Types of dental fillings based on materials of manufacture and their properties. Which dental filling is better? Review of modern materials

© Sebastian Kaulitzki / Fotolia

No dental treatment is complete without filling. Today it is one of the most affordable and effective methods restoring the integrity of the crown part of the tooth.

If several decades ago only single types of materials were used for these purposes, today they surprise with their diversity. The materials differ not only in their physical characteristics, but also at cost.

What does the cost depend on?

The cost of dental filling services will depend on several factors:

Kinds

All materials used for dental restoration are divided into two groups according to their temporary purpose: permanent and temporary. Each of them has its own characteristics, differing in composition and purpose.

Temporary

Temporary materials include materials installed for a limited period. The service life of the filling will depend on its composition.

Most often, materials are used that allow fillings to be placed. for 2–5 days. But, such specimens are also used that can remain in the tooth for a long time. 3 or 6 months.

Temporary fillings are used in the treatment of the following diseases:

• pulpitis;
• caries;
• cyst;
• granuloma.

The primary role of a temporary restoration is to create a barrier that prevents saliva, food debris, and bacterial deposits from entering the inflamed pulp cavity or root canal.

They cover medicinal inlays with an anti-inflammatory effect, ensuring the penetration of the medicine into the internal dental tissues. Sometimes their installation is used to diagnose the condition of the pulp after partial extirpation and during the period of prosthetics during the manufacture of dental inlays.

To temporarily close a cavity, the material used must be resistant to moisture and not disintegrate from saliva, ensure tightness and be plastic, and can also be easily removed from the dental cavity.

The following materials meet these requirements:

1. Zinc sulfate cement (artificial dentin). It is a powder consisting of zinc sulfate and zinc oxide, as well as kaolin. This combination of components makes it possible to install a strong filling for up to 3 days. Its cost is approximately 150 rubles.
2. Dentine paste. It is based on artificial dentin in combination with petroleum jelly and glycerin, thereby increasing the plasticity of the material. Its warranty period is at least 7 days. The cost will be approx. 200 rubles.
3. Vinoxol. It is a combined material consisting of calcium, zinc, polystyrene. It has excellent adhesion and does not irritate the pulp chamber tissue.

   Due to its high mechanical strength, the material can remain in the tooth for 6 months. Its price is higher than that of previous options and on average is 400 rubles.

4. Zinc-eugenol cement. It consists of zinc and eugenol, which are mixed immediately before placement in the tooth cavity. The cement hardens within 8 hours, forming an elastic inlay that can be installed for no more than 5 days. The cost in this case will be equal to 120 rubles.
5. Polycarboxylate cement. The material is characterized by high biological compatibility with dental tissues. In addition, it prevents acids and monomers from penetrating inside.

   Used to restore the canals of permanent and baby teeth for up to 3 months. Restoration price in in this case will be within 300 rubles.

Materials are selected individually in each case, depending on the type dental disease and the patient's age.

Permanent

Materials that differ from each other act as permanent fillings. increased strength, shock absorption and high aesthetic qualities.

Their main task is to recreate the anatomical shape of the tooth with full color rendition and the most approximate physical characteristics.

The following materials are used as permanent fillings:

Metal

Is the cheapest option, ensuring the strength of the restored area, but characterized by low aesthetics. Most often, amalgam is used to place a filling - an alloy of silver and mercury, which can last more than 10 years.

Today this option is not popular, as it has a negative effect on the oral cavity and requires detailed, painstaking work. The cost of installing such a filling will cost approximately 500 rubles. But the price may increase if a more expensive metal is used instead of silver.

Light-curing composite

It is a material based on an adhesive structure. Thanks to this, the material quickly adheres to the dental surface.

It is mainly used for the restoration of chipped parts of the front row of teeth, as it is highly aesthetic. Service life of light-curing fillings from 5 years or more, with average cost from 1500 rubles.

A filling installed under a crown can be inserted for about 600 rubles.

Glass ionomer cement

Unlike the previous version, this material is more durable and resistant to mechanical stress. It tolerates temperature changes well and adheres tightly to various dental surfaces. In addition, it contains fluoride, which remineralizes tooth tissue.

A filling made from it under a crown will cost 1,000 rubles, and restoring part of a tooth will cost from 1,700 rubles. The service life of the glass ionomer is at least 5 years.

