dental materials

imogendental.co.ukmember

dental materials

imogendental.co.uk

AmalgamAmalgam is the least expensivematerial for filling a cavity. It is alsovery strong and durable. It is relativelyeasy to place and somewhat forgivingof an imperfect environment duringplacement.

Since amalgam does not bond to thetooth, it is held in place with mechanicalretention. This requires the removal ofmore tooth structure than the othermaterials available. Enamel seems tocrack around amalgam restorationsmore than other materials, which maylead to tooth fracture and the need fora crown. Amalgam is unaesthetic andgets more unaesthetic as it ages (andturns from silver to black).

Amalgam is an alloy composed ofseveral metals, specifically mercury andsome combination of silver, tin, copper,and zinc. Mercury makes up 40-50% ofthe alloy. A small amount of mercury isreleased throughout the lifespan ofthe restoration. Opinions vary aboutwhether or not this poses a health risk.

Advantages

• strong, durable and stands up tobiting force

• can be placed in one visit

• normally the least expensive fillingmaterial

• self-sealing with minimal to noshrinkage, and resists leakage

• resistance to further decay is high

• frequency of repair or replacement is low

• only material that can be used in awet environment (good for kids).

Disadvantages

• research and studies have not foundevidence of harm, but there aresome people and groups who haveraised concerns about the very lowlevels of mercury vapour released byamalgam

• amalgam scrap (waste left over afterrepairing a cavity) contains mercuryand requires special handling toprotect the environment

• can darken over time as it corrodes,but this does not affect the functionof the restorations

• placement requires removal of somehealthy tooth structures

• in rare cases, a localised allergicreaction such as inflammation or rashmay occur.

dental materials

Composite ResinComposite resins comprise most of the‘white’ or ‘tooth coloured’ fillings andare, essentially, plastic. While thematerials are constantly evolving andimproving, there currently are nocomposite resins that are as strong anddurable as amalgam, gold, orporcelain. This means that a compositeresin filling will fail sooner and need tobe replaced sooner than an amalgam,gold, or porcelain restoration.

Composite resins require perfectconditions for successful placement. Ifthe tooth cannot be kept perfectly dryduring placement, the restoration willfail. Since composite resin chemicallybonds to the tooth, it is not necessaryto remove as much tooth structurewhen preparing a tooth for acomposite resin filling, as compared toan amalgam filling.

While a composite resin restoration isvery aesthetic, it will discolour overtime and may need to be replaced if itis in an area of aesthetic concern.

Advantages

• colour and shading can be matchedto the existing tooth, composite isrelatively strong material providinggood durability in small to mid sizerestorations that need to withstandmoderate chewing pressure

• generally used on front and backteeth

• usually complete in a single visit

• moderate resistant to breakage

• often permits preservation of asmuch tooth as possible

• low risk of leakage if bonded only tothe enamel

• does not corrode

• moderately resistant to further decay

• frequency of repair is low andmoderate.

Disadvantages

• can break and wear our more easilythan metal fillings

• may need to be replaced more thanmetal fillings

• sometimes difficult and timeconsuming to place

• cannot be used in all situations

• more expensive than amalgam

• may wear faster than the enamel

• in rare cases there can be a localisedallergic reaction.

Composite bondingrepair fractured corner

Before

After

Before

After

Composite filling

dental materials

imogendental.co.uk

Glass Ionomer Glass Ionomer is similar to compositeresin and, like composite resin, bondswell to the tooth. However, it is not asstrong or durable as composite resin. Itis also not as aesthetic as compositeresin and will discolour more easily.

Glass Ionomer is, however, easier toplace than composite resin and is moreforgiving of less than perfectconditions.

This makes it a good choice for fillingsin childrens teeth. Glass Ionomers havethe added benefit that they releasefluoride for a time after placement andcontinue to absorb and release fluorideduring the lifespan of the filling.

