There are a lot of reviews about the artistic restoration of the front teeth. Someone scolds her, and someone admires the skill of the doctor. However, patients, as a rule, understand this term as the restoration of only the front teeth. In fact, both the erasure of the incisal edge of the front tooth and the chipping off of a piece of the lateral, chewing tooth are indications for artistic restoration. Over time, the border of the filling has become stained or it needs to be replaced due to the recurrence of caries, or there is no caries yet, but the filling does not fit well. In all these situations, aesthetic restoration is needed.
Types of artistic restoration of teeth
Restoration is of two types: composite and ceramic. Composite restoration is the restoration of a tooth with a light-curing filling material. Due to the fact that the destroyed part of the tooth is recreated in the patient's mouth, thisrestoration is also called direct.
Indirect restoration is restoration using a ceramic inlay. The dentist makes an impression of the tooth. In the laboratory, a plaster model is made on it, and then a ceramic inlay. The doctor installs it in the cavity of the tooth, replacing the destroyed tissue.
Domestic dentists in matters of aesthetics of dental restoration are more inclined to the European school: they create natural irregularities, cracks, even specks on the tooth. While the American dental school, on the contrary, considers the creation of unnaturally white, perfectly even and identical teeth to be the standard. What result the patient will receive is determined by his preferences. Therefore, it is important to clearly voice your wishes even at the consultation stage.
Indications for the installation of ceramic inlays
In order for the patient to leave a good review of the artistic restoration of the tooth, it is necessary that the work does not fall out after two months. If more than half of the tooth is affected by caries, the filling will not work - it will not last long. It happens that the tooth is damaged on two or three surfaces, i.e., the carious cavity passes from one wall to the opposite. The dentist will have to drill such a tooth very hard. In this case, restore with a tab.
The method does not involve depulpation (nerve removal). If it is risky to leave a tooth alive, then a crown is placed.
Indications for composite restorations
A filling is used if the edge of the front tooth has broken off, but on condition that the defect is small. On the lateral teeth, the composite restoration is not visible. Therefore, a seal is placed,if more than half of he althy tissue remains.
Benefits of indirect restoration
Reviews of artistic restoration of teeth using ceramic inlays are often better, and here's why.
- Perfect shape and match to opposing teeth. The inlay is made in the laboratory, not in the patient's mouth. The dental technician makes a plaster model from the impression made by the dentist. On it, he checks the height of the bite, the shape, so that it exactly matches the existing teeth, located next to and on the opposite side.
- Smoothness. Ceramic remains smooth even after years. On such a surface, plaque does not “keep” well, and the tooth looks shiny and natural.
- Durability. Ceramic is a strong material, it lasts much longer than the composite, it does not wear off.
Disadvantages of indirect restorations
- Price. To restore a tooth with an inlay, 2-3 specialists work: a therapist, an orthopedist, a dental technician. Often an impression is made by a dentist who is engaged in treatment without resorting to the help of a prosthodontist. Of course, the work of several specialists is more expensive than the work of a therapist who puts a filling.
- Duration. Indirect restoration requires a minimum of two visits. During the first visit, an impression of the tooth is taken. A few days later, when the technician has made the tab, the patient is invited to try on. Most often, the whole process stretches over three visits.
Pros of composite restoration
It's cheaperceramic and takes less time. The filling is placed in one visit. In the most difficult case, it takes no more than an hour and a half.
Composite restorations are more gentle on the tooth than inlay restorations. The dentist drills only caries or an old filling, preserves he althy tissue in full. The more you can save, the longer the tooth will “live”, the stronger it will be. When restoring with a tab, the doctor is forced to remove a little bit of he althy tissue along with caries.
Cons of composite restoration
Gradually, the filling, even well polished, loses its luster, scratches. This happens while eating, brushing your teeth. The natural tooth has a natural shine, while the composite restoration becomes matte and starts to stand out. The place where the filling connects to the tooth stains, darkens from tea, coffee, cigarettes.
Plaque easily "sticks" to the surface of the composite. With poor hygiene, it also stains, and the filling becomes even more noticeable.
Composite is based on plastic, so direct restoration is not as strong as a ceramic inlay. Over time, chips that are invisible to others appear on the seal. It no longer sticks to the tooth so tightly. As a result, food remains, plaque get under the filling, caries develops.
Not all composite materials can restore a tooth to look natural. Therefore, for people who are very demanding on the aesthetics of a smile, a filling is not suitable.
In the light of disco lights, some filling materials will look blackholes. It is unlikely that in this case the patient will leave a positive review of the artistic restoration of the tooth.
Description of filling teeth restoration
To make the patient feel comfortable, the dentist necessarily uses local anesthesia. Some people are afraid that pain relief won't work, and for good reason. Modern anesthetics always work, the problem can only be on the part of the doctor - incorrect calculation of the injection site.
If there is anything unpleasant in the whole process of tooth restoration, it is the moment the syringe is injected into the gum. To minimize discomfort, the doctor "freezes" the anesthetic injection site with a special spray or gel. From the moment of injection to the beginning of the restoration, it takes from 2 to 20 minutes: for sensitivity to disappear, different teeth need different times. On the lower front teeth, as well as on the entire upper jaw, the injection acts faster. You have to wait longer for the “freeze” of the lower lateral teeth.
