Porcelain Inlays & Replacing Metal Fillings
Old unsightly metal fillings?
Hate those ugly, black fillings?
Worried about the mercury in your fillings?
It may be time to replace your old, failing amalgam fillings with new white fillings.
White fillings are much kinder to teeth than the old, metal fillings. They are bonded to the teeth, making the tooth structure as strong as possible.
Because metal fillings aren’t adhesively bonded to the teeth like white fillings, the cavity has to be undercut to retain the amalgam filling, this means more loss of tooth structure.
Metal expands and contracts with temperature, and so do the metal fillings, this often causes pieces of the remaining tooth structure to become brittle and break off.
White restorations, not only look like tooth structure, but they make the tooth much stronger.
There are 2 types of white restorations that can be used:
- white fillings placed at the chairside (composites)
- ceramic / porcelain inlays which are made in a dental laboratory
How long will an Inlay or white filling last?
Although no dental restoration lasts forever, the average lifespan of an inlay is around 10 years, they can actually last up to 30 years or more with proper care. One reason why a 10 year mark is given is because a dentist can usually provide patients with this number and be confident that an inlay that the dental lab makes will last at least this long.
Well placed white fillings can have the same expected lifespan.
All who are familiar with dentistry will agree that the most important factor affecting the lifespan of any restorative is the continuing oral hygiene performed by the patient. Similar to almost anything, a poorly-made object can last well past its predicted lifetime if it is properly cared for, and even a well-made item can last only a relatively short time if handled improperly. Other factors depend on the skill of the dentist and his lab technician, the material used and appropriate treatment planning and case selection.
White Composite Fillings
When the cavity is relatively small, a chairside composite or white filling can be placed.
It is an easy procedure involving only one dental visit.
What will happen during the appointment?
The area to be worked on will need to be anaesthetised. Once the area is numb, the dental drill will be used to create a cavity or to remove the old filling, this will only take 5 minutes per tooth.
Once a nice clean cavity is achieved, then we can start to place the new white restoration. A bonding agent will be used in the base of the cavity this gains adhesion between the tooth and filling. The white filling will then be built up incrementally, setting the filling between applications with a high intensity light.
We will then polish the filling, making sure that it fits neatly within your bite.
When the cavity is larger, occupying one or more of the walls of the tooth, it is necessary to make an inlay rather than using a chairside composite.
Inlays are made in the laboratory where they are heat and pressure cured, this makes them a single, strong, nugget of filling. The technician is also able to get the contacts between the teeth absolutely perfect, this is much harder to achieve when building up with white filling material.
If the dentist thinks that an inlay is more suitable in your case, he will let you know. After all the minimum of dentistry is always the best. If the restoration is done in the best way possible first time, then there is less chance of failure, and the restoration will last longer.
What will happen during the appointment?
Appointment 1, ‘the inlay preparation’
The area to be worked on will need to be anaesthetised. Once the area is numb, the dental drill will be used to create a cavity, or to remove the old filling. This will take approximately 5-10 minutes per tooth.
Once we have got a nice, clean cavity, an impression can be taken (this will be sent to laboratory to have your cast piece made). The impression takes around 5 minutes to set completely.
We then place a temporary filling, which is set with the high intensity light.
Appointment 2, ‘the inlay fit’
Local anaesthetic will need to be given again today. The tooth is live, and would be too sensitive once the temporary is removed otherwise.
The temporary will be removed, then the new inlay tried in for size. Any minor adjustment can, if necessary be made to the cavity or inlay by the dentist at this stage.
The tooth will then be disinfected, then cement syringed into the cavity and inlay pressed into place. Once any excess cement has been cleaned off by flossing the contact points, the cement can be set with the high intensity light.
The height of the inlay can, if necessary be adjusted at the end.