Advantages

• tooth coloured filling

• can contain fluoride that may helpprevent further decay

• minimum amount of tooth structureremoved

• low incidence of allergic reactions

• usually complete within a single visit.

Disadvantages

• low resistance to fracture

• it is limited to non-biting surfaces

• moderate costs (costs more thanamalgam)

• as it ages this material may becomerough and plaque can build up on it

• can become dislodges

• rare localised allergic reactions.

dental materials

imogendental.co.uk

GoldThere are no materials available todaywith the longevity of gold. Gold is verydurable but, obviously, not aesthetic. Ifaesthetics are not a concern, there isno better material for restoring atooth. Gold restorations are difficultand technique-sensitive. They requiretwo appointments because therestoration is fabricated at a dentallaboratory. Also, the material itself isexpensive.

Gold Alloy

Gold alloy is a gold-coloured mixtureof gold, copper, and other metals andis used mainly for crowns and fixedbridges and some partial dentureframeworks

Advantages

• good resistance to further decay ifthe restoration fits well

• excellent durability; does notfracture under stress

• does not corrode in the mouth

• minimal amount of tooth needs tobe removed

• wears well; does not cause excessivewear to opposing teeth

• resists leakage because it can beshaped for a very accurate fit.

Disadvantages

• is not tooth coloured; alloy is yellow

• conducts heat and cold; may irritatesensitive teeth

• high cost; requires at least twodental visits and laboratory services.

dental materials

imogendental.co.uk

Porcelain is the most aesthetic of thetooth coloured restorations and it doesnot discolour or stain like compositeresin or glass ionomer. Porcelain is verystrong and much more durable thancomposite resin or glass ionomer. Italso bonds very well to the tooth.

Porcelain is actually harder thanenamel so it may cause prematurewear of the tooth opposing theporcelain restoration. Porcelainrestorations are difficult andtechnique-sensitive. They also, likegold, usually require two appointmentsbecause the restoration is made at adental laboratory.

While porcelain itself is not asexpensive as gold, the restorations aremore difficult and, therefore, moreexpensive to produce. For this reason,porcelain restorations are usually themost expensive of all restorations.Porcelain restorations are also notfeasible on primary teeth.

Porcelain fused to metal

This type of porcelain is a glasslikematerial that is ‘enameled’ on top ofmetal shells. It is tooth coloured and isused for crowns and fixed bridges

Advantages

• good resistance to further decay ifthe restoration fits well

• very durable, due to metalsubstructure

• the material does not cause toothsensitivity

• resists leakage because it can beshaped for a very accurate fit.

Disadvantages

• more tooth must be removed (thanfor porcelain) for the metalsubstructure

• higher cost because it requires atleast two visits and laboratoryservices

• the porcelain can wear with timeand also fracture.

Porcelain

dental materials

imogendental.co.uk

Zirconium CrownsZirconium crowns and bridges are sostrong they can be used anywhere inthe mouth. Zirconium crowns canwithstand the biting pressure of thefront teeth as well as back teethgrinding.

The look of zirconium crowns andbridges is so close to natural teeth thatit is hard to tell the dif ference and it isthis quality which makes it veryuseable within dental work. Zirconiumcrowns can be fixed using traditionaldental cements.

Zirconium crowns have quickly becomethe preferred material for dentalcrowns. Zirconium is a very strongsubstance that can endure wear andtear of everyday use. When looking atZirconium crowns from an aestheticpoint it is clear and very similar to anatural tooth and reflects light thesame way. This may be important ifyour new crowns are on the front ofyour mouth and it is particularlyrelevant in cases where the crown willbe seen next to the natural teeth.

Zirconium crowns will not corrode andthe normal black gum line that you cansee around a porcelain fused metalcrown, will not happen because of thestrong ceramic material used. Also thenormal too hot/cold sensations you canfeel with other crowns does notnormally occur because of the lack ofelectrical conductivity.

