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In days long
since past, silver or gold fillings were the only options available
for filling cavities. Over the past four decades, new fillings have
been developed which blend in with the color of the teeth, making
them almost undetectable. Due to limitations in the materials used,
these fillings were normally reserved for cavities in the front teeth,
but now, with the many scientific advances made, cosmetic fillings
can be done anywhere in the mouth.
There are two basic types of cosmetic, or tooth-colored filling materials
which are widely used in Dentistry today: Composite and Porcelain.
Composite Fillings
Composite is a resin-based tooth filling material. It is used almost
exclusively to fill cavities in the front teeth, and in recent years
used also to fill cavities in the back teeth. The most common type
of composite comes in the form of thick putty which is directly condensed
into the cavity after all decay has been cleaned out. It is chemically
bonded to the tooth, which is why these types of fillings are often
referred to as "bonded restorations."
The primary disadvantage to these directly applied composites is relative
lack of strength. For this reason very large fillings of this type
typically will not hold up well over time.
Porcelain Fillings
Porcelain fillings are usually referred to as "inlays" because
they are custom-made in a laboratory to precisely fit the hole in the
tooth. (Similarly, inlays can also be made of high-strength composite
which is heat and pressure-cured in a laboratory) Inlays are used when
the size of the filling dictates the use of a stronger material than
directly-applied composite. The inlay, whether it is composed of porcelain
or composite, is bonded in place using low viscosity composite resin
cement.
Since these restorations are fabricated in a dental laboratory, a temporary
inlay is made to fill the cavity for the period of about two weeks
while the permanent inlay is being made.
PORCELAIN INLAY PROCEDURE
There are two steps involved: First, all decay is removed from the
tooth, and the inside cavity walls are shaped to allow insertion of
an inlay. A highly accurate impression is then taken of the tooth from
which a plaster model (which is an exact duplicate of the prepared
tooth) is made. This plaster model serves as a template for the fabrication
in the laboratory of a precisely-fitting porcelain inlay.
Secondly, once the inlay has been made, the temporary inlay is gently
removed from the cavity, and the permanent inlay is bonded into the
tooth.
Limitations of Porcelain Inlays:
Porcelain inlays are considered to be an intermediate tooth restoration.
That is to say, if the cavity is small, then a conventional filling
should be adequate. However, if the cavity is very large, or if there
has been significant loss of tooth structure, an inlay would be insufficient
to restore the tooth. In such a case, a crown,
which covers and protects the entire tooth would be indicated.
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