to fracture under stress
and on impact.
Indirect
Composites
These filling materials are similar
to those of direct restoration fillings. Their colour is like those of teeth.
These fillings do not excessively wear opposing teeth. They show less strength
and durability than porcelain or metal restorations. In addition, they wear and
discolour relatively easily.
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