Dr. Maneesh RaiBDS 

Smile Designig   Implants   Orthodontia   General Dentistry

Types of Fillings

Dental Fillings The very next step after decay is removed from a tooth is that something must be placed in that space to give strength back to the tooth. 

Fillings : 
Fillings are the best and most common restorative procedure.

Inlays and onlays : In addition to fillings, lab fabricated inlays and onlays are also sometimes used. Although many patients think of these as fillings as well, they are actually different since they are laboratory fabricated. 

White fillings : 
The most popular kind of 'white filling' is called a Composite filling. It is made up of a composite quartz resin (glass and porcelain) and usually contains some sort of light sensitive agent that is used during curing. They are an attractive, durable alternative to silver (amalgam) fillings. In the past, white fillings were placed only on front teeth, but recently these composite materials have been specifically designed to be able to survive the pressure of grinding when you chew.  These light cured composites are best looking and in most cases they can be inserted in one appointment. 

Silver (amalgam) fillings: 
Today, the use of white composite resin fillings is more in vogue by most dentists. The principal components of amalgam is Silver alloy and Mercury. American Dental Association has declared Silver amalgam fillings as totally safe and they continue to be in use . Gamma-2-free amalgams continue to be used today because they are hard, durable and inexpensive, There may  be unique circumstances that call for a silver (amalgam) filling, like placing on back teeth (molars).

White Porcelain inlay or onlay : This is used when cosmetics and wear resistance is most important for a patients. A porcelain inlay or onlay is used when the cavity is too big for a filling, but isn't so big that a crown is required. An inlay is a filling within the cusp tips of the tooth. Onlays (also known as overlays) will overlay one or more cusps in order to protect and strengthen the tooth. This type of filling costs about the same as an indirect composite inlay/onlay and takes two visits. 

An inlay or onlay may also be made of gold. Gold fillings despite being expensive, have long history of use with excellent durability, wear well, and do not cause excessive wear to the opposing teeth. But they do conduct heat and cold making its presence felt in the mouth. Recent advances has brought consumer focus on aesthetic results of composites and procelain veneers and crowns. 

Glass Ionomer Fillings: It is a filling material that is tooth colored and contains strontium, phosphate and fluoride ions. These fillings are a mixture of glass and an organic acid. They are also tooth-coloured but vary in translucency. Glass ionomer fillings are less aesthetic in result as compared to what is achieved by composite resins.

As far as the cavity filling preparation is concerned, glass ionomer is comparable to the composite resin. Glass ionomer is considered fairly conservative procedure as it disturbs fairly less tooth structure. This filling material interacts with the enamel and dentin and actually allows the tooth tissue to remineralize at the filling interface. This provides a true biological and chemical seal with the tooth. It is good for those who feel sensitivity with the rest of their otherwise healthy looking teeth. 

The glass ionomers are chemically set and require no light cure to harden the material once placed in the cavity preparation. It however need time to fully set and harden. The glass ionomers advantage over composite resins include no shrinkage and micro leakage as bonding is acid-base reaction and not a polymerization reaction; Glass ionomers contain and release fluoride that helps prevent carious lesions; Glass ionomer has less wear as compared to composite resins.