Nanocomposites (microhybrids)

Used to restore both front and chewing teeth. The materials are distinguished by their reliability, increased resistance to aggressive environments and mechanical stress. They accurately convey the shade of natural enamel and its natural transparency.

Service life of a restored area made of nanocomposite at least 5 years. Its cost is higher than its predecessors and begins from 2000 rubles.

Seals made from the listed materials can last a guaranteed service life only if the technology for their installation is followed. If the dentist is insufficiently professional, the filling may fall out within a few months, regardless of the cost and modernity of the material.

How to install them - see the following video:

Use in children

Separate consideration is given to filling in childhood, since for temporary teeth it is necessary to select gentle technologies and safe materials that are able to adhere to the surface of the teeth due to mechanical forces.

Meets these requirements zinc eugenol cement, used as temporary fillings. The material does not require a dry environment, which is important in treating the teeth of young children. It hardens even when interacting with saliva.

Mainly used as a permanent filling polycarboxylate cement. The material has an analgesic, aseptic and regenerating effect, as well as a slight sedative effect.

One of the restoration options is light seal, which does not harm tooth and periodontal tissues, but requires good perseverance from the child.

An example of its installation is in the following video:

The cost of filling children's teeth starts from 2500 rubles. The cost of the service includes mandatory injection and treatment of dental tissues on 3 surfaces and their restoration using cement or composite.

If a colored photopolymer was used for filling, the price of the service will increase by 500 rubles or more. When treating pulpitis, the price of filling for each channel will be added to the final cost, which starts from 500 rubles.

Signs of quality

© Tyler Olson/Fotolia

To the main features High Quality fillings include:

• accurate representation of the anatomical shape in compliance with the masticatory tubercles;
• smoothness of the transition, which is not noticeable even with instrumental examination;
• high aesthetic indicators. The filling must have a smooth, glossy surface with a tint and transparency that completely matches the natural part of the enamel;
• increased resistance to chipping and abrasion due to the density of the material;
• uniformity of the filling;
• tight fit to the walls of the formed cavity.

Installation steps

Installation of a seal takes place in several stages, each of which is considered mandatory:

• Stage 1. At the first stage, the carious tooth tissue is polished off.
• Stage 2. If the infection has penetrated into the pulp, then its chamber is opened and expanded, and then the canals are treated.

  In this case, the procedure will cost more than with conventional superficial caries, since the price will include canal filling, which varies from 600 to 1500 rubles.

• Stage 3. Restoration of anatomical shape. This stage will also affect the final cost of the procedure. The price will depend on the volume of material used.

  The more you need, the higher the cost of the service. For example, restoration of 3 sides of a molar begins from 2500 rubles. Restoration of the front incisors can cost 3,000–5,000 rubles.

In addition, depending on the material used, when sealing, you may need a special shock-absorbing pad and other additions, which, although not significant, still affect the cost.

When is pain relief required?

© elainenadiv / Fotolia

As a rule, anesthesia is carried out during any dental procedures. If the impact on dental tissue is minor, application anesthesia is used, which allows you to numb the tooth to a depth of 3 mm.

The cost of one application is about 150 rubles. For more extensive interventions involving the pulp, they resort to infiltration or, the price of which varies from 300 to 1000 rubles, depending on the status of the clinic and the drugs used.

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Usually at the dentist's office you will be asked, “Which dental filling should you get?” And this question is often confusing, because there are many types of fillings.

In order not to get lost in this issue anymore, let’s figure out what types of dental fillings there are, what are the most reliable and the best types.

In dentistry, they are distinguished by composition and use. These can be plastic, ceramic fillings, as well as temporary and permanent.

Temporary ones are used when long-term treatment, when it is necessary to use drugs inside the cavity, and permanent ones - for instant treatment at a time.

This is a classic of dentistry, but it is used for not very large damage, but if the defect is especially large, then an alternative to filling is used - inlays that can cover larger sizes.

Today clinics use several various materials for making fillings.

Materials from which fillings are made

All modern materials are divided into several groups. Let's look at the types of dental fillings.

Cement (silicate and silicophosphate) fillings

This material is also able to resist the re-development of caries, however, it is very fragile and may not last very long, or can be used as a temporary option.