Before

After

dental materials

imogendental.co.uk

The E-Max crown is a type of all-ceramic crown which is preferred forits longer lasting, aesthetic qualities.This crown and the Zirconia crown areplaced due to their highly attractiveappearance which ensures that theycomplement the rest of your teeth.

It is considered a good option fordamaged, stained or poor qualityteeth.

What is an E-Max crown?

This is a type of all-ceramic crown withan appealing translucent colour whichis combined with extra strength anddurability.

This crown is made from a single blockof lithium disilicate ceramic: this is atop grade material which has beenharvested for its toughness, durabilityand opaque qualities which makes it ahighly prized crown.

You get a glass ceramic crown which istough and enduring but delicate inappearance.

Advantages

• this crown is considered to be thebest match with your own naturalteeth. The transparent colour andlifelike shape ensures that it isunlikely to be noticed amongst yourown natural teeth

• there is no metal alloy base with thiscrown which means no unsightlylooking grey line around the gum line

• they are strong, long lasting andunlikely to crack or fracture ascompared to many other types ofporcelain crowns. They are consideredto be at less risk of chipping.

Disadvantages

• the only disadvantage is to do withthe cost. A premium crown such asthis which can be fitted with minimalneed for any preparation is likely tobe more expensive than other typesof crowns

• they may not be suitable foreveryone so check with your dentistto see if this crown is available and ifit is right for you.

E-Max crowns

dental materials

imogendental.co.uk

Partial Dentures

Full Dentures

A partial denture is a removable dental appliance that replaces the missing teethin the mouth. You may need a partial denture for aesthetic reasons, or for eating,talking or to protect remaining teeth from drifting or over -erupting.

Partial dentures are removable, meaning they are not fixed and can be insertedand removed at your convenience. This works by using the remaining teeth forretention, therefore stabilising the denture so that it does not move or fall.

Partial dentures come in a few dif ferent materials; namely Acrylic, Valoplast orChrome.

Full dentures are for people without any remaining healthy teeth. T raditionaldentures rest on top of the gum line. Upper dentures remain in place with abuild up of suction that can developing between the denture and palatehowever lower full dentures constantly move around and only stay in placewith the control of your tongue, lips and cheeks. Adhesives can be used andwill help prevent the denture from slipping or moving, increasing your overallconfidence. Full dentures are not true replacements for natural teeth. Onlydentures attached to dental implants will superiorly improve stability , retentionand your ability to eat properly.

Various denture teeth are available to improve wear resistance and appearance.Please ask your dentist for details.

dental materials

imogendental.co.uk

Acrylic Partial DenturesAcrylic partial dentures are usually themost cost effective and can be madewithin a short period of time. Otheradvantages are that they can be addedto (in case you lose any more naturalteeth) and can be used as a temporarydenture before dental implants, orwhilst waiting for chrome dentures.

Some of the disadvantages are that theacrylic denture base is slightly weakerdue to its irregular shape and tend tobreak frequently, especially those madefor to replace lower teeth. In order tocounteract this, the acrylic is usuallybuilt thicker and bulky, which can takea little extra time to get used to.

Advantages

• are the most economical way toreplace missing teeth and are veryeasy to add to. Eg if you have one orseveral gaps and think that theremaining teeth may also be lost intime then an acrylic denture is oneway to have the flexibility of addingteeth without breaking the bank

• acrylic dentures can look very natural.

• can be used for replacing 1, few or allof your teeth

• quick – sometimes can be done in afew weeks (temporary dentures only)

Disadvantages

• patients who have acrylic denturesoften complain that they get foodstuck under them so they need to becleaned after every meal.

• acrylic dentures tend to move aroundduring eating and do not stay firmlyin place. Some patients use dentureglue to stick them in.

• bulky, often affect speech

• patients report that they don’t tastetheir food as well.

