Esthetic fillings

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.

Esthetic fillings: Before and After:

Prieš estetinį plombavimą Po estetinio plombavimo

When to choose esthetic fillings and when esthetic prosthetics?

Dental professionals do not have the unanimous opinion on this matter. All-ceramic restorations are widely used in western countries (Europe, USA, Japan) while in post-soviet countries esthetic fillings are preferred. Only lesser tooth defects should be restored with composite fillings. In case of big tooth defects, esthetic prosthetics is recommended instead. Here we present some facts and research data on various modern filling and restorative materials, which should help our patients to make a decision.  

  • Composite filling – light curing resin with incorporated glass particles.
  • Metal-free (all-ceramic) restoration (porcelain crown, veneer, inlay, onlay) – porcelain with incorporated glass particles (“cast ceramics”) or pure porcelain (aluminum oxide or zirconium oxide-based ceramics).

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.

Walnut test:

Biting nuts, carrots or other solid objects generate stress to particular parts of the restoration or filling. Common everyday situation is recreated during the test, measuring the resistance to fracture under a concentrated force.

Estetinio plombavimo testas

Wear resistance is also measured in many ways, most often by simulating a number of chewing cycles in laboratory conditions. It should be emphasized that both modern filling materials and ceramic restorations (particularly) have good or even excellent mechanical properties and are constantly evolving.

However, different materials have different characteristics and, naturally, different purpose.

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.

Esthetic fillings: just after the procedure, 3 months after the procedure

Iš karto po estetinio plombavimo    3 mėn. po estetinio plombavimo
Just after the procedure             3 months after the procedure
(Source: International Esthetic Restoration Contest “Prisma”

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.

Thus, the wrong choice of treatment can lead to serious medical complications. Restoring entire tooth with fillings, when large defect is present or only roots are remaining, as it is sometimes suggested, is contraindicated and should not be done in any case. The strength of composite fillings is totally insufficient in such situations and long-term perspective will not be good. However, composite fillings are strong enough to restore small dental defects when necessary support comes from remaining healthy tooth tissues.

Patients often prefer esthetic composite fillings as a cheaper alternative, even in the event of a serious tooth defect. However, in such case, they must be properly informed that with time esthetics of composite fillings changes and additional risks such as restoration chipping or fracture arise.

Considering the nature of the material, esthetic composite fillings should not be used in complex and expensive cases. We offer all latest esthetic procedures. Our treatment is based on innovation and scientific evidence, thus we can help you chose the most appropriate high quality restoration.

High quality dental restoration is a good investment:

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

Find out the cost of esthetic composite fillings here.

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