Although this material has outlived its best years of popularity, however, it is not forgotten in in some cases, because it is low cost and easy to use.

Plastic

Their popularity is explained by the same factors as the previous ones - low price and quick, simple installation.

However, they have many disadvantages:

• when the material hardens, severe shrinkage occurs;
• after a while, a color change occurs;
• increased abrasion of the material;
• often possible .

Such fillings are the prerogative free medicine.

Amalgams or metals

This material includes silver and mercury, or other alloys containing the second element. It is distinguished by its hardness and service life of up to 10 years. This material is hazardous due to its mercury content and possible harmful effects this element for seals. It hardens for a long time and is difficult to use; the dentist must have high professionalism in order to place a filling from such a material.

On a note: When installing a product made from this material, the dentist should take into account the fact that it expands greatly during the curing process, and accordingly, a fragment of the tooth wall, which is located near the filling itself, is possible.

Their use is popular on chewing teeth, as well as under crowns, when the composite will not be visible.

Composite

What dental fillings are considered the best of the inexpensive options are composite ones. They include plastic in their composition, but their distinctive feature is quartz powder, which provides them with the desired hardness. In addition, they are distinguished by relatively good color fastness and durability. Their service life is on average 2-5 years.

Light-curing composites

This is a group of materials that require special equipment in the form of a halogen lamp, they are also known as solar curing or photopolymer. It is with its help that the lamp is given the necessary hardness. When asked which fillings are the best, we can accurately answer that these are those made of this material.

Important: However, in order for a product made from this material to be as strong, durable and aesthetic as possible, it is necessary to carry out careful grinding and polishing.

If polishing is carried out once every six months, the color will last much longer. The most memorable feature of such materials can be called mandatory application adhesives special purpose, capable of securing raw materials “tightly”.

It consists of various fillers and polymers that harden under the influence of that same blue lamp.

It has a fairly wide color palette, so you can choose any desired color and the shade, as a result, is as close as possible to a healthy tooth.

This material will last at least 5 years.

But such a seemingly flawless material has three main drawbacks:

• Shrinkage due to the chemical composition can be up to 5%, which reduces the quality of the installed filling. That is why it is better to use such material in small areas;
• with severe shrinkage, deformation is possible to such an extent that the thin wall of a natural tooth breaks off;
• incomplete hardening. Hardening of this material occurs only by 70%; more is impossible due to the peculiarities of using the lamp.

Glass ionomer cement

Dental fillings, which are considered the best for use in pediatric dentistry, since they contain 10-15% fluoride, which helps protect against re-infection. In addition, they are chemically bonded to the natural tooth, and therefore the likelihood of various cracks appearing is minimal. The coefficient of expansion under temperature is as close as possible to that of dental tissue, therefore minimizing the risk of the tooth cracking.

However, even this seemingly ideal material has its drawbacks. These are reduced strength indicators, both in abrasion and in bending. In addition, they do not look particularly attractive, and therefore are better used with more aesthetic fillings.

Chemically cured composites

This material was developed to replace conventional cement options. Their fundamental difference is the filler used, in this case it is porcelain. These composites can be further divided into:

1. Light-curing.
2. Acrylic-containing.
3. On epoxy resin.

Composites that contain acrylic are highly durable and resistant, but they are also very toxic. It is often noted that after installing fillings made from this material, a large number of por. And the consequence may be the development of secondary caries both on this tooth and on neighboring ones.

Resin composites are more fragile, although they wear out less. They are not as toxic as their acrylic counterparts, however, they inevitably darken several years after installation.

How much do the products cost?

Which fillings are best to install based on their cost? It seems that the only correct answer to this question is that all good things come at a price. However, this is not so; in each specific case, one must start from specific features, and only they will dictate the future price of the filling.

However, in order to get at least a little orientation in the pricing policy, you should know that inlays cost in the range of 3000-14000 rubles, compomers from 650 to 1000 rubles, chemically cured composites from 600 to 800 rubles.

Video on the topic

Modern dentistry has a large arsenal of high-quality materials for filling teeth. What kind of filling should I put in order to reliably preserve the dental crown from destruction - plastic or ceramic, silicate or cement, chemical or light? Let's take a closer look different kinds filling material and answer the question which filling is better.

