Dental Restoration Treatment

A dental restoration or dental filling is a treatment to restore the function, integrity, and morphology of missing tooth structure resulting from caries or external trauma as well as to the replacement of such structure supported by dental implants.

They are of two broad types—direct and indirect. Restoring a tooth to good form and function requires two steps:

(1) preparing the tooth for placement of restorative material or materials, and

(2) placement of these materials. The process of preparation usually involves cutting the tooth with a rotary dental handpiece and dental burrs to make space for the planned restorative materials and to remove any dental decay or portions of the tooth that are structurally unsound.

The prepared tooth, ready for placement of restorative materials, is generally called a tooth preparation. Materials used may be gold, amalgam, dental composites, glass ionomer cement, or porcelain, among others.

Preparations may be intracoronal or extracoronal. Intracoronal preparations are those which serve to hold restorative material within the confines of the structure of the crown of a tooth. Examples include all classes of cavity preparations for composite or amalgam as well as those for gold and porcelain inlays. Intracoronal preparations are also made as female recipients to receive the male components of Removable partial dentures.

Extracoronal preparations provide a core or base upon which restorative material will be placed to bring the tooth back into a functional and aesthetic structure. Examples include crowns and onlays, as well as veneers.

Direct restorations

This technique involves placing a soft or malleable filling into the prepared tooth and building up the tooth. The material is then set hard and the tooth is restored. The advantage of direct restorations is that they usually set quickly and can be placed in a single procedure. The dentist has a variety of different filling options to choose from. A decision is usually made based on the location and severity of the associated cavity. Since the material is required to set while in contact with the tooth, limited energy (heat) is passed to the tooth from the setting process.

Indirect restorations

In this technique, the restoration is fabricated outside of the mouth using the dental impressions of the prepared tooth. Common indirect restorations include inlays and onlays, crowns, bridges, and veneers with a dental cement. It is often done in two separate visits to the dentist. Common indirect restorations are done using gold or ceramics. Removable dental prostheses (mainly dentures) are sometimes considered a form of indirect dental restoration, as they are made to replace missing teeth. There are numerous types of precision attachments (also known as combined restorations) to aid removable prosthetic attachment to teeth, including magnets, clips, hooks, and implants which may themselves be seen as a form of dental restoration.

The CEREC method is a chairside CAD/CAM restorative procedure. An optical impression of the prepared tooth is taken using a camera. Next, the specific software takes the digital picture and converts it into a 3D virtual model on the computer screen. A ceramic block that matches the tooth shade is placed in the milling machine. An all-ceramic, tooth-colored restoration is finished and ready to bond in place.