Restorative dental treatment focuses on mending or substituting teeth that have sustained damage or are absent. Its objective is to enhance oral health, restore functionality for proper chewing and speaking, and bring back the natural integrity and appearance of the smile.
Common Restorative Procedures
Dental fillings address cavities caused by tooth decay. A dentist removes the decayed portion of the tooth and fills the space to prevent further bacterial invasion and restore its structure.
Crowns, also known as caps, fit over an entire tooth above the gum line. They are recommended when a tooth is severely damaged, fractured, or has undergone a root canal, making it too compromised for a simple filling. Crowns encase the tooth, providing strength, protecting the remaining structure, and restoring its original shape and size.
Dental bridges replace one or more missing teeth by joining artificial teeth to adjacent natural teeth or implants. The adjacent teeth are prepared to support crowns, which then hold the replacement tooth or teeth in place, effectively “bridging” the gap. This helps maintain proper spacing of remaining teeth and restores chewing function.
Dental implants offer a durable solution for missing teeth, involving a surgical procedure where an artificial tooth root, typically made of titanium, is placed into the jawbone. Once the implant integrates with the bone, a custom-made crown is attached, providing a stable and long-lasting replacement that functions much like a natural tooth. Implants also help preserve jaw bone density, which can diminish when a tooth is lost.
Inlays and onlays, sometimes called indirect fillings, are used when a tooth has too much damage for a conventional filling but not enough to require a full crown. Inlays fit within the cusps, or raised points, of the tooth, while onlays extend to cover one or more cusps or the entire biting surface. These custom-made restorations are bonded into place, strengthening the tooth structure and providing a precise fit.
Materials Used in Restorations
Composite resin is a material for dental restorations, particularly for fillings and bonding. It consists of a blend of plastic and fine glass or ceramic particles, allowing it to be color-matched to the natural tooth for an aesthetic result. This material bonds directly to the tooth structure, requiring less removal of healthy tooth tissue. Composite fillings are cured with a special light, hardening them in layers.
Amalgam, often recognized as silver fillings, is an alloy created by mixing liquid mercury with a powdered alloy primarily composed of silver, tin, and copper. This material is known for its durability, high compressive strength, and cost-effectiveness, making it suitable for restorations in posterior teeth that endure significant chewing forces. Amalgam is packed into the prepared cavity where it hardens, relying on mechanical retention within the tooth structure.
Porcelain, also known as dental ceramic, offers a lifelike appearance and biocompatibility. It can be crafted to mimic the translucency and color of natural tooth enamel, making it a preferred choice for crowns, veneers, inlays, and onlays, especially in visible areas. While strong in compression, porcelain can be brittle under tensile forces, sometimes addressed by fusing it to a metal substructure for increased fracture resistance.
Gold alloys have a long history in dentistry, known for their exceptional durability, corrosion resistance, and biocompatibility. Pure gold is too soft for most dental applications, so it is alloyed with other metals like copper, silver, and palladium to enhance its strength and wear resistance. Gold restorations, such as inlays, onlays, and crowns, are highly resistant to tarnish and withstand chewing forces effectively.
Zirconia is a white, non-metal ceramic material known for its strength, durability, and aesthetic properties. It offers superior fracture resistance and flexural strength compared to other dental ceramics, making it an excellent option for crowns, bridges, and implants, particularly in high-stress areas like molars. Newer formulations of zirconia also offer improved translucency, balancing strength with natural appearance.
The Restoration Process
Examination and Diagnosis
Restorative dental treatment begins with an examination and diagnosis. This initial step involves a visual inspection, often supplemented by dental X-rays, to assess the extent of decay or damage and determine the most suitable treatment plan. A precise diagnosis ensures the chosen restoration effectively addresses the patient’s specific dental needs.
Tooth Preparation
Following diagnosis, the tooth undergoes preparation, which involves carefully removing any decayed or damaged tissue using specialized dental instruments. The dentist then shapes the remaining tooth structure to create a stable foundation for the chosen restorative material. This preparation is tailored to the type of restoration being placed, ensuring proper fit and longevity.
Impressions
For restorations that are custom-made in a dental laboratory, such as crowns, bridges, inlays, or onlays, an impression of the prepared tooth is taken. This can involve using a putty-like material in a tray or employing digital scanning technology to create a precise 3D model of the tooth. This impression serves as a blueprint for the dental technician to fabricate the custom restoration.
Temporary Restoration
If the restoration requires laboratory fabrication, a temporary restoration may be placed on the prepared tooth. This temporary cover protects the tooth from sensitivity and further damage while the permanent restoration is being made, which can take a few weeks. Temporary restorations are made from materials like acrylic or resin.
Permanent Restoration Placement
The final stage involves the placement and fitting of the permanent restoration. During this appointment, the temporary restoration is removed, and the dentist meticulously checks the fit, bite, and appearance of the new restoration. Once satisfied, the permanent restoration is securely bonded or cemented onto the tooth, restoring its function, integrity, and natural look.