dental restorations

Dental Restorations

Dr Huda Yaser

The structural loss typically results from

• Caries
• External trauma.
• It is also lost intentionally during tooth preparation to improve the aesthetics.
The Dental Restoration
Is a dental restorative material used to restore the function, integrity and morphology of missing tooth structure

ADA: criteria for a new material

Must not be poisonous or harmful to the body.
Must not be harmful or irritating to the tissues of the oral cavity, (BIOCOMPATIBLE)
Must help protect the tooth and oral tissues of the oral cavity.
Must resemble the natural dentition.
Must be easily formed and placed in the mouth.

Properties of any restorative material

The process of preparation usually involves cutting the tooth with special dental burrs, to make space for the planned restorative materials, and to remove any dental decay or portions of the tooth that are structurally unsound.

Tooth Preparation

Preparations may be

• Intracoronal : all classes of cavity preparations for composite or amalgam, as well as those for gold and porcelain inlays
• Extracoronal: Crowns and onlays, as well as veneers.





This technique involves placing a soft or malleable filling into the prepared tooth and building up the tooth before the material sets hard.
Can be placed in a single visit.
As the fillings become larger, indirect restorations may be the best choice in some cases.
Direct restorations

Amalgam

Silver amalgam (mainly consists of mercury and silver )
Today amalgam is used most commonly in the posterior teeth. It is one of the oldest filling materials and has been used (and improved) for more than 150 years.
But need removal of much tooth structure
Concern of mercury toxicity has existed since the invention of amalgam. It is banned or restricted in Scandinavian countries.

Direct Restorations

Dental composites

Are also called white fillings or tooth colored restoration.
They are more estheticaly acceptable than amalgam
Need less tooth structure removal


Their strength and durability is not as high as porcelain or metal restorations and they are more prone to wear and discolouration.
Direct restorations

Direct Gold

Although rarely used, due to expense and specialized training requirements, gold foil can be used for direct dental restorations.
Direct restorations

Glass ionomer cement(GIC)

Is one of the commonly used materials in dentistry as filling materials and luting cements.
Have two main advantages : they bond chemically to dental hard tissues and release fluoride for a relatively long period.
Only used in low-stress areas such as smooth-surface and small anterior proximal cavities in primary teeth. (Lower strength than composite)
Direct restorations

Intermediate Restorative Materials (IRM)

• eg: Zinc-Oxide Eugenol
• These are inserted as a temporary measure only. They are too soft to use as permanent fillings.
Direct restorations

used:

• As a first-aid measure to relieve pain
• When there is insufficient time to complete the cavity and insert a permanent filling in one visit

In this technique the restoration is fabricated outside of the mouth using the dental impressions of the prepared tooth.
Common indirect restorations include inlays and onlays, crowns, bridges, and veneers.
Usually a dental technician fabricates the indirect restoration
INDIRECT RESTORATIONS





(Computer-aided Design And Computer-aided Manufacturing) to improve the design and creation of restorative materials especially indirect restorations
The prosthesis can be luted or bonded the same day.
But the chair side for CAD/CAM often involves extra time on the part of the dentist (because of the digital impresion and miling by the machine), and the fee is often at least two times higher than for conventional restorative treatments using lab services.
CAD/CAM Restorative Procedure

Inlays

Is an indirect restoration (filling) consisting of a solid substance (as gold, porcelain or less often a cured composite resin) fitted to a cavity in a tooth and cemented into place.
INDIRECT RESTORATIONS

Onlays

Is the same as an inlay, except that it incorporates a replacement for a tooth cusp by covering the area where the missing cusp would be.
INDIRECT RESTORATIONS

Crown

‪is a tooth-shaped "cap" that is placed over a tooth -- to cover the tooth to restore its shape and size, strength, and improve its appearance.‬
Crowns are onlays which completely cover all surfaces of a tooth.
Crowns as metal-free "Jacket crowns” made of Porcelain (ceramics)
INDIRECT RESTORATIONS

Crown

Another type is known as porcelain-fused-to-metal, which is used to provide strength to a crown or bridge. These restorations are very strong, durable and resistant to wear, because the combination of porcelain and metal creates a stronger restoration than porcelain used alone.

INDIRECT RESTORATIONS

Dental Bridge

A bridge is a fixed dental restoration (a fixed dental prosthesis) used to replace a missing tooth (or several teeth) by joining an artificial tooth permanently to adjacent teeth or dental implants
INDIRECT RESTORATIONS

Veneers.

A veneer is a very thin shell of porcelain or composite that can replace or cover part of the enamel of the tooth. In order to apply a veneer, we have to shave away a substantial portion of the tooth enamel
Full-porcelain veneers are particularly desirable because their color and translucency mimic natural tooth enamel

INDIRECT RESTORATIONS

LUMINEERS

Are thin Full-porcelain veneers
There is no need to grind or shave the teeth because LUMINEERS are as thin as a contact lens, or roughly half the thickness of veneers.

INDIRECT RESTORATIONS