Dental Filling are undertaken to restore a cavity/ missing tooth structure which could have been lost due of decay , cracked or damaged due to an accident or worn down from misuse. This requires the removal of the decayed portion of the tooth and then filling it with a restorative material of choice to stop any future progression of caries and consequent pain or discomfort.
Types of Dental fillings
Fillings can be classified based on the position of caries, type of material used and process of restoration done
Types of fillings based on material used
- Metal Cast Gold Fillings
- Silver Amalgam Fillings
- Composte Restorations
- Porceien Restorations
They may be also classified based on the process of restoration
- Direct restorations - Placed Chairside- Eg: Silver Amalgam, Composite
- Indirect resorations- Fabricated in the lab-Eg: Cast Gold restorations, Lab fabricated Inlays and onlays.
Types of fillings based on material used
1. Metal Cast Gold Filling
Cast gold fillings were the restorations of choice in the yesterdays and offered several advantages like durability to last upto 10-15 years, strength to withstand occlusal forces and better aesthetic than the Silver amalgam restorations With the advent of more economical and more aesthetic tooth colored materials that could be placed in a single visit, gold fillings lost their edge.
2. Metal Silver Amalgam Filling
Silver amalgam was the most widely used filling material as it offered high durability and strength to last many years at a much cheaper cost than the earlier cast gold fillings. Although amalgam fillings offered several advantages, they were unesthetic, required more extensive tooth preparation for retention and in long term caused tooth discoloration. The mercury contained in the amalgam releases low levels of mercury in the form of a vapor that can be inhaled and absorbed by the lungs. High levels of mercury vapor exposure are associated with adverse effects in the brain and the kidneys
In 2008, the American Dental Association, (ADA), announced that the use of mercury-silver, or amalgam, dental fillings has been banned in Sweden, Denmark and Norway as mercury is considered in those countries to be a dangerous environmental toxin as well as a potential health risk..Malgam restorations are suspected to release low levels of mercury in the form of a vapor that can be inhaled and absorbed by the lungs. Exposure to high levels of mercury vapor, which may occur in some occupational settings, has been associated with adverse effects in the brain and the kidney. Today, amalgam filings are commonly replaced with tooth-colored fillings.
3. Composite Filling
These are of the same color as your teeth. These are preferred if a person does not want their filing to be seen. It is recommended & suitable for front teeth. It bonds well with the tooth structure. It is also used for a chipped tooth, however, does not last long as compared to metal and amalgam filling and can also wear off with time.
Our clinics uses the highest quality Tooth-colored Composites for composite resin fillings
Advantages of composites:
- Aesthetics : Can be closely matched to the color of existing teeth.
- Bonding to tooth structure : unlike amalgam restorations that require mechanical retention by extensive tooth preperation, composite fillings micro-mechanically bond to tooth structure, providing further support.
- Versatility : teeth in addition to use as a filling material for decay, composite fillings it can also be used to repair chipped, broken, or worn
- Conservative : less tooth structure needs to be removed compared with amalgam fillings
- Instant Hardening: Light Activated filling is placed, light cured and hardened in less than a minute.
- Lesser Sensitivity reported : When compared to amalgam fillings, composite resins result in fewer instances of tooth sensitivity
- Low polymerization shrinkage for less stress on the tooth
Disadvantages of composites:
- Less Durable : composite fillings wear out sooner than amalgam fillings
- Increased chair time
- Chipping : depending on location, composite materials can chip off the tooth.
- More expensive than amalgam restorations .
4. Porcelain / Ceramic Filling
Porcelain fillings have become an increasingly popular choice among patients who value oral hygiene and pleasing aesthetics.. These cover most part of the tooth, as a result, can be used if the decay is large enough. Porcelein fillings are more durable and do not stain or wear off easily but are more expensive and time consuming.
5. Inlays and Onlay
In certain clinical conditions decay or fracture is so extensive that a direct restoration would compromise the structural integrity of the restored tooth or provide substandard opposition to occlusal forces. In such situations, an indirect gold or porcelain inlay restoration may be indicated.
Advantages
- Restore extensively damaged or decayed teeth.
- They offer higher strength and durability
- Porcein inlays are highly Aesthetic
- Lesser microleakage and resultant postoperative senstivity
- Better contact and contours with adjacent teeth than direct fillings
Disadvantages of Inlays
- More expensive due to additional lab cost
- Lengthier fabrication process and increased chairside time.
- Over time may present with marginal leakage and staining
- Ceramics can be brittle
- Repair of Inlay is difficult
Onlays are more extensive than inlays, covering one or more cusps. an onlay might be indicated. All of the benefits of an inlay are present in the onlay restoration. The onlay allows for conservation of tooth structure when full crown is the only other option. that is the reason onlays are sometimes called partial crowns.
Just as inlays, onlays are fabricated outside of the mouth in the lab and are typically made out of gold or porcelain. Inlays and onlays are more durable and last much longer than traditional fillings.
Another type of inlay and onlay -- direct inlays and onlays -- follow similar processes and procedures as the indirect, but the direct is made in the mouth and can be placed in one visit. The type of inlay or onlay used depends on how much sound tooth structure remains and consideration of any cosmetic concerns.