St. James Oral Surgery, Implantology and Dental Clinic

Restorative Dentistry

Restorative dentistry is that branch of dentistry which deals with restoring tooth structure. The reasons why teeth should be restored are to remove infected dentine, to protect the pulp and avoid pain, to remove a source of cariogenic bacteria, to facilitate plaque control and to restore tooth appearance.

Tooth Fillings

Tooth fillings are further subdivided into crown and root fillings.

The crown of a tooth can be restored either by tooth-coloured restorations which are termed composites, or else by a silver-grayish material which is amalgam.

Composites consist of a mixture of resin and filler. The main indication for composites is in the restoration of anterior teeth, obviously being tooth coloured. However special composites are also available which are strong enough to be used on posterior teeth.

Amalgam, conversely, is an alloy of mercury with silver and other metals. Because it is a  silver-grayish colour its’ use is limited to posterior teeth.
Also, amalgam is strong in bulk, and therefore is more adept to be used in large cavities.

Root fillings on the other hand are needed when caries reaches the pulp of the tooth. In these cases, a root canal treatment needs to be carried out and this is normally done in 3 stages. In the first visit, the pulp of the tooth is exposed and removed. Next, the root canal is cleaned and shaped in a manner in which it can be filled, and finally the root canal is sealed. The material used to fill root canals is gutta percha. This is a form of rubber obtained from tropical trees.

Prosthodontics

Prosthodontics are categorized into fixed and removable. Fixed prosthodontics are essentially bridges whilst removable prothodontics are dentures.

Fixed prosthodontics is the art and science of restoring damaged teeth with cast metal, metal-ceramic or all ceramic restorations, and of replacing missing teeth with a fixed prosthesis. Traditionally, cast metal or ceramic-metal restorations were deemed to be the strongest restorations; however the use of a metal substructure at the expense of aesthetics.

Nowadays, a new ceramic material, Procera AllCeram, with universal anterior and posterior applications, has been introduced. This material makes it possible to produce all ceramic restorations which have a very high aesthetic value whilst in the same time having adequate strength. In addition, the absence of metal substructure not only has the potential to produce a restoration with superior aesthetics, but also one with enhanced biocompatibility.

Removable prosthodontics, on the other hand, can be made either from acrylic or from chrome-cobalt. The advantages of chrome-cobalt denture is very thin therefore it is lighter and easier to clean, and finally metal, being a good conductor, will transmit hot and cold and so sensation in the mouth is not lost.