• upper denture usually covers some orall of the palate

• full lower denture (with all lower teeth)is impossible to eat with and will movein and out of view during speech!

• having a full upper or lower denture(or both together) will seriouslyrestrict your diet – to soft foods!

Acrylic full Acrylic partial

Acrylic v chrome

Acrylic v chrome v valoplast

dental materials

imogendental.co.uk

Chrome Partial DenturesChrome dentures are more of a longterm material for a partial denture, asthe frame and required componentsare all cast in one piece. This is just oneof the many advantages chromedentures have over acrylic dentures.

The components of a chrome partialdenture rest on soft tissue and naturalteeth therefore distributing the loadevenly during eating, helping toprotect the underlying bone.

Due to the strength of the chrome itcan be made in a smaller, moreefficient design, making it morecomfortable to wear and live with,whilst giving you the security ofknowing it has less chance ofbreakage.

Advantages

• much slimmer than acrylic ones

• stay in place better than acrylic ones(more secure)

• easier than acrylic teeth for eatingwith as they move less

Disadvantages

• more expensive to produce

• often a metal clip or clasp will showat the side of your smile

• food gets stuck under them/aroundthem (but not as badly as underacrylic dentures)

• harder to add teeth to later

• require some solid existing teeth toattach to

• not possible if there are no existingteeth to attach to

• take longer to complete than acrylicdentures

dental materials

imogendental.co.uk

Valoplast dentures (also known as ‘flexi-dentures’)Valoplast dentures are flexible and canwork to replace a small number ofteeth and fill a gap without necessarilycovering the palate.

They look and feel very much likeacrylic dentures but being slightlyflexible allows them to ‘pop’ into placewhere 2 or 3 teeth are missing butthere is still a tooth either side of thegap.

Advantages

• quick and easy to fit

• less bulky than acrylic dentures

• good for small to medium sized gaps

Disadvantages

• stain more easily than conventionalacrylic dentures or porcelain teeth

• not appropriate where a largenumber of teeth are missing eg awhole lower or upper jaw.

Valoplast 1 unit

Valoplast partialValoplast flexibility

dental materials

imogendental.co.uk

Allergic Reactions to Dental Materials Components in dental fillings may have sideeffects or cause allergic reactions, just like other materials we may come in contactwith in our daily lives. The risks of such reactions are very low for all types offilling materials. Such reactions can be caused by specific components of the fillingmaterials such as mercury, nickel, chromium, and/or beryllium alloys. Usually, anallergy will reveal itself as a skin rash and is easily reversed when the individual isnot in contact with the material.

There are no documented cases of allergic reactions to composite resin, glassionomer, resin ionomer, or porcelain. However, there have been rare allergicresponses reported with dental amalgam, porcelain fused to metal, gold alloys,and nickel or cobalt-chrome alloys. If you suf fer from allergies, discuss thesepotential problems with your dentist before a filling material is chosen.

The durability of any dental restoration is influenced not only by the material it ismade from but also by the dentist’s technique when placing the restoration. Otherfactors include the supporting materials used in the procedure and the patient’scooperation during the procedure. The length of time a restoration will last isdependent upon your dental hygiene, home care, and diet and chewing habits.

Allergic Reactions

Dr. Neel Tank & AssociatesNorth Street. Kingsclere. Berkshire. RG20 5QXT: 01635 299981 E: kingsclere@imogendental.co.uk

14 High Street. Benson. Oxon. OX10 6RPT: 01491 833380 E: benson@imogendental.co.ukImogen Dental (Benson) is part of Imogen Dental Limited. Company number: 8450290,

Registered office: 14 High Street, Benson, Oxon OX10 6RP. Director: Neel Tank .

imogendental.co.uk

Scan me to discover more

@ImogenDental

Des

ign

ed a

nd

pri

nte

d b

y Th

e A

lph

a X

per

ien

ce ·

0163

5 52

3240

· A

lph

aXp

erie

nce

.co

.uk