Dental fillings are a method of replacing a broken or a disease part of a tooth. Dental fillings have been around for nearly 5 centuries now, with the first one ever documented dental filling performed by a German dentist in 1528.
The most common type of dental filling material in the world in an amalgam. However, over the years the use of dental amalgams have diminished due to the large controversy regarding its mercury content and the potential association of mercury toxicity to various systemic and immunological diseases. The second reason dental amalgams have lost their popularity is because of discovery of other dental materials that are more stable, wear resistant and tooth colored.
In general there are two different types of dental filling materials:
Direct dental materials can be made of variety of dental materials, such as amalgam, resin composite, glass ionomers, or gold. The direct filling materials are placed immediately after the dentist has prepared the tooth and has removed any decay from a tooth. The filling material then is inserted into the prepared are and carved to the tooth anatomy. Once the filling materials have hardened then the filling material is checked against the opposing tooth to insure a harmonious bite. Direct fillings are performed in a single appointment.
In-Direct filling in contrast with direct filling materials are generally done over two dental appointment. With the advanced in CAD/CAM technology such as CEREC, patients now can have all of the benefits of an indirect filling restoration in a single appointment in the majority of cases. Direct dental fillings have many benefits compared to a traditional direct filling. The biggest advantage of an indirect filling material is the control that your dentist and dental laboratory technician has over the fabrication process and quality control as this process is done in a laboratory setting than inside of the mouth. Also, the direct dental materials that are used are typically much more durable and resistant to wear and micro-leakage.
In-direct dental materials are most of the time referred to as Inlays or Onlays. Inlays refer to an indirect restoration that fits inside of a tooth and once is made in the laboratory is then bonded or cemented in place by the dentist On the other hand, Onlays refer to in-direct dental filling materials that not only replaces the internal part of a tooth but also extends over outside parts of a tooth such as the cusps.
Inlays and Onlays can be made up of various dental materials such gold, porcelain or resin.
Amalgam fillings or metal fillings have been used for centuries and they remain one of the most commonly used filling materials. They are often referred to as silver fillings. Amalgam is a mixture of silver and other metals, such as copper, tin and zinc, grounded into powdered form. The silver powder is mixed with mercury and placed into the cavity preparation where it is shaped before hardening.
In recent years, the safety of amalgam fillings has come under scrutiny because of the mercury it contains. However, recent studies have proved amalgam fillings to be perfectly safe. It is true, that mercury vapor is toxic but mercury molecules in hardened amalgam are bound to the silver molecules rendering the level of toxicity harmless. The American Dental Association and the Food and Drug Administration have researched the safety of amalgam fillings and have found them to be not only safe but extremely effective.
Gold fillings are widely viewed as being the cr่me de la cr่me of restorations. From a bio-mechanical perspective, they are the ideal material as they will not tarnish or corrode and they wear at the same rate as tooth enamel. The placement of a gold filling requires two separate visits with us. At the first visit, the cavity is removed and the tooth is prepared. An impression is taken of the tooth preparation and a temporary restoration is placed. A custom made filling is made from the impression. At the second visit the temporary restoration is removed and the gold filling is placed.
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