Filling

The dental filling is a material that is used to fill the gaps in the tooth made by removing the decayed parts. When there is cavity the dentist first needs to remove all the decay and the bacteria and to shape the area. After that, he has to fill that area with a compatible filling material. Different materials can be used in dentistry such as gold, amalgam, composite and porcelain.

Dental caries is one of the most common diseases that have to be treated on time. Once the whole decay is removed, there is a cavity inside the tooth. That cavity can’t stay open, so it has to be properly sealed. The best way to do it is to use filling dental materials. Dentists and scientist have spent a lot of time in exploring different materials and finding the perfect one. After all this time they still haven’t found the ideal one, but with each advancement, materials become much better. With the use of fillings, the dentist is able to reproduce the anatomy of the damaged tooth and restore its functions. If the tooth is decayed, the patient will feel pain, and won’t be able to eat.

Types of fillings:

– Gold fillings/inlays are known as one of the most precise restoratorative materials. The advantage of gold is as well its ductability and capacity to “adjust”/abradeursive jaw movements. The lifespan of this kind of restoratoratove material, is if its properly done extremely long.

They are biocompatible with the surrounding tissues and are very durable. Unfortunately plaque adheres easily to gold which makes it to a disadvantage, as well the non tooth color esthetics is one of the disadvantages of this material beside its high material price.

– Amalgam is also known as silver filling. Dentists have been using it for many years now. It has a dark black color with a silver shine to it. It is a very durable material that can stay in the mouth for longer than 20 years. The amalgam fillings are perfect for the posterior region, but patients don’t like them because of the color. With the appearance of the composite, fewer dentists use amalgam. It is affordable and very easy to use. It is safe for the patient, in spite of the many claims that mercury can be harmful.

– Composite is a tooth-colored material used for fillings. These days a lot of dentists use it because it provides great aesthetic results. It comes in so many different shades and colors so that it can be used for different people. It is placed directly in the cavity and it is adapted to imitate the shape of the tooth.

– Porcelain fillings are known as inlays and onlays. They are made based on an impression of the tooth and made from high-quality porcelain. They require several visits to the dentist.

Procedure:

Composite is the material most commonly used for fillings these days. The procedure is very simple. Once the dentist has located caries, he has to completely remove all the decayed tissue. That

is done with rotating instruments. Once he’s done that there is a clean cavity left. That cavity has to be properly disinfected before the filling is applied. Composites are placed in layers to get a better appearance. In the end, this material has to be exposed to light so that it will harden. Once it’s hard, the dentist will correct the shape and polish it.

After the examination and inspection, when caries is diagnosed, the procedure starts with application of local anesthesia. When the proper teeth are numbed, dentist can start with cleaning the tooth of caries. For that purpose, diamond burs and high speed handpieces are used for initial preparation. When the enamel is prepared, the dentist continues with caries removal with proper carbide burs. Contemporary protocols include minimal-invasive caries removal. This means that only infected hard dental tissue should be removed regardless the design of cavity.

This is possible scenario in cases when composite fillings are indicated. However, removal of entire caries is a must in every case, but the differences in cavity design are more prone to the choice of restorative material.

If the composite material is indicated, after entire caries is removed, depending of the type of caries and the depth of the defect, placing some base and liners may be necessary in order to protect the pulp tissue and allows reparation processes. For that purpose, calcium-hydroxide liners or glass-ionnomer liners are usually enough. In the latest years, materials based on three-calcium silicates like Biodentin from Septodont, are materials of choice for therapy of deep caries lesions. Further treatment consist of chemical cleaning of smear layer from the cavity surface by using the 37% phosphoric acid which also etches the surface of enamel and dentin in order to create the condition for adequate bonding of a filling material.

After proper rinsing for at least 30 seconds, and later adequate drying of the cavity surface, the bonding agent may be applied and polymerized for 20 seconds with LED curing lamp.

Depending on the type of composite material there are different generations of etching and bonding materials. Newer agents are mostly biphasic, which means that a single material contains both: the etching part and bonding agent. These materials reduces the working time and minimizes the potential invasive influence of phosphoric acid to the dental pulp. The next step is placing a composite filling by multilayer technique. Since the composite material can be properly polymerized in the thickness of up to 2 mm, each layer should not be thicker than that. That is why your dentist will place a filling material several times, and polymerize each layer for 40 seconds. Thanks to technological improvements, new materials appeared on the market that can reduce time consumption for this phase too. Bulk-fill materials like SDR(flow) present a great alternative for conventional multilayer technique. These materials have a great translucency which allows placement of 4 mm thick layers with proper polymerization.

Since the lack of their esthetic properties, the superficial layer of the filling demands the conventional composite with adequate color for proper esthetical results. When composite placement is finished, the occlusion needs to be restored to the patient’s individual and physiological function. Removal of excess material can be done with different shape burs. The final step is polishing that can be performed with different polishing rubbers, discs and pastes. Specially designed rubbers and pastes with diamond micro-particles are convenient for proper polishing since they provides smooth surface of composite filling.