Esthetic fillings

Esthetic fillings allow direct restoration of damaged tooth tissues, adjustment of tooth shape, color and minor malpositions. If large restoration is needed, esthetic prosthetics is recommended instead. Prior to correcting minor malpositions with esthetic composite fillings, teeth need to be prepared, significantly reducing the amount of healthy tooth tissues. If teeth are intact, such procedure is considered harmful. In need of teeth straightening (in most cases), as well as bite corrections (always), it is better to choose orthodontic treatment.

Natural tooth consists of several layers, differing in color, transparency and hardness. When restoring a tooth, composite filling is precisely layered in order to maximally replicate the esthetic appearance of a natural tooth. Tooth shape is restored to be functional and esthetic. This teeth restoration method is maximally conservative, since only damaged and non-esthetic looking tissues are removed. To achieve optimal moisture control, special rubber dam is used. Optimal moisture control determines excellent durability and adhesion of the filling material. Our dental professionals “jewelers” will do everything to ensure that restorations are correctly chosen, esthetic and long-lasting.

When to choose one?

There is also no unanimous opinion among dental professionals on this issue. Aesthetic prosthetics with metal-free restorations is much more widely used in Western countries (Europe, USA, Japan), while aesthetic restorations are very common in the countries of the former USSR. The medical indications for aesthetic restorations should be minor crown defects. In the case of larger defects, aesthetic restorations are more appropriate. To help patients decide, here are some facts and research data on the various modern materials used for restorations and restorations.

• A composite filling (“helium filling”) is a light-cured plastic with a glass filling.
• Metal-free restoration (porcelain crown, laminate (veneer), inlay, overlay) – porcelain with glass filling (cast ceramics) or pure porcelain (polished ceramics based on alumina or zirconia).

The human teeth experience huge, long-term, constant mechanical load. Therefore a vast number of scientific studies use the knowledge about strength of materials to evaluate and compare the longevity and resistance to load and overload of various fillings and restorations. In reality, however, objective data is often distorted or biased.

Of many complex scientific studies the easiest to understand is bending resistance test (“walnut” test) and wear resistance test.

The “Walnut test” measures the resistance of a filling or restoration to fracture when subjected to a point force – similar to biting a nut, carrot or other hard object.

Wear is also measured in a number of ways, most commonly by simulating many chewing cycles under laboratory conditions. It should be stressed that both modern restorative materials and, in particular, ceramic restorations have good or even excellent mechanical properties and are constantly being improved.

Even the best filling materials have bending resistance of only 100 – 150 MPa. Glass infiltration ceramics (porcelain) has bending resistance of 200 – 400 MPa, crystalline aluminum oxide ceramics – 500 MPa, zirconium oxide/yttrium ceramics (often referred to as “ceramic steel”) even surpasses many metals with bending resistance of over 1000 MPa. It is considered that chewing load (bending strength) approximately equals 400 – 450 MPa per human molar, 200 – 250 MPa per premolar and 100 – 150 MPa per frontal tooth. In case of parafunctions and/or traumatic bite, chewing load can double. This must be considered when selecting the restorations.

Composite fillings wear approximately two times faster than natural teeth. Porcelain restorations wear at the same rate as teeth enamel, or even slower. Therefore, if large area of the tooth is restored with filling, the patient should not expect a perfect surface gloss to last longer than a few months.

If the defect is large (the entire surface of frontal tooth needs to be covered or more than half of the molar tooth crown needs to be rebuilt), the expedience of esthetic filling always is highly questionable. In such cases composite restorations are not strong enough, so ceramic restorations should be chosen instead. A claim that esthetic composite filling is always the most conservative option can be false in cases, when, prior to correcting malpositions or restoring large defects, a large portion of tooth tissues needs to be reduced. In such cases the preparation is not any less than the one before prosthetics. Even the most modern fillings wear about two times faster than the natural tooth enamel. Fillings lose gloss in frontal teeth area and cause occlusal height descent in molar teeth area. Esthetic fillings need to be polished periodically to renew the surface microstructure and to restore gloss.

Occlusal height mainly depends on molars. Thus, if several molars have large fillings, this may lead to total occlusion atrophy and temporomandibular joint pathology over the years. It is a serious problem requiring complex treatment.

You have the right to expect a high quality of dental restorations. It has to serve and to look like your own teeth:

• Look natural and beautiful
• Be biologically compatible
• Be strong and durable, long-lasting
• Harmonize with your natural teeth