Restoration of teeth is a series of restorative procedures aimed at recreating the original state of the dentition. There are quite a few ways today and everyone can choose the one that suits them in terms of quality and price. The term restoration of teeth in dentistry is the restoration of the anatomical shape of the tooth, its color and the preservation of its functionality. The choice of method is made by the dentist. He conducts a preliminary examination and takes into account the zone of destruction, bite, the integrity of the dental tissue, the presence of allergies and other features. Without prior treatment of caries or removal of other destructive consequences, the restoration will not be carried out by anyone.
Main species
The main division comes from whether the work is done inside the mouth or outside of it. It is rather conditional today, because there are no clear boundaries, many methods pass into each other. But the goal of any method remains the same - to eliminate the shortcomings of the dentition. The main slogan of the restoration is to achieve maximum naturalness in terms of the natural shade of the enamel and the shape of the tooth. Photos before and after restorationare shown below.
Direct method
The direct method of restoring teeth is what used to be called fillings. All work is done in the oral cavity. The restored tooth does not differ from he althy ones. Removing part of the restoration is impossible even by a dentist.
Indirect method
Indirect method of dental restoration is restoration by cast. The work is performed by an orthopedic dentist. The cast is made identical to the same tooth from the he althy side of the jaw. If this is not possible, virtual modeling of the dentition comes to the rescue. At the same time, the destroyed parts are, as it were, “finished” - a 3D model is obtained.
With the indirect method, the patient spends much less time in the dental chair. Inlays for the oral cavity are made in the laboratory. Remanufactured parts are easily removed in the clinic without much damage.
What materials are used?
When choosing materials for restoration, 4 features are taken into account:
- consistency;
- curing method;
- destination;
- filler sizes.
Restoration can involve anterior and posterior teeth, and the methods are different. For frontal with the direct method, light-curing composites and amalgam are used.
With indirect restoration of teeth, the choice is greater: it can be reflective polymers, ceramics, zirconium, aluminum oxide, metal ceramics. Crowns can be made traditionally from gold, or from metal-ceramic, which is now popular.
Contraindications for restoration
Contraindications for dental restoration are:
- allergic to composite material or adhesives for it;
- impossibility to isolate the tooth and its cavity from moisture;
- increased abrasion of teeth in combination with a direct bite;
- bruxism;
- pronounced incisal overlap;
- lack of oral hygiene.
Lifetime of used restoration materials
No dentist will give the exact date of preservation of the restoration, since everything is individual. Hygiene plays a role, the presence of bad habits, diet, etc. And also the duration depends on the qualifications of the dentist.
Restoration classes
According to the degree of destruction, 3 conditional classes of tooth restoration can be distinguished. They are also called approaches:
- 1 class. It is used for caries of fissures, which happens quite often. The problem is unpredictable because, at the start of treatment, the volume of the lesion is often much deeper than expected. The chewing surface is not broken here. Restoration is carried out using the occlusal key method. This is a preparation from the chewing surface of the impression, with which the necessary portion of the composite is subsequently squeezed out in order to obtain the original shape of the tooth. Bit-silicone is used to make the key. They are quite hard, and all the smallest details of the chewing surface are imprinted very accurately.
- 2 class destruction and restoration. It's about deep cavities and insolventfillings. The main feature of class 2 is the destruction of up to 50% of the chewing surface, but the preservation of the main outlines of the tubercles, ridges, part of the ridges, etc. Therefore, the dentist can quite easily recreate the external contours and get a very accurate copy of the chewing surface. The work is carried out by the method of layer-by-layer restoration.
- Restoration of the 3rd class of destruction. This category includes large-scale defects, any pathologies with absent hard tissues. If the destruction of the crown is more than 50% of the volume, the indirect method will be used. The class is problematic, because the doctor has few guidelines. It is impossible to feel the necessary forms of the tooth, and to understand the correct spatial position of the components. A preliminary wax-up is done in the dental laboratory using a properly adjusted articulator. The doctor reproduces the morphology of the tooth at his own discretion, and then checks the compliance of the occlusion, and removes the excess with a burr.
Composite restoration
Composite restoration is the filling of the outer side of the tooth with a special composition (photopolymer in several layers). The procedure is progressive, it takes 1 visit, in time - 30-60 minutes. It does not require turning and preparation.
The composite method is similar to veneers, because the filling is also placed on only 1 side of the tooth. However, the enamel is not affected by this method. Only 2 grooves are drilled on the tooth surface as boundaries for the resin. Then a special compound is applied to degrease the enamel and destroy microbes.
Finalstage - layer-by-layer application of a photopolymer. Each layer is dried with a special lamp. The number of layers is chosen by the dentist according to the condition of the tooth.
Photos before and after the restoration of teeth in this way are presented below. There is almost no pain during the procedure, but local anesthesia is still performed. Composite restoration can be used in the presence of chips, cracks, chips, spots on the enamel. Use only on frontal teeth.
Other names for composite restoration are artistic or aesthetic because the whole process is quite creative.
Composite method details
Aesthetic restoration of teeth with a filling light-curing material is carried out in such a way that the remaining part and the polymer are completely merged into a single whole due to mutual diffusion. The great advantage of composite materials is that they can withstand the load of chewing due to their plasticity.
Another plus is the ability to complete the restoration in one visit, without impressions and creating crowns. This also reduces the cost of treatment. Even if part of the filling has fallen off, it can be restored in an hour. In addition, the composite material does not grind down the tissues of the antagonist teeth.
Disadvantages of the composite method
There are certain drawbacks to the method of direct restoration of a tooth with composites. Firstly, such fillings give some shrinkage. For each material it is individual. Secondly, in terms of color fastness, composites are inferior to other materials, for example, ceramics orveneers.
