Dental materials: role of the Dental materials: role of the filling, classification, filling, classification,

temporary and permanent temporary and permanent filling materialsfilling materials

Conservative treatmentConservative treatment of caries, when of caries, when the pulp is vital and unexposed, is by the pulp is vital and unexposed, is by filling.filling.

If the pulp si exposed or dead, If the pulp si exposed or dead, root root canalcanal therapytherapy is usually necessary is usually necessary before the filling is done.before the filling is done.

Dental materialsDental materials What is a Filling?What is a Filling? A filling is a way to restore a tooth damaged A filling is a way to restore a tooth damaged

by decay back to its normal function and by decay back to its normal function and shape.shape.

Dental fillings are dental materials that have Dental fillings are dental materials that have been used to repair a decayed tooth. been used to repair a decayed tooth.

The tooth is first prepared using dental drills to The tooth is first prepared using dental drills to remove decay and create space for the dental remove decay and create space for the dental material of choice – then the material is material of choice – then the material is inserted .inserted .

The normal function of the tooth is The normal function of the tooth is thereby restored, pain is prevented, and thereby restored, pain is prevented, and the vitality of the pulp is preserved.the vitality of the pulp is preserved.

In frontIn front teeth, fillings restore normal teeth, fillings restore normal appearance, in appearance, in backback teeth, stagnation teeth, stagnation areas can be eradicated and further areas can be eradicated and further caries prevented. caries prevented.

Which Type of Filling is Best?Which Type of Filling is Best?

No one type of filling is best for everyone.No one type of filling is best for everyone. Each has its advantages and Each has its advantages and

disadvantages, and where and when it disadvantages, and where and when it can be used.can be used.

The location and size of the decay often The location and size of the decay often limits your options.limits your options.

Dental materials are grouped Dental materials are grouped

into two main categories:into two main categories: A) A) Temporary Fillings:Temporary Fillings: These are inserted as a temporaryThese are inserted as a temporary

measure only. They are too soft to usemeasure only. They are too soft to use as permanent fillings.as permanent fillings. The temporary fillings are:The temporary fillings are: - Zinc oxide and eugenol cement- Zinc oxide and eugenol cement - Zinc phosphate cement- Zinc phosphate cement - Zinc polyacrylate cement- Zinc polyacrylate cement - Gutta-percha- Gutta-percha

Generations of Cements

Zinc Phosphate Polycarboxylate Glass Ionomer

Resin-Modified Glass Ionomer Composite CementWhat do you use ???

Temporary FillingsTemporary Fillings

They are not used as permanent fillings They are not used as permanent fillings as they are too soft and soluble and as they are too soft and soluble and would not remain intact for long periods.would not remain intact for long periods.

Calcium hydroxide cannot be used as a Calcium hydroxide cannot be used as a temporary, it is an excellent cavity lining. temporary, it is an excellent cavity lining.

Uses of Temporary FillingsUses of Temporary Fillings

1.1. As a first-aid measure to relieve pain,As a first-aid measure to relieve pain,

2.2. When there is insufficient time to When there is insufficient time to complete the cavity and insert a complete the cavity and insert a permanent filling in one visit,permanent filling in one visit,

3.3. For permanent fillings requiring more For permanent fillings requiring more than one visit, e.g. inlays, crowns, a than one visit, e.g. inlays, crowns, a temporary restoration is necessary temporary restoration is necessary between visit.between visit.

Purpose of Cavity LiningsPurpose of Cavity Linings

1.1. Protection of pulp against thermal Protection of pulp against thermal shock, i.e. conduction of heat or cold shock, i.e. conduction of heat or cold through metal fillingsthrough metal fillings

2.2. Protection of pulp against chemical Protection of pulp against chemical

irritation of non-metallic fillingsirritation of non-metallic fillings

ZOE- zinc oxide eugenolZOE- zinc oxide eugenol Temporary medicated fillings (zinc oxide Temporary medicated fillings (zinc oxide

eugenol or ZOE) can be used when a eugenol or ZOE) can be used when a tooth is too sensitive with a regular filling tooth is too sensitive with a regular filling and the dentist wants to see if it will calm and the dentist wants to see if it will calm down before putting a permanent filling down before putting a permanent filling back in, or he may think you need one to back in, or he may think you need one to begin with for a while before he puts in a begin with for a while before he puts in a permanent permanent

Temporary fillings are made of two major Temporary fillings are made of two major componentscomponents::

Oil of clove (eugenol), which has been used for Oil of clove (eugenol), which has been used for centuries to relieve toothaches, and Zinc Oxide centuries to relieve toothaches, and Zinc Oxide powder.powder.

Zinc oxide is an excellent disinfectant. The oil Zinc oxide is an excellent disinfectant. The oil and oxide mix together to make a stiff paste and oxide mix together to make a stiff paste that eventually hardens into a waterproof that eventually hardens into a waterproof substance which soothes the nerve of the tooth substance which soothes the nerve of the tooth and kills germs while protecting the cavity like and kills germs while protecting the cavity like a hard band aid. When used as a temporary a hard band aid. When used as a temporary filling material or cement, this material is called filling material or cement, this material is called “zinc oxide and eugenol”, ZOE for short “zinc oxide and eugenol”, ZOE for short

ZOE - AdvantagesZOE - Advantages

It is also used as a temporary filling and as a It is also used as a temporary filling and as a non irritant lining for very deep cavities. It is non irritant lining for very deep cavities. It is also used as a permanent root filling. In also used as a permanent root filling. In addition it is often used as a sedative dressing addition it is often used as a sedative dressing for dry sockets and gingivectomy.for dry sockets and gingivectomy.

