Fillings, Inlays & Co

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Fillings, Inlays & Co
Fillings, Inlays & Co

Video: Fillings, Inlays & Co

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Video: Dental inlays and onlays © 2023, January
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Fillings, inlays & Co

Teeth that have been damaged by injury or tooth decay can be treated using various methods. The aim is to close the defect, restore the normal function and shape of the tooth and protect it from caries attack. The spectrum of available filling materials for fillings, inlays etc. ranges from tried and tested materials such as and gold to modern plastics (composites) and ceramics…

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  • Continue reading
  • more on the subject
  • Advice, downloads & tools
  • Types of tooth-preserving treatment
  • amalgam
  • Plastic (compomer and composite)
  • gold
  • Ceramics
  • Galvanic ceramics
  • Whom can I ask?
  • How are the costs going to be covered?

Types of tooth-preserving treatment

A distinction is made between different types of tooth-preserving treatment depending on the manufacturing process.

  • Conventional fillings in a soft consistency are placed directly into a cavity of the tooth - a hole that the dentist widened, smoothed and cleaned with drills - using shaping aids, where they then harden. Materials such as amalgam and plastic are most commonly used.
  • Inlays, onlays and overlays are manufactured in the dental laboratory. These are precisely fitting workpieces that are glued into the tooth that has been appropriately ground by the dentist. The boundaries between these three types are fluid. The main materials used are gold, ceramics, galvanic ceramics (combination of gold and ceramics) or plastic (composite).

    • Inlays are characterized by the fact that their marginal areas lie within the chewing surface and the cusp tips of the teeth are not covered. So they only lie in the "valley" of the tooth, the tips of the teeth remain free.
    • Onlays, in turn, also cover the tips of the tooth, in other words, to put it simply, lie “on” the tooth.
    • Overlays completely enclose the tooth tips and also offer chewing edge protection. They are "above" the tooth.

There are various substances to choose from, which differ in appearance (aesthetics), durability and price.

amalgam

Amalgam fillings ("seals") are made from an alloy of mercury (50 percent) with silver, copper, indium, tin and zinc. They have been in use for more than 150 years.

  • Advantages: Amalgam is easy to process, has high wear resistance and a long service life of ten years and more. In addition, it is relatively inexpensive.
  • Disadvantages: The dark gray metallic colored amalgam can only be used on optically inconspicuous areas of the tooth for aesthetic reasons. The extent to which the body is exposed to mercury due to amalgam fillings is controversial. Many dentists advise against replacing existing fillings that are still intact because a lot of mercury is released when they are removed.

Note The daily mercury intake from amalgam fillings is lower than that from food and air. Nevertheless, amalgam fillings should not be used, for example, in pregnant women and patients with severe kidney dysfunction and proven amalgam allergy.

Plastic (compomer and composite)

Composites are used for fillings and inlays in the anterior and posterior area of ​​both milk teeth and permanent teeth. They consist of about 70 percent glass and quartz particles and about 30 percent of various plastics (especially methyl methacrylate).

  • Advantages: Composites allow the tooth-colored treatment of defects, can stabilize the tooth substance and are mercury-free.
  • Disadvantages: Composites require a time-consuming multilayer technique and are relatively expensive. They are less resilient than amalgam and therefore only suitable to a limited extent for the chewing surfaces of the molars. Usually they only last for about three to five years. They can also be discolored by coffee, tea or tobacco. Furthermore, if they have not yet hardened, they can trigger contact allergies - this problem rarely occurs in patients and primarily affects dental staff.

A compomer is a relatively new filling material used in dentistry and dental technology. It is a mixture of glass ionomer cements and composites.

According to this composition, a compomer combines the advantages, but also the disadvantages of both filling materials. Compomers are tooth-colored (opaque) and are mainly used as an alternative to gold, amalgam or ceramic fillings when only a temporary restoration of the tooth is required, for example in the deciduous dentition of children. A disadvantage is higher wear compared to composites.

gold

Gold is used in alloys with harder metals such as platinum, palladium, silver, copper, iridium etc. for fillings, inlays, onlays and overlays.

  • Advantages: High stability and resilience ensure extremely long durability even in the heavily used molars. The chewing pressure deforms the material in such a way that it is “pressed” into the tooth and thus has an otherwise unattainable tightness. Gold is very well tolerated and allergic reactions are extremely rare.
  • Disadvantages: The inadequate aesthetics significantly limit the applicability of gold in visible dentition areas. In addition, both the manufacture and the material itself are relatively expensive.

Ceramics

Ceramic is used for the production of tooth-colored inlays, onlays and overlays, especially in the case of large tooth defects. It consists of quartz crystals that are embedded in a base mass of feldspar.

  • Advantages: Ceramic is better tolerated, harder and therefore more durable than plastic and does not discolour. The bond with the tooth material and the ceramic stabilizes weakened tooth walls.
  • Disadvantages: Plastic adhesives are required to attach ceramic to the tooth, which can cause contact allergies, especially in dental staff. Nowadays, gloves are mostly worn. Another disadvantage is the high manufacturing costs.

Galvanic ceramics

Electroplated inlays consist of a ceramic core that is coated with a thin layer of fine gold on the surfaces facing the tooth substance, extending into the visible area. The electroplated inlay thus occupies an intermediate position between gold and all-ceramic inlays.

  • Advantages: The technique combines the aesthetic advantages of ceramic inlays with the advantage of gold cast inlays that can be used with conventional luting cements. This eliminates the need for plastic adhesives that can cause contact allergies.
  • Disadvantages: In addition to aesthetic reservations about the fine gold rims, the high costs must be mentioned. Therefore, galvanic inlays are hardly used anymore.

Whom can I ask?

Doctors for dentistry are responsible for conservative dental treatment. They also advise on the different options and any advantages and disadvantages.

How are the costs going to be covered?

The costs for amalgam fillings in the posterior region as well as plastic fillings in the anterior region (in individual cases, for example, in the case of proven allergies also in the posterior region) are covered by the social security agencies. If, in a medically justified individual case (e.g. with proven allergy), filling with the contractually agreed materials (e.g. amalgams, silicate and stone cements, composites, etc.) cannot be used, the social insurance carriers will provide a subsidy for some other forms of treatment.

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