Fillings are divided into permanent and temporary. A constant is set at minor damage temporary tooth crowns are used for long-term complex treatment or diagnostics. It is also used to protect medicinal compositions during dental treatment: a medicinal composition is placed under it.

The materials from which fillings are made are divided into several types:

• cement, silicate;
• plastic;
• metal, amalgam;
• ceramics;
• composites.

Depending on the material used, fillings are divided into several main types:

• cement;
• composite;
• compomers.

The dental industry also produces other types of fillings - plastic, metal and ceramic.

The most durable material is made from light-curing composite. Such fillings are expensive, but the high price justifies the long service life. The fillings look aesthetically pleasing and have the ability to change their shade with changes in lighting.

The most popular material is dental cement. These fillings are still in demand among patients due to their low cost, high adhesion and strength. The fillings literally stick to the surface of the crown and do not form air gaps.

Cement materials

Cement differs significantly from composite in its lower hardness, however, it is able to protect the tooth from repeated carious development. The disadvantage can be attributed high density cement compared to tooth tissue: over time, this contributes to the thinning of the surface of the crown adjacent to the filling.

Cement compositions have three subtypes, according to additives to the main ingredient:

1. silicate;
2. phosphate;
3. glass ionomer.

Silicate compounds are the oldest of all. The material contains special glass mixed with phosphoric acids. The silicate composition has a different release of fluoride, which prevents the development of dental caries. The harmfulness of the material lies in its aggressive phosphoric acid, which destroys the pulp. To neutralize the effect of acid on the pulp tissue, a special gasket made of safe substances was installed.

Phosphate compounds are characterized by fragility and fragility, weak adhesion (adhesion to tooth tissue), and high abrasion. The peculiarity of these fillings is their high toxicity, which provokes the proliferation of aggressive bacteria. This substance(phosphate) does not protect well against the re-development of caries.

Glass ionomer cement is used to treat children. The substance is as close in texture as possible to dental tissue, has high adhesive characteristics and safety. The glass ionomer is illuminated with a special ultraviolet lamp, which promotes rapid hardening of the material and high-quality tooth protection from infection. The advantages of this material include the fluoride contained in the composition, which protects against the development of recurrent caries.

The disadvantages include fragility - softness and instability of the composition. IN modern dentistry A strengthened glass ionomer is used, the composition of which is supplemented with metal or ceramic particles. This material is used for filling chewing molars; it is most resistant to abrasion. The last word in the development of dental materials is the production of nanoionomer, which reliably protects dental tissue from infection and caries development.

Composite compounds

Chemically cured composites were invented as an alternative to simple cement fillings. The composition of the composite includes porcelain, which gives greater strength to the cement. Also, according to their composition, composites are divided into three types:

1. acrylic-containing;
2. resin (epoxy);
3. light-curing.

Of the listed compositions, the acrylic-containing composite has the greatest strength. These fillings are characterized by wear resistance, are little susceptible to abrasion, however, they have a toxic effect on the body. Due to toxicity, acrylic is contraindicated in many patients. Acrylic also often provokes the formation of pulpitis. Another negative feature of acrylic is its high absorbency, due to which the risk of caries increases significantly.

Resin composite material is not highly wear-resistant and durable, however, it is non-toxic and harmless to the body. The disadvantages of resin structures include a change in color after a few years: the fillings darken. Another feature of resin (epoxy) fillings is their excessive fragility: they can be “eaten.” Therefore, it is better not to use epoxy composition on primary chewing molars. Epoxy composite also provokes the development of pulpitis, just like acrylic.

The light-curing composite gains its strength from a halogen lamp. They are also called photopolymer or solar-cured. The disadvantage of this material is the complexity of installation: polishing and grinding of the material is necessary. The filling must be polished every six months to maintain the original tone of the material.

What other disadvantages are typical for this material? These include the following properties of the filling:

• shrinkage after curing;
• possible chipping of the crown wall;
• poor-quality hardening of the material.

The filling can shrink up to five percent of its original volume, which significantly reduces the effectiveness of protecting the tooth. Even with slight shrinkage of the filling, there is a high probability of chipping of the adjacent wall of the dental crown. Due to the technical difficulties of working with a halogen lamp, the hardening of the material may be incomplete - only 70%.

