Tooth Filling - Modern Methods Of Dental Filling

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Tooth filling

Tooth filling is the process of eliminating defects in hard tissues, filling the formed pathological cavity. To perform the procedure, dental fillings are used - materials of various composition and characteristics, allowing to isolate sensitive tooth tissues and prevent microbes from entering its cavity.

Modern dentistry has the opportunity to offer a person a tooth restoration procedure, taking into account its anatomical structure, structure, color and transparency. Thanks to the latest methods of dental filling, materials and techniques used, this process is painless for the patient.

Content:

• Classification of materials for filling teeth
• Metal seals
• Non-metallic seals
• Materials for filling the root canals of teeth
• Modern methods of filling tooth canals

Classification of materials for filling teeth

1. Classification by the type of filling material.

Depending on the composition that is used to create a seal, a distinction is made between metallic and non-metallic materials:

• Metal fillings can be made from amalgam, pure metal or metal alloys.
• Non-metallic fillings can be made of special cement, plastic, or ceramic. A distinction is also made between non-metallic light-curing and glass ionomer materials for dental fillings.
• Fillings for tooth canal filling. To fill the tooth canal, the following materials are used: gutta-percha, pins (silver and titanium), natural sealers, Cortismol filling powder, glass ionomer cement, polymer sealers, calcium hydroxide cement, polymethylsiloxane.
2. Classification by the service life of the seal.

Depending on the service life of the seal, there are:

• Temporary seals. After a short period, they will be removed. Therefore, they are made from polymer materials, from artificial dentin or dentin paste, from plastic, from zinc phosphate, from glass-ionomer cement.
• Seals for permanent use. These seals are installed after the temporary seals are removed.

Metal seals

Filling teeth with amalgam

Amalgam is a medical metal that contains tin, zinc, mercury and silver. Most often, this filling is placed on the distal chewing teeth. Modern dentists use copper and silver amalgams, where these metals prevail.

The advantages of amalgam fillings are as follows:

• Long service life, which can reach 15 years or more;
• Strength;
• Low price;
• Plastic;
• The ability to preserve the color of the tooth appears if the latest generations of amalgam fillings are used;
• Easy to install;
• Tight edge fit.

Disadvantages of using amalgam for dental fillings:

• Low aesthetics: the filling will stand out noticeably against the background of the tooth;
• Long curing time;
• The release of mercury vapors, from which it is more likely not the patient himself who suffers (it has been proven that even when wearing 10 amalgam fillings, the body will not receive mercury exceeding the maximum permissible concentration), but the employees of the dental office;
• Impossibility of installing a gold crown, as the amalgam filling will collapse;
• Shrinkage of the filling;
• Increased thermal conductivity.

Gold alloy for dental fillings

Fillings made of metals, including their precious analogs, are not popular in modern dentistry, as they are too noticeable on the teeth. While most patients strive for maximum naturalness and naturalness. However, those who decide to get such a filling should be aware of its advantages and disadvantages.

Advantages of gold alloy fillings:

• Long service life;
• Increased durability.

Disadvantages of gold alloy fillings:

• High price for filling;
• Impossible to install with amalgam fillings.

Non-metallic seals

Cements for dental filling

Cements are widely used for the manufacture of a wide variety of fillings. They are included in permanent fillings in adults, these materials are used to fill milk teeth for children, and cements are used to make insulating gaskets.

• Phosphate cements cannot act as an independent material for making fillings, since after installation they tend to decrease in volume. Therefore, so that a gap does not appear between the tooth and the filling, in order to avoid a loose fit of the filling, zinc phosphate cements are used only as a spacer when installing other fillings, and it is also used to fix crowns.
• Silicate cement for filling a tooth is used after a phosphate cement pad is installed on the pulp. The fact is that the silicate material is not able to independently provide the necessary permeability, and it can have a pathogenic effect on the pulp. In addition, this cement will dissolve under the influence of saliva and has toxic properties; therefore, modern dental clinics do not use silicate cement.
• The combined silicate-phosphate cement incorporates all the best qualities of the two previous cements. It does not adhere to the walls of the dental cavity, while it is as hard as silicate cement and has the necessary transparency. Another advantage of this cement filling is that it does not have thermal conductivity. The disadvantages of silico-phosphate cements fillings are: not too high aesthetic qualities, low strength and poor resistance to the environment in the oral cavity, as well as toxicity to the pulp, and therefore it is necessary to use an insulating pad. It is these fillings that are most often installed in free dental offices, since they have a low cost.
• Glass ionomer cement is another modern cement that is characterized by increased strength and durability. This cement adheres well to the tooth and is not toxic. In addition, in the process of wearing such a filling, fluoride is released from it, which contributes to additional protection of the tooth from carious destruction. However, this modern material also has disadvantages. It is brittle and, like all other cements, has increased abrasion. In this regard, glass ionomer cement is used as insulating spacers and for anchoring dental inlays.

Plastic fillings

In dentistry, plastic is used as a material for making temporary fillings.

Their advantages:

• High speed of solidification;
• Resistant to chemical agents;
• No oral irritation.

There are many more disadvantages of plastic fillings than positive qualities:

• Reducing the volume of the seal during operation;
• Sealing of the seal;
• Quick change of the original color;
• Tooth decay due to deformation of the filling.

Plastic fillings include acryloxide and carbodent.

Acrylic plastics are produced by a domestic manufacturer and have the following advantages:

• High adhesion (adhesion to tooth tissues);
• Tight fit to cavity walls, negligible shrinkage;
• Easy to dispense powder and liquid;
• Resistance to external stimuli;
• Long-term preservation of the original color.