Thirdly, it often happens that the material does not adhere tightly to the walls of the tooth cavity over time, which may cause a recurrence of caries. Fourth, composite materials are very sensitive to moisture, which adversely affects their proper polymerization, and the filling may fall out.
Composites darken over time. According to studies, within 5 years, 15% of these fillings require some degree of cosmetic "repair" or polishing.
Modern filling materials for the restoration of teeth allow you to restore lost structures without involving he althy tissues. The method and materials are chosen by the dentist, it depends on his knowledge, experience.
Pros and Cons of Direct Restoration
Direct Dental Benefits:
- speed of work (1-3 hours);
- high quality and affordable price;
- one visit can restore several teeth;
- may eliminate a major defect from destruction.
Flaws:
- with the correct technology and quality of performance, the period does not exceed 10-15 years;
- success depends on the professionalism of the dentist;
- after restoration, hygiene procedures require special care - the use of high-quality pastes and brushes;
- periodically they need to be polished;
- the color of any teeth changes over time, but there are no polymers, so the difference becomes noticeable.
Main stages of restoration
Restorationtooth composite includes the following steps:
- Preparation for restoration - complete cleaning of teeth from tartar and plaque. Determination on a special color scale, and selection of the appropriate shade of the composite filling.
- Administration of local anesthesia.
- Drilling carious cavities.
- Tooth isolation from wet breath and saliva, during which a rubber dam is used.
- If the crown is destroyed by more than 50%, the tooth is depulped, a pin must be placed. This enhances the strength of the seal during loading.
- The shape of the tooth must be completely restored so that it looks natural. In this case, the technique of layered restoration is used. The layers are different in color and transparency, but together they should merge into a natural design.
- Tooth finishing. This procedure includes the final burr modeling, grinding and polishing of the filling.
Tabs
This is a way to restore chewing teeth, their inner part. It is an alternative to pins. Tabs are temporary and permanent. In the latter case, they are made of metal or ceramics. Sometimes a tab can fill in the missing part. But it should replace no more than half of the tooth surface.
Despite the fact that the inlays are direct restorations of teeth, an impression is required for their manufacture and installation. They will vary in size. The stump tab becomes the basis for the crown. For this type of restoration, several visits to the doctor are required. On the first visit, the nerve is removed, then the "hollow" and channelsseal up. And only then, from a clean tooth, an impression is taken.
During the second visit, the temporary tab is removed and the installation of a permanent filling begins. It is fixed on a special compound.
It is impossible to notice a filled tooth if the filling is not made of metal. In terms of reliability, service life, inlays are superior to restorations, and if they are made of ceramics, then they will surpass artistic restoration.
Pins
Pins are used for severe destruction. Even if only a stump remains on the gum instead of a tooth, such a design will restore it. The pin itself resembles a metal pin that is inserted into the root canal. Its upper part, protruding above the gum, becomes the basis for the restored tooth.
For incisors and canines, 1 pin is required, for molars - 2. Installation of such structures is a preparatory stage for forming a base for a crown. A damaged tooth for a pin is not removed. It is only cleaned as much as possible, the channels are drilled, and a fixing solution is poured into them under the filling, into which the rod is inserted.
After the solution dries, the missing part of the tooth is built up on the pin. The downside of this method is the risk of splitting, the metal base is not very reliable.
Crown
A crown is a kind of prosthesis, like a cover that is put on a heavily worn off, affected tooth or pin. For its installation, 3-5 visits to the dentist are required. The crown is made from a cast or a virtual model. Therefore, it repeats the shape very accurately.he althy tooth. A similar recovery method is indicated for large lesions, and when other methods are not suitable.
Even if the tooth is destroyed by more than 70%, it can be restored with a crown. The most in demand are such structures made of ceramics and cermets. They have a natural color and high strength.
Establishing a crown does not require the removal of a diseased tooth, but treatment and cleaning of the canals are mandatory procedures. After that, an individual impression is made. For a crown, the tooth is ground to a minimum size. And it becomes like a low thin stump. If there is no natural tooth, a pin is placed.
Initially, a temporary plastic crown is placed, because it takes time to create a permanent structure from an impression. The structures made of zirconium dioxide serve longer than others (more than 20 years). Therefore, this material is most often recommended by dentists for the restoration of a tooth with a crown.
Alternative Anterior Restoration Methods
Veneers or Lumineers are an alternative to fillings. In fact, this is the same thing: a thin ceramic plate attached to the tooth. They differ only in their thickness. Depulpation is not needed here.
When installing veneers and lumineers, the teeth are minimally turned, but the enamel is almost completely erased, to the depth of the size of the structure. This is necessary for the evenness of the row. Veneers make the tooth lighter by 2-3 tones, and they are recommended to be installed if it is impossible to apply bleaching. Moreover, such structures cancreate the perfect smile, even if the patient has an overbite, is chipped or cracked, or is missing a few teeth altogether.
Monolithic veneers are much stronger than any filling. For this reason, they are durable. The most popular are ceramic ones, since they are the most densely associated with the surface of the teeth. In all their properties, they are as close as possible to natural enamel. Veneer shape accuracy up to 1 micron.
Lumineers are thinner and lighter. When installing them, turning the enamel is not necessary. The structures are attached to the fixing gel, which includes fluorine. Therefore, the installation of lumineers is also beneficial for the teeth. The gel is fixed faster under the lamp.
Veneers and lumineers are almost the most expensive designs that are made on special equipment. Another problem is that, being a hard material, they quickly disable this very equipment. Therefore, the price of the structure also includes the cost of its repair and replacement.
Veneers and Lumineers are ordered for a full row. The complete installation of such structures can be completed in 2-3 visits to the doctor. Veneers last up to 10 years, Lumineers last even longer - up to 20 years.