An innovation in modern dentistry is a nanocomposite, the structure of which consists of tiny particles. The nanocomposite is characterized by high adhesion (adhesion) to tooth tissues, providing reliable protection from infection and spread of caries.

What are compomers

This material takes the best from cement glass ionomer and composite compositions. The ingredients of compomers are:

• monomer;
• epoxy resin;
• polyacrylic acid;
• benzoyl peroxide;
• amine.

After hardening, the compomer forms a uniform, homogeneous layer that prevents bacteria from entering the dental tissue. Compomers have the disadvantage of being fragile. Therefore, this composition is used for frontal teeth.

Plastic, metal and ceramic compounds

Plastic fillings are also at the peak of popularity, also due to their low price. Plastic has many disadvantages:

• gives significant shrinkage after curing;
• changes its color over time;
• quickly wears out and becomes unusable;
• poorly protects against secondary caries.

Important! Cement and plastic fillings are placed in free dental clinics.

Ceramic compositions

The distinctive characteristics of this material are high strength, lack of shrinkage and aesthetics. Ceramics does not darken during use and is not painted. In modern dentistry, ceramics is considered an almost ideal filling material. Types of ceramics include:

1. transparent material;
2. pressed material;
3. metal ceramics.

The disadvantages include the difficulty of installation: the composition fills the hole in the tooth, like an inlay. The inlay is formed using an impression of a previously sanitized tooth.

Metal alloys

Amalgam material includes a mercury compound along with silver. The dangers of exposure to mercury in the body pose a certain health risk. The advantage of amalgam is its long service life and abrasion resistance.

Another disadvantage of this material is expansion during hardening. If the dentist does not correctly calculate the volume of the filling, the possibility of slight destruction of the crown cannot be ruled out.

Due to the unaesthetic appearance of metal structures, they are used on back teeth or the hidden surface of the crown.

Which material to prefer

The dental compositions described above have their own characteristics, advantages and disadvantages. Which filling do you prefer? Which is better - light or chemical (ordinary)? The choice will depend on financial capabilities and the location of the tooth in the oral cavity - posterior molar or frontal.

It is preferable to place fillings made of durable, indelible compositions on posterior chewing molars. For example, metal, glass ionomer or nanocomposite materials.

If we consider from an aesthetic point of view, it is better to put light or ceramic fillings on the front teeth, which are identical to tooth enamel and are invisible when smiling. Light dental products are characterized by a certain fragility, and therefore cannot withstand heavy chewing load on the rear molars.

For restoration or damaged teeth in the anterior rows, use light fillings. Using a composite material, you can completely restore the shape of a tooth, which will look organic. Distinctive feature light composite is a multi-variant choice of color to match the tone of the natural enamel of the dentition.

If we consider the quality of the composition from the standpoint of durability, then the most durable materials are metal and photocomposite - a service life of more than ten years. All other trains last from four to five years.

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Most often, before filling a tooth, the dentist asks the patient a question regarding the type of filling. And it certainly causes confusion among most people, since today there are a large number of types of fillings.

And in order not to make your choice at random, you need to know which dental fillings are better? We will also consider the cost of various filling materials.

All fillings differ in two ways:

1. Their composition is ceramic, plastic, metal, etc.
2. Regarding the application, the filling can be permanent or temporary. The latter are applicable when any medicine is used inside the dental cavity, while a permanent filling is focused on treatment at a time.

Dental filling is one of the main methods of caries treatment in modern dentistry. However, they are used for predominantly small defects. If the damage reaches large sizes, then in this case an inlay is used, which is an alternative to filling and is intended for large cavities.

What materials are used to make fillings?

As mentioned above, today there are quite a lot of materials from which fillings can be made. Depending on the material, fillings may have different technical characteristics.
Silicate, silicophosphate, and cement fillings. Such materials perfectly prevent relapses of caries, but at the same time they are fragile, and therefore they do not last long, which is why in modern dentistry they are most often used as a temporary option.
This material is mostly a relic of the past, but in some cases it is still used due to its cheapness and ease of use.

Plastic fillings

They are highly popular due to their ease of use and relative cheapness. But at the same time, such fillings have no less disadvantages:

• Subject to severe shrinkage after hardening.
• Characterized by high washability.
• They change color over time, which negatively affects aesthetic qualities.
• In most cases, there is a high probability of recurrent caries.