However, despite the strength of acryloxide, it is chemically toxic and, over time, will lead to an inflammatory reaction under the filling.

Compared to acryloxide, carbodent is denser, less toxic, but very fragile and darkens quickly.

Ceramic fillings

Ceramic fillings have a number of advantages, including:

• Increased hardness;
• The durability of the original color;
• Maintaining the original size, no shrinkage;
• Excellent aesthetic qualities.

Ceramic fillings are made according to the type of inlay, that is, according to a pre-made impression from the processed tooth. The configuration of the ceramic filling makes it possible to evenly distribute the load over the entire tooth during the process of chewing food. There are several types of ceramic fillings: pressed ceramics, metal ceramics, with zirconium oxide included in their composition. One and, perhaps, the most significant disadvantage of a ceramic insert is its high cost compared to fillings made from other materials.

Light-curing composite fillings

Light-curing fillings are those that harden as a result of exposure to light of a certain frequency. They are as close as possible to the appearance of a person's own teeth, are almost invisible after their installation, are durable and initially look perfect. The advantage of these materials is that they lend themselves well to polishing, and their high aesthetic qualities make it possible to use these fillings for the treatment of anterior teeth. However, over time, these fillings need to be replaced as they will shrink.

Materials for filling the root canals of teeth

Root canals are sealed when caries passes into the stage of pulpitis. The essence of filling is to fill the tooth canal with the selected material as tightly as possible. Modern dentistry makes this process painless and quick.

For this, the following materials are used:

• Gutta-percha is the result of recycling material such as latex. When heated, gutta-percha becomes stringy, and after cooling it hardens. This material has high biological compatibility with tooth tissues, has low toxicity, does not dissolve, does not cause allergic reactions. If the need arises, the gutta-percha can be removed from the root canal. The disadvantages of the material include the lack of bactericidal properties, the impossibility of adhesion of the material to dentin and the difficulty of installation.
• Silver pins are used less and less in modern dentistry, since it was found that they tend to oxidize and provoke a relapse of inflammation.
• Titanium pins do not provoke allergic reactions, are very durable, lightweight and do not corrode. However, they can only be used in cases of minor tooth decay and no nerve in the canal.
• Natural pastes (sealers) contain various antiseptic and antibacterial components that prevent the development of inflammation, they do not cause difficulties in installation and are absorbed over a long time. The disadvantages of sealers include the likelihood of an allergic reaction, the presence of toxic components. In addition, on contact with the mucous membrane, they can cause pulsating pain.
• Polymer pastes (sealers) are used more often than natural ones, since they do not contribute to tooth staining, do not dissolve in liquids, and have good adhesion to the canal walls. However, they can provoke an allergic reaction, especially for patients prone to similar manifestations.
• Cortismol is a powder that helps to relieve pain after its introduction into the root canal of the tooth, as it contains hormones. However, it will not be possible to fill the front teeth with it, as it contains coloring pigments.
• Kanason Kombipak acts as an antiseptic and antibacterial filling agent. It perfectly isolates the channel, but the main disadvantage of its use is the long installation time.
• Glass ionomer cement is not suitable for filling the canals of teeth, since it has low strength and is permeable to liquids. Therefore, it is more often used for filling milk teeth.
• Polymethylsilxane has excellent ability to fill even the smallest cavities, as it consists of the smallest particles. Its main drawback is the novelty of the material and insufficient knowledge of its effect on the body.
• Cements are used for filling tooth canals only after the application of insulation.

Modern methods of filling tooth canals

1. The depophoresis method allows you to sterilize the canals, filling all existing cracks and cavities. Depophoresis allows you to cure even the most difficult cases, for example, when the canals of the tooth are crooked, or access to them is difficult. Using a special tool, a medicinal substance (calcium and copper hydroxide) is injected into the canal, achieving complete sterilization.

2. Filling of teeth by means of obturation with thermophiles using heated gutta-percha. This is a simple and reliable way of filling canals, but an unpleasant consequence can be the release of material for filling beyond the borders of the canal.

   The warmed gutta-percha can be used for filling according to the following methods:

   • Injection method, when gutta-percha is supplied to the problem area, the temperature of which reaches 100 ° C (only a highly qualified dentist can perform the procedure);
   • The method of vertical condensation allows you to perform a three-dimensional filling of the canal, but it is very difficult to implement;
   • The continuous wave method is similar to the vertical condensation method, but is not as long in time;
   • Syringe insertion is a quick and convenient method of filling the canal, but it will not be possible to reach the lateral tubules.

3. The method of filling the canals with cold gutta-percha.

   • Method of one pin (a pin is made of gutta-percha in the shape of a canal);
   • Lateral condensation method (several gutta-percha pins are used to fill the canal), in this case there is a risk of fracture of the tooth root and loose filling of its canal;
   • The method of thermomechanical condensation (the canal is filled with a rotating instrument), in this case there is a risk of instrument fracture and poor-quality filling of the dental canal.
4. Channel mummification. In this case, the pulp is treated with a large number of antiseptics, which stops the progression of the inflammatory process.
5. Retrograde filling of teeth is a modern method of filling canals. To perform the procedure, use a special nozzle and a gun to perform an injection. Initially, the root is filled with the selected material using a retrograde motion, and then the doctor can proceed to vertical filling.

Previously, canal filling using a resorcinol-formalin mixture was used, but this method has many side effects, and modern dentists have abandoned it.

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The author of the article: Muravitsky Boris Viktorovich, dentist, especially for the website ayzdorov.ru