Whether you’re getting old fillings replaced, broken teeth repaired or new restorations for decayed teeth, it’s vital that your dentist use only biocompatible materials. There are hundreds of restoration materials and cements available, and these can be combined in thousands of different ways. But whatever is used, it must be nontoxic, non-allergenic and appropriate to your unique body chemistry. So we do testing – energetic, muscle and/or blood – to determine the best choices. This is especially important for those who are having mercury amalgam fillings replaced and detoxing from heavy metals poisoning. The last thing you want to do is replace one toxin with another.
That said, there are several materials that we use much more often than others. I’d like to tell you a little about each of them to help you begin to appreciate the options available to you.
“Composite” is the generic term for any one of a number of synthetic, tooth-colored resins. They are less durable than amalgam or ceramic, but do last about seven to eight years.
Composite can be bonded directly to a tooth like a “regular” filling, or it can be used to create restorations such as crowns and bridges. It can even be used for veneers. Fillings can be done in a single office visit and are known as direct composites. Crowns, bridges and other restorations, on the other hand, are made in a dental lab and later cemented to previously prepared teeth. Thus, these are called indirect composites, and they require two office visits: one for preparing the teeth, one for fitting and cementation.
There are five composite systems we use most often: Diamond Crown, Diamond Lite, Filtek-LS, N’Durance and Sculpture Plus.
Diamond Crown and Diamond Lite
Diamond Crown and Diamond Lite are highly biocompatible materials that also have the virtue of being a little less expensive than newer composites. Lite is a microhybrid used for direct fillings and is most suited for the back teeth. It is extremely strong and resistant to fracture. Crown may be used for both direct and indirect restorations, and has somewhat better aesthetics than Lite.
This nanohybrid composite exhibits a very low shrinkage rate (all composites shrink during curing, the hardening process), which allows for exceptional marginal integrity. This is important since gaps at the margins – where the tooth and gums meet – can become a place for bacteria to colonize and damage the oral tissues. Strong and durable, Filtek-LS is an excellent choice for use in molars.
This nanotech composite from Septodont can be used in both the front and back teeth. Like Filtek, it exhibits minimal shrinkage and excellent hardness. The restorations are strong and do very well under biting pressure. There is seldom post-operative sensitivity with this material.
Sculpture Plus is another nanohybrid composite, typically used for indirect composites, including veneers. A highly durable material exhibiting strong, reinforced margins, it is aesthetically fine, especially in terms of its long lasting luster and fine translucency.
Porcelain and Ceramic
Like indirect composites, porcelain and other ceramic restorations are made in a lab and require two visits. Unlike either type of composite, they are very durable, needing replacement much less frequently.
Feldspathic porcelain is the standard, traditional porcelain used for crowns. Considered by many dentists to be the most beautiful porcelain, it comes closest to resembling natural teeth. And since these restorations have no core material, they have great optical properties.
Even better are the newest ceramics, which are often made using CAD-CAM technology – computer-aided design and manufacture. Of these, we most often use one called Lava.
Lava restorations are made of a zirconia ceramic that can be placed anywhere in the mouth. They exhibit excellent marginal fit and optimal strength and translucency. They are as strong as metal without containing any metal, and their surfaces come close to enamel in hardness. Like porcelain, they are shaded to blend perfectly with your natural tooth coloring so as to be practically undetectable.
See examples of dental restorations in Dr. Erwin’s Smile Gallery
Learn more about issues to consider when choosing restorations