Operative Dentistry

Operative Dentistry

Selecting Materials Used for Tooth Restorations

There are many different types of metals that can be used in dentistry for the replacement and restoration of oral structures. While most of these materials are considered inert when placed in the human body, some have been implicated as being potentially toxic or allergenic. Ceramics, metals, and plastics are all commonly used as tooth restoratives, and have not been shown to have adverse biologic effects in patients. The information below will help you make decisions about which materials are best for you:

Fillings

Silver Amalgam
Silver amalgam has a long history of use in tooth restoration. Used since the mid 1800s, this alloy contains silver, tin, copper, zinc and mercury. While highly successful when used in tooth restoration, it is not an attractive material. In addition, there has been much debate
recently about the use of mercury in

dentistry, but amalgam is still strongly supported by the American Dental Association and other major health organizations.

Gold Inlays And Onlays
Average longevity 20 years to life, gold colored, moderate to high initial cost. May be used in most locations where metal is not displayed to an objectionable level.

Resin (Plastic)
Direct (one-day appointment placement). Average longevity 10 years, tooth colored, moderate cost. Best used in small-to medium-sized restorations for any teeth. Considered at this time to be comparable to silver amalgam’s service potential.

Ceramic
Indirect (two-appointment placement). Average longevity 10-15 years, tooth colored, moderate to high initial cost. Best used in moderate to large restorations for any teeth.

Crowns or Fixed Prosthesis (Bridges)

Alloys
When it comes to crowns or bridges, you have a variety of choices. Gold alloys have been used successfully for many years and provide strong, long lasting service. There are other alloys available that can be used including:

High-noble metal: Mostly gold, but also palladium, silver, and occasionally platinum, zinc, and copper.

Noble metal: Mostly palladium, but also silver, gold, and other trace metals.

Base metal: Dr. Duda does not use base metals because he feels there is a risk of allergic reactions to some of the constituent alloys and he feels he obtains a more bio- compatible result and fit with the high nobel metals

Of particular note is the cost of noble or high noble metals, which are higher than base metals.

Material Options For Crowns Or Fixed Prostheses (Bridges):
Fixed prostheses are strongest when metal is used with or without porcelain on it; but, in certain limited situations, all-ceramic or polymer fixed prostheses may be used, especially in the front ofthe mouth highly visible areas. Options include:

Metal alone
High noble, or noble,. Average longevity 20 years to life, gold, moderate to high initial cost. May be used in any area where metal display is not objectionable.

Porcelain Fused-To-Metal
Average longevity 10-20 years, tooth-colored, moderate to high initial cost. May be used in any area where extreme biting stress is not present, and patient does not have severe tooth grinding habit, which can result in porcelain fractures.

Ceramic, Non-Metal
These restorations are constructed from ceramic alone. Average longevity is 10-plus years, moderate to high initial cost. May be used when extreme stress or grinding habits are not present. All ceramic fixed prostheses may be used in a few clinical situations, but they are improving constantly.

Dr. Duda will inform you about the best types of tooth restoration for your mouth, and we welcome your questions.

Tooth Colored Restorations
Tooth-colored resin (plastic) material contains small “filler” particles of glass-like material for strength and wear resistance and can last for many years. These materials contain the finest, most up-to-date, widely accepted materials in use today. If you choose this material, please be aware of the following information:

Avoid chewing excessively hard foods such as hard candy, corn nuts, ice, bones, etc., because the resin material can be broken from the tooth with extreme force.

You may experience mild sensitivity to hot and cold foods for a few days. because the freshly prepared tooth structure needs time to heal. This sensitivity should disappear in a few days. If it does not do so, please contact us.

Recall Visits: Professional six-month examinations are necessary. Developing problems can be found at an early stage and corrected more easily. Waiting for a longer time may require redoing the entire restoration, and may involve more expensive remedial procedures. If you wish, will contact you when it is time for your recall.

Preventive Procedures

  • Brush twice daily, and floss.
  • Swish vigorously for 30 seconds daily with a fluoride rinse such as Johnson & Johnson ACT.
  • Use 1.1 percent neutral sodium fluoride as a brush-on material. These products can be obtained from our office.
  • Use a electric toothbrush, we recommend the Oral B Braun.

Future Care
We expect several years of service from these restorations. However, after a service period of years, we have seen the following situations occur:

  • Slight stains may occur at locations around juncture of the tooth restoration. Often, we can remove these stains.
  • Slight chipping at the juncture of the tooth and restoration. Usually these chips can be smoothed by us.
  • The gums (gingival) may shrink from the restorations, displaying an unfavorable appearance underneath. This condition may require remaking the restoration using a more esthetic type of restoration.

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