When decay gets into the dentin of the tooth (dentin is the layer below the surface enamel), a dentist must remove the caries and fill the space with a restorative material. The main two choices are amalgam (silver) and composite resin (tooth colored). In our practice, we mainly use composite resin because of its conservative nature, ability to bond to the tooth, and esthetic qualities.
We believe that using resin is best for our patients because it is the most conservative option. Silver fillings, or amalgam, don't stick to the tooth and instead are only held in by making the preparation wedge shaped so they can't fall out. This means that the preparation is larger than the area of decay. In contrast, composite fillings are much more conservative because you only have to remove the area of decay and not adjacent tooth structure before filling the cavity because composite bonds to the tooth.
Additionally, this bond adds strength to the tooth, making it less prone to fracture or breakage than with a larger, wedge shaped amalgam restoration.
Composite also comes in a wide array of shades so that we are able to exactly match the color of the surrounding tooth structure in most cases. Composite technology is constantly advancing, allowing us to provide increasingly more esthetic results. In addition to filling cavities, composite resin is used to perform a cosmetic procedure called tooth bonding. Bonding helps improve the look and/or function of teeth by reshaping them.
Indications for composite resin:
· Fill cavity due to decay
· Close gaps between teeth
· Minor tooth reshaping
The disadvantage of using composite as opposed to amalgam is that it is much more time and technique sensitive, making it a more costly procedure.
A dental crown is a dental restoration that is cemented over the whole tooth structure above the gum line. The purpose of a crown is to increase the longevity of a tooth by restoring structure, support, shape, function, and beauty. Crowns aren't limited to restoring a tooth to its original shape and can often enhance the esthetic appearance of teeth.
Crowns are needed for a variety of reasons and can be made from a range of materials, all with different benefits.
Indications for a crown:
· Large cavity or defect
· Restore function to a badly worn tooth
· Endodontically treated tooth (Root canal treated)
· Implant restoration
· Surveyed crown (crown made to support a removable partial denture framework)
CEREC is a camera, computer and precision manufacturing machine all in one. We use CEREC’S built in camera to take a picture of the damaged tooth. Using this image, the CAD (Computer Assisted Design) function of the CEREC designs the porcelain restoration. Then, the CAM (Computer Assisted Manufacturing) function mills the restoration out of a block of porcelain. We check the crown in your mouth to make sure it fits properly before sintering and glazing it in our oven. This process increases the strength of the ceramic and provides the esthetic finish. We then bond the crown/filling to your tooth and are finished!
Dental ceramic has become a desirable material for crown restorations because of its esthetic beauty and compressive strength. By carefully selecting a ceramic shade, dentists are able to achieve results that are often indistinguishable from the surrounding natural teeth. Porcelain also gives the dentist or laboratory technician the opportunity to customize the tooth with characteristics found on your other teeth to seamlessly blend the new crown into your mouth. Another benefit of ceramic is that we are able to match the level of translucency found naturally so light hits porcelain teeth in the same way as your other teeth. This is why porcelain crowns are even more esthetic than Porcelain Fused to Metal (PFM) crowns; the porcelain doesn't have to be opaqued to block the metal substructure from showing through. Natural teeth are more transparent than we are able to make PFMs, especially at the tips.
We have a wide range of ceramic available for use in porcelain dental crowns. We are able to select nearly every shade in different strengths, hardnesses, and translucencies.
This allows us to create a restoration that will enhance your teeth and maintain their strength for many years.
Porcelain Fused to Metal (PFM)
A porcelain fused to metal crown is the same color as the surrounding teeth and has acceptable esthetic qualities. PFM crowns are strong because their substructure is made of an alloy of noble metals. After the dentist completes preparing your tooth, they will take an impression using a custom fitted tray and a material that hardens around your teeth. Laboratory technicians will use this impression to create a stone cast of your teeth and from that will make the metal substructure for your crown. Once the substructure has finished firing in an oven, technicians bake layers of porcelain over it to give it a natural, tooth like appearance. Due to the color of the metal, this porcelain must be more opaque than natural teeth and so light is not transmitted in the same way as a virgin tooth.
Gold crowns are sometimes under-utilized in today's dental world because they are not a good esthetic option. However, gold crown tooth preparation is very conservative of the existing tooth structure. Additionally, gold is very gentle on opposing teeth. For some patients, gold crowns are a proven, reliable option.
A bridge is a fixed dental restoration used to replace a missing tooth by joining an artificial tooth permanently to adjacent teeth or dental implants. Types of bridges may vary, depending upon how they are fabricated and the way they anchor to the adjacent teeth. Conventionally, bridges are made using the indirect method of restoration.
Complete or partial dentures can replace your missing teeth and give you the confidence to smile. Dentures can be used to replace teeth that have been lost due to trauma, decay, or gum disease. It is important to replace missing teeth, not only because teeth help with eating food, but because they help support the facial muscles and are critical for speech.
There are two different types of removable full dentures; immediate and conventional. Immediate dentures are typically made when the patient’s existing natural teeth are being removed and the new dentures are delivered the day of the extractions. Conventional dentures are typically made when existing dentures are being replaced.
A partial denture is a removable dental appliance that replaces multiple missing teeth. It can be attached to the teeth with clasps, which are like small metal “c” clamps that hug nearby teeth, or may be attached to teeth with crowns with precision attachments (hidden clasps). Both types typically have a metal framework and plastic teeth and gum areas. A temporary partial dental may have a plastic base with no metal.