If there is plaque, then professional cleaning is carried out before restoration. This is the removal of dental deposits with a sandblaster, cleaning with special abrasive pastes, polishing. If you skip this step, the dentist will not be able to see the natural color of the enamel, which means that the restoration will be inaccurate.
Due to contact with saliva, gum fluid or moisture from the patient's breath, the filling will fall out. The reason for this is the sensitivity of the composite to moisture. So that the work does not go down the drain, the dentist isolates the tooth with a rubber dam. This is a special elastic film. When it is "pulled" over the tooth, it breaks, and the edges fit snugly.
The doctor drills all damaged tissue out of the tooth. The resulting cavity is treated with an antiseptic so that the dust infected with caries does not lead to re-inflammation. The dentist lubricates the tooth with a special acid. It makes the surface slightly rough so that the adhesion to the material is better. The next step is to apply the adhesive. This is the "glue" that holds the filling to the tooth. The adhesive is illuminated with a photopolymer lamp.
The dentist starts working with the filling material. At this stage, the artistic restoration of the tooth begins. The feedback that the patient leaves depends on whether the doctor can create a tooth that is indistinguishable from a natural one. If you watch the work of a good doctor, it becomes clear why restoration is called aesthetic. The dentist, as a sculptor, recreates the shape of the tooth with all its elevations and fissures (hollows between the tubercles), grooves and longitudinal irregularities.
He pays special attention to shades. The fact is that the color of the enamel of any person is not uniform, but has transitions. The incisal edge of the tooth is translucent. The coronal part has a yellowish, grayish or other shade - it all depends on the color of the dentin under the enamel. The dentist works like an artist. He selects several composites of different colors to simulate enamel and dentin. It does not apply the material immediately, but in 5-6 approaches. Each layer lights up with a lamp.
The quality of the sanding matters a lot. The doctor removes excess composite so that it does nothung over the gum so that the filling was not too high. Otherwise, the patient will feel discomfort, the bite will be disturbed. The doctor necessarily smoothes the junction of the filling and the tooth: the transition should not be felt by the tongue.
Final stage - polishing. The tooth is made smooth so that it does not “collect” plaque, and glossy so that it looks he althy.
Inlay restoration
Restoration of a tooth with a ceramic inlay at the first stages is no different from restoration with a filling. The difference appears after the dentist has prepared the cavity. He makes an impression and passes it to the dental technician. When the laboratory has made the inlay, the patient is invited to try it on. This is where the benefits of indirect restoration come into play. When placing a seal, it must be carefully checked. The doctor does not have the opportunity during the work to ask the patient to close his mouth and make a couple of chewing movements. Corrections are made only in the final, they do it by eye. For ceramic restorations, they are corrected on a plaster model.
What does restoration lead to?
Artistic restoration will have negative consequences only when the technology is broken. Or the indications for restoration are too high. For example, if caries has destroyed more than half of the tooth, and the dentist took a chance and put a filling, it may not withstand the load. It happens that a piece breaks off from the front tooth. It seems safe to restore with composite. But if the chip occurred as a result of a strong blow, then the nerve can be inflamed. If the dentist has not checked this, then insoon the tooth under the restoration will need to be depulped.
Before restoring a tooth, one more feature must be taken into account: ceramic and composite restorations do not bleach. If the patient plans to whiten his teeth, then there is no need to rush to install a filling or inlay - it is worth installing a temporary plastic crown.
Art restoration or veneers?
To make an artistic restoration of teeth or veneers - the decision depends on the initial situation and aesthetic requirements.
Veneers are ceramic overlays for teeth that are attached with cement. The technology involves grinding a small layer of he althy tissue (0.5-0.8 mm) and does not require depulpation.
Veneers are placed only on the front teeth, which are visible when smiling. Do it in such cases:
- When the teeth changed color. A dead tooth can darken. There are also so-called tetracycline teeth. They turn dark during fetal development.
- When you need to restore more than a third of the tooth. If you make it with a composite, the filling will be visible.
- When an adjacent tooth is covered with a ceramic crown. If restored with a composite, then the filling and ceramics will differ over time, because they have different aging periods.
Reviews about the restoration of teeth are controversial due to the fact that the dentist does not take into account some of the nuances and puts veneers or light fillings on everyone. He may not warn that veneers are beyond repair, unlike fillings. Moreover, they are in2-3 times more expensive.
Reviews about the aesthetic restoration of the front teeth with veneers are better. This is due to the fact that they are not erased and last 10-15 years, and a seal with poor hygiene can only “live” for two years.
Patient feedback
It would seem that reviews of the artistic restoration of teeth in Moscow should only be positive, because dentists in the capital have high qualifications, the most modern equipment. Unfortunately, not all patients are satisfied, and here's why. A dentist may insist on a certain restoration technique, not because it is more suitable, but because he owns only her. Hiring another doctor means losing money. As a result, a person receives an unreliable filling for the entire tooth only because the therapist does not know how to make casts.
Bad reviews about the restoration of teeth in Moscow can be left even by patients who are lucky enough to be treated by a conscientious dentist, a master of his craft. Why is this happening? Some people think that fast work means professionalism. They are satisfied that the “experienced” doctor “covered up” the tooth with a filling in 15 minutes. They scold the doctor who pored over the tooth for 1.5 hours. In fact, the first one broke the technology. Such a restoration will last a little (it will quickly be erased or fall out), spoil the bite. The second created a tooth of the correct anatomical shape, which will last a long time, be functional and aesthetic.
