Fillings

Progress in contemporary dental materials and techniques is opening up new possibilities for creating more aesthetically pleasing and natural-looking smiles. Ongoing research, often spanning decades, is dedicated to developing esthetic materials like ceramic and plastic compounds that closely resemble the appearance of natural teeth. Consequently, dentists and patients now have a range of choices when it comes to selecting materials for repairing missing, worn, damaged, or decayed teeth.

Despite the introduction of these innovative materials, the value of traditional dental restoratives persists. This category includes gold, base metal alloys, and dental amalgam. The enduring strength and durability of these conventional dental materials make them particularly useful in situations where restored teeth must endure substantial forces generated during chewing, especially in the posterior regions of the mouth.

While there are alternatives to amalgam, such as cast gold restorations, porcelain, and composite resins, they tend to be more expensive. Gold and porcelain restorations, in particular, require a lengthier production process and may involve two appointments. Although composite resins, commonly known as white fillings, offer aesthetic appeal, their placement typically takes a longer time.

Here’s a look at some of the more common kinds of alternatives to silver amalgam:

• Composite fillings – Comprised of acrylic resin and finely ground glass-like particles, composite fillings create a tooth-colored restoration. These fillings offer good durability and resistance to fracture, particularly in small-to-midsize restorations that endure moderate chewing pressure. When preparing the tooth, the dentist removes less tooth structure, potentially resulting in a smaller filling compared to amalgam. Additionally, composites can be “bonded” or adhesively secured in a cavity, enabling the dentist to pursue a more conservative repair approach. However, in teeth subjected to high chewing loads, composite fillings exhibit lower wear resistance than silver amalgams. Moreover, the process of placing a composite filling tends to be more time-consuming.
• Ionomers – Tooth-colored materials known as glass ionomers consist of a blend of acrylic acids and fine glass powders. These materials are employed for filling cavities, especially those located on the root surfaces of teeth. Glass ionomers have the capability to release a small amount of fluoride, beneficial for individuals at high risk of decay. Primarily utilized as small fillings in areas not subject to heavy chewing pressure, glass ionomers are chosen for their low resistance to fracture. They are commonly applied in small, non-load-bearing fillings (such as those between the teeth) or on the roots of teeth. Resin ionomers, also incorporating glass filler along with acrylic acids and acrylic resin, share a similar application for non-load bearing fillings between the teeth, with a low to moderate resistance to fracture. When placed on chewing surfaces, ionomers experience high wear. Both glass and resin ionomers replicate the natural color of teeth but lack the inherent translucency of enamel. Patients generally tolerate both types well, with rare instances of allergic responses.
• Porcelain (ceramic) dental materials – Dental materials made entirely of porcelain (ceramic) encompass fillings and crowns crafted from porcelain, ceramic, or glasslike substances. These materials find application in inlays, onlays, crowns, and aesthetic veneers. Veneers, in particular, are exceptionally thin porcelain shells capable of either replacing or covering a portion of the tooth’s enamel. The allure of all-porcelain (ceramic) restorations lies in their ability to replicate the color and translucency of natural tooth enamel. However, the process of obtaining these restorations typically involves a minimum of two visits and potentially more. While such restorations exhibit high resistance to wear, they are susceptible to fracture under tension or impact. Their strength hinges on the porcelain’s thickness and its capacity to bond effectively to the underlying tooth. Notably, if the porcelain surface becomes rough, there is a risk of accelerated wear on opposing teeth.