Disadvantages:Disadvantages: It is too soft to use it for a permanent fillingIt is too soft to use it for a permanent filling It is not compatible with every kind of non It is not compatible with every kind of non

metallic fillingmetallic filling

Zinc phosphate cementZinc phosphate cement

Contains zinc oxide powder and phosphoric Contains zinc oxide powder and phosphoric acid liquid, which must be mixed together to acid liquid, which must be mixed together to the creamy consistency.the creamy consistency.

UseUse as a cavity lining for amalgam fillings and as a cavity lining for amalgam fillings and permanent root filling and in prosthetics as a permanent root filling and in prosthetics as a adhesive cement for cavities and crowns.adhesive cement for cavities and crowns.

AdvantagesAdvantages- it is drying quickly and is enough - it is drying quickly and is enough adhesive to be layed under inlays and crowns.adhesive to be layed under inlays and crowns.

Disadvantages-Disadvantages- it is irritant in the deep cavities, it is irritant in the deep cavities, that´s why has to be sub- lined by the calcium that´s why has to be sub- lined by the calcium hydroxyde.hydroxyde.

Bad adhesivity to a wet cavity.Bad adhesivity to a wet cavity.

Zinc polyacrylate cementZinc polyacrylate cement

Contains zinc oxide powder and Contains zinc oxide powder and polyacrylic acid liquid.polyacrylic acid liquid.

UseUse as an alternative of zinc phosphate as an alternative of zinc phosphate cement.cement.

AdvAdv.: it is less irritant and more adhesive .: it is less irritant and more adhesive than the zinc phosphate cement. than the zinc phosphate cement. Because of it´s adhesivity it is more Because of it´s adhesivity it is more difficult to prepare it.difficult to prepare it.

GUTTA-PERCHAGUTTA-PERCHA Contains eucalyptus and petroleum oil. It is Contains eucalyptus and petroleum oil. It is

supplied in white or pink sticks.supplied in white or pink sticks. UseUse: as a temporary filling for inlay cavities: as a temporary filling for inlay cavities - vitality tests- vitality tests - permanent filling for root canals- permanent filling for root canals - temporary obturator for cleft palates and - temporary obturator for cleft palates and

cyst cavities cyst cavities - lining for Gunning splints- lining for Gunning splints AdvAdv.: it needn´t to be mixed and hardens .: it needn´t to be mixed and hardens

immediatellyimmediatelly DisadvDisadv.: it is too soft and decomposes if left in a .: it is too soft and decomposes if left in a

cavity too long.cavity too long.

Calcium HydroxideCalcium Hydroxide

Contains Calcium hydroxide powder and water Contains Calcium hydroxide powder and water as liquidas liquid

Use:Use: as a cavity lining. It promotes formation of as a cavity lining. It promotes formation of secondary dentine and repair of hard tissue, secondary dentine and repair of hard tissue, and is also used for pulp capping, pulpotomy and is also used for pulp capping, pulpotomy and other root treatment procedures.and other root treatment procedures.

AdvAdv: non irritant, can be used in deepest : non irritant, can be used in deepest cavities and it is compatible with all materialscavities and it is compatible with all materials

DisadvDisadv: sub.lining only, in deep cavities under : sub.lining only, in deep cavities under metal fillingsmetal fillings

B) B) Permanent Fillings:Permanent Fillings: Permanent fillings fall into two

categories based on the method used to place them: They are:

A) direct restorations B) indirect restorations

A) Direct restorations are fillings placed immediately into a prepared cavity in a single visit.

They include dental amalgam, glass ionomers, resin ionomers and most composite (resin) fillings. The dentist prepares the tooth, places the filling and adjusts it during one appointment.

( next lectures)( next lectures)

B)B) Indirect restorations may require two or more visits. They include inlays, onlays, veneers, crowns and bridges fabricated with gold, ceramics or composites. During the first visit, the dentist prepares the tooth and makes an impression of the area to be treated. The impression is sent to a dental laboratory, which creates the dental restoration (filling). At the next appointment, the dentist cements the restoration to the prepared tooth and adjusts it as needed.

Dental amalgam The word “amalgam” when referring to

dental fillings means a mixture of two or more metals in which mercury is a component.

Dental amalgam is a mix of approximately 43 percent to 54 percent mercury with other metals, including silver, copper and tin. Today,amalgam is used most commonly in the back teeth. It is one of the oldest filling materials and has been used (and improved) for more than 150 years.

AmalgamAmalgam

CompositComposite (resin)e (resin) Composite is a mixture of acrylic resin

and powdered glass-like particles that produce a tooth-colored filling. This type of material may be self-hardening or may be hardened by exposure to blue light. Composite is used for fillings, inlays and veneers. Sometimes it is used to replace a portion of a broken or chipped tooth.

CompositeComposite

Glass IonomerGlass Ionomer

Glass ionomers are tooth-colored materials made of a mixture of acrylic acids with fine glass powders that are used to fill cavities, particularly those on the root surfaces of teeth. They are primarily used for small fillings in areas that need not withstand heavy chewing pressure. Glass ionomers also are used to cement dental crowns.

Thank you Thank you

for your attentionfor your attention