Restorative Options (Which Where and When)
With the advancement in dental technology, there has been a proliferation of new restorative materials and techniques to restore decayed or fractured teeth.
At Contemporary Smiles, we offer our patients the benefit of these technological advancements by ensuring we partake in further education and by investing in the latest technologies, such as the CEREC Omincam. This enables us to provide our patients with the most thorough and comprehensive care.
As with everything, there are advantages and limitations with each technique and material. Each patient that attends our clinic with an issue that they wish to resolve, presents us with a unique set of circumstances and history. There is generally a range of options that can be employed to rectify the situation which may have differing long-term outcomes and require different levels of investment of resources.
During our initial consultation, we advise the patient on the most appropriate restorative option that will suit their individual need.
We take into account the following:
- Current medical history: to assess any underlying systemic issues that could contribute to the dental issue, such as dry mouth and the associated increase in risk of decay
- Dental history: What has happened in the past and why? How frequently are the restorations failing? This can help indicate further risk
- Thorough radiographic and clinical examination with our digital radiography and intraoral photographs
- Caries (tooth decay) risk assessment
- Wear risk assessment.
Once we have completed the assessment, we provide our patients with a clearer picture of what is the most appropriate restoration for their specific situation to give the best long-term outcome. The objective is always to place a restoration that has the highest probability of lasting into the long-term. As the more frequently a tooth is treated the poorer the prognosis of that tooth into the future.
The types of restorative materials that we currently use at Contemporary Smiles fall into three major categories:
- Composite resin restorations
- Ceramic restorations
- Metallic restorations.
Although restorative materials have advanced greatly, the ideal scenario is that no restorative material need be used at all. Nothing will approach the integrity and the perfection of a fully intact tooth.
The rationale for treatment is that if we do not intervene to restore the tooth the cavity or crack will progress towards the pulp of the tooth, which will eventually lead to pain, infection and removal of the tooth. The very fact that a restoration is required compromises the tooth from the outset, which is why prevention is always our preferred option.
Ceramic is an excellent restorative material that can be used in a wide variety of clinical conditions.
Ceramic Restorations are a highly aesthetic material that have excellent durability and can also be used in Cosmetic Dentistry to create beautiful smiles.
They are also used to maintain the functionality of the back teeth.
At Contemporary Smiles we have invested in the latest technology for Ceramic inlays, onlays and crowns called the CEREC Omnicam system. This system allows us to three dimensionally scan a prepared tooth, design a crown and mill the restoration from a ceramic block on site in our Corrimal Practice.
We then bond the ceramic restoration to the underlying tooth structure that forms a very durable bond as evidenced by clinical research and our own clinical experience.
For the convenience of our patients, this ceramic inlay, onlay, overlay or crown is all completed on the same day and typically takes 90 minutes to complete.
- Durability – Many years of clinical, evidenced based research suggests excellent long term outcomes when using ceramic restorations in a wide range of clinical conditions.
- Conservative of the tooth structure – we generally use the Cerec Ceramic system in teeth with extensive damage or which are symptomatic due to Cracked Tooth Syndrome. We can very effectively adhere the ceramic restoration to the tooth which means we are able do more conservative preparations than traditional crown preps, which relied more on mechanical retention, to achieve the same clinical outcome. The rationale is that the more remaining tooth structure that is present, the better the overall prognosis.
- Aesthetic – materials blend seamlessly with the surrounding tooth structure
- Cost effective – over the long term due to the decreased need for re-treatments
- Higher initial cost
Composite Resin Restorations
Composite Resin Restorations are the most commonly used material at Contemporary Smiles. Composite Resins are applied directly to the tooth and “cured” in situ with light activation.
Modern Composite Resins come in a variety of colours allowing us, with the correct technique, to blend restorations seamlessly with the remaining tooth structure.
Direct Composite Resins are bonded to the tooth structure with adhesive and are ideal for small to medium sized cavities with good quality tooth structure.
- Aesthetic appeal
- Bonded to the tooth thus allowing for a more conservative preparation of tooth structure
- Flexes similarly to tooth, therefore is can be less aggressive in terms of proliferation of cracks in the underlying tooth
- Excellent longevity when used appropriately and in the right situations
- The durability of the restoration decreases the bigger the restoration becomes
- The durability of the bond may decrease over time when bonded to poor quality tooth structure
- Not ideal for those who are particularly high risk of developing further tooth decay as they may fail more quickly than the alternatives.
We take a lot of pride in what we do here at Contemporary Smiles. We enjoy restoring a tooth to its natural shape, contour and colour.
We adhere strictly to clinical protocols to ensure the best outcome with any restorative material and this is particularly necessary when using composite resin. Composite Resin can also be used for the restoration of front teeth, for more detailed information please refer to the cosmetic section of this website.
Amalgam restorations have been used in dentistry for well over a hundred years, and therefore have a long track record. While Amalgam is not our first choice restorative material here at Contemporary Smiles, it is still part of our armamentarium.
- Cost effective
- Durability proven by its long term track record
- Relies on mechanical retention, therefore can be used where moisture control is difficult or where the remaining tooth structure is of poor quality which may adversely affect the durability of bonding long term
- Effective for people with rampant caries
- To create retention we need to remove more tooth structure
- Flexes differently to the underlying tooth which can cause more aggressive crack proliferation over time
- Can result in increased sensitivity post placement
Although Amalgam has been implicated in the media as the source of systemic health issues, this has been studied extensively and has been shown to be without foundation. We tend to use amalgam in situations where we feel that a resin restoration would not safely have long term durability and is a more cost effective solution to ceramic.
Here at Contemporary Smiles, one size does not fit all. We employ our knowledge of dental materials, expertise in their application and in consultation with our patients, we will determine the right fit for that individual.