Taking into account all the above factors, such fillings cannot be considered the best modern material for the treatment of caries. However, for free medicine they are indispensable.

Ceramic inlays

This material is distinguished by its excellent strength and aesthetic component, which is similar to the enamel of a healthy tooth.

Indications for use– large cavities formed as a result of complicated caries, replacement of old fillings, root canal treatment.

Advantages:

• Such inlays are much more durable than conventional fillings made directly into the tooth. If the cavity is large, then the only correct solution is an inlay. This is due to the fact that the fillings quickly become damaged. Thanks to ceramic microinserts, it is possible to strengthen the tooth extremely well.
• Perfect aesthetics. Ceramics are characterized by translucency, which allows you to simulate the color of a healthy tooth.
• A ceramic inlay models the anatomical shape of the tooth with extreme precision. Since it is not created in oral cavity, then it is possible to achieve the ideal shape.
• Resistant to external manifestations. Even drinking coffee and smoking cannot spoil their color over time.
• Fast production. At the first visit, the cavities are processed and an impression is taken. And the very next trip to the doctor will end with the installation of ceramic inlays in the oral cavity.
• Ceramic inlays do not sag, unlike fillings (shrinkage up to 2%).

Zirconium dioxide

If tooth decay is more than 30%, then you should turn your attention to one of the new methods of microprosthetics - zirconium inlays. Such inlays will provide an excellent aesthetic appearance of the structure, as well as high strength, not inferior to metals.
Pros:

• Maximum natural appearance, providing a magnificent aesthetic effect.
• Over time they do not darken or stain, which indicates good performance.
• Minimal risk of allergies.
• Can be used on front teeth. The zirconium inlay is not translucent and does not impart a blue tint to the future tooth.
• High wear resistance.

There is only one disadvantage - high cost.

Zirconium inlays are prescribed:

• With a completely destroyed tooth;
• For defects in the shape or location of teeth;
• As a support for bridge structures.

Metals or amalgams

Such materials contain mercury and silver. Instead of silver, any other components are possible. The material has high hardness and is durable (the filling lasts more than 10 years). However, the material is dangerous due to its mercury content. It is characterized by a very long hardening and has certain difficulties in application, and therefore requires the dentist high level skill.

On a note! As this material hardens, it is susceptible to expansion, which the dentist must consider when installing it. If this feature is not taken into account, the tooth wall located next to the filling may be destroyed.

The use of such fillings is desirable in places where they will be unnoticeable, for example, on chewing teeth or under crowns.

Composite

Perhaps for budget option These dental fillings will be the best in terms of price and quality. This material contains plastic, but the high hardness of the filling is ensured due to the fact that they contain quartz powder. In addition, they are characterized by excellent color fastness and durability. They serve on average about five years.

Light-curing composites

These seals require the use of special adhesives that can firmly strengthen the seal. Such materials include a number of polymers and special fillers that harden under the influence of a special lamp. A very wide palette of shades allows you to choose a filling that will not stand out against the background healthy teeth.
The average service life of the material is from 5 to 7 years.

In addition to the obvious advantages, photopolymers also have several disadvantages:

• Shrinkage is up to 5%, but can slightly reduce the quality of the filling. Due to this feature, this material is most often used to fill small tooth defects.
• Severe shrinkage can cause deformation, leading to chipping of the thin wall of the tooth.
• Hardening of the material is incomplete and reaches only 70%, which is due to the characteristics of the lamp used when installing such fillings.

The risk of cracks appearing in healthy tooth tissue is virtually eliminated, since the temperature coefficient of expansion of such fillings closely matches that of the dental tissue.
The main disadvantage of such materials is their low strength to bending and abrasion. In addition, one should take into account the very unattractive appearance of such fillings.

Chemically cured composites

The main purpose of this material is to replace cement analogues. The difference from cement fillings lies in the filler, which in this case is porcelain. Composites can be of three types:

1. Acrylic-containing.
2. Light-curing.
3. On epoxy resin.

Acrylic-containing composites are characterized by high durability and strength, but are toxic. It often happens that after their installation many pores appear, after which it is quite possible for both the development of secondary caries and pulpitