Conservative Treatment – Filling
Bacterial plaque, which consists of bacteria in the mouth and their adhesive secretion, Dextran, forms acid from the leftovers of sugary and floury foods. These acids dissolve the mineral tissue of the teeth, causing the enamel of the tooth to deteriorate (demineralization) and eventually to start caries.
The first sign of dental caries is a white spot on the surface of the tooth. At this stage, the bruise can be stopped and returned. The white stain indicates in which part of the enamel there is mineral loss. After a while, the mineral loss grows to make a hole (perforation-perforation of the enamel). In simple terms, the attachment of the sond (hook) is a criterion for the detection of the caries start! If this loss continues, the soft inner parts of the tooth are also affected and the destructive process is accelerated. Treatment will be a major filling at best.
Today, we can apply aesthetic filling materials (composite fillings, ceramic inlay fillings) in tooth color and shape instead of amalgam (silver) fillings to molar teeth with traditional methods. Now it is both stronger, more aesthetic and longer lasting. Today, dental color porcelain (ceramic) fillings can be easily applied.
Composite – Teeth Color Fills
It is a plastic mixture with silicon dioxide particles inside. They are defined as white fillings because they are tooth-colored. Although they were used only in the front teeth in the 1960s, with the advanced development of the material, they can now be successfully applied to the back teeth as a filler that is more resistant to chewing pressures and less abrasive.
Composite fillings are placed layer by layer in prepared cavities and each layer is hardened with a special light (halogen light). When this process is completed, composite fillings are shaped and corrected according to the tooth. The biggest advantages of these fillers are their aesthetics. In addition, since these fillings are firmly attached to the teeth, they support the dental tissues, prevent them from breaking and temperature passing. Composites can be used not only to restore caries, but also for cosmetic effects by changing the color and shape of the teeth. The most important disadvantage beforehand is that there are sensitivities after the procedure; The colors of the fillings were that they could slightly change with staining foods such as coffee and tea. With the recent developments, the sensitivity (hypersensitivity) and color change in fillings have been minimized.
Why Amalgam Not a Filler?
Amalgam fillings are a mixture of mercury, silver alloy, copper and tin. The mercury that is dangerous in this mixture is. Although mercury taken with fillings is a very small amount, it is not used much anymore thanks to the rapid development of composite and ceramic filling materials. Because porcelain or composite fillings can be made both aesthetically and without harm to health and durable fillings.
Porcelain (Ceramic) Composite Inlay – Onley Fillings
Porcelain fillings are fillings prepared in the laboratory (indirect method) with superior aesthetics and durability. Compared to composite fillings, it is much better compatible with the teeth they are applied to and neighboring teeth. This feature is due to the fact that the filling is prepared in the laboratory environment by indirect method outside the mouth. After the broken, rotten or old filled part of the tooth is removed, the remaining solid part is measured and sent to the laboratory. The model, prepared with a sensitive technology in the laboratory environment, is taken into the special IPS machine and fillings with excellent aesthetics and function are obtained.
IPS porcelain (Leucide reinforced pressable porcelain) fillings are the most suitable material for dental tissue among the oral restoration materials available in the world. It is the best alternative to porcelain-ceramic coating. Because in the Inley-Onley filling method, healthy dental tissue in the mouth is not touched. Maximum retention is achieved with minimum loss of substance. The edge leakage is minimal since they are made of a special compressed porcelain and are not hardened in the mouth (This prevents underfilling caries-secondary caries).
In addition, these porcelains are the materials closest to the hardness of the tooth and the most compatible with the gums. Since its hardness is very close to the enamel tissue of the tooth, it does not corrode teeth like other porcelains, nor does it wear like composite fillings. For large material losses, composite filling or crowns (coating) should be preferred. In teeth with excessive substance loss, especially canal treatment, lost parts of the tooth can be replaced with porcelain onlays by using adhesive bonding systems.
- Like the crown coatings we know, the tooth is not cut and prevents loss of substance in the tooth. Only the bruise is removed. With the tissue remaining in the tooth, the missing part (inlay-onley) completed in the laboratory is in close relationship like a key-lock.
- They do not change color over time; because they are made of porcelain, they do not stick to the substances that give color.
- Due to their strong structure, they protect the tooth against vertical forces coming to the tooth.
- Like amalgam fillings, they do not cause aesthetic loss in the tooth. They have a natural appearance. They can be made in the color of your teeth.
- It only takes 2 sessions to get it done.
- Food scraps do not stick because their surfaces are polished. Therefore, they are more hygienic.
- Since they are porcelain, there is no shrinkage that we call “polymerization shrinkage” that can be seen in composite fillings after gluing and there are no sensitivities that may occur on the teeth, and no recurrent caries occur.
Composite Inlay – Onlay Fillings
They are prepared from composite material outside the mouth and applied to the tooth. After removing the broken or carious part of the tooth, the gap formed is taken and the filling is prepared with the help of this model. The prepared filling is applied to the tooth with special adhesives (adhesive). Composite inlay-onlays can be used in cavities that are too large to be applied normally (directly in the method-surgery). Since they harden outside the mouth, shrinkage problems are few; but still they are not as durable and aesthetic as porcelain fillings. They can be preferred especially because they are economical compared to ceramic inlays.
Kole (Gingiva) Fillings
They are dental colored fillings used in the parts of the tooth close to the gingiva to treat substance loss caused by wear or bruise. The cause of wear is generally; structural defects are bruxism (clenching-grinding), malnutrition and erroneous brushing. With Kole fillings, both sensitivity and non-aesthetic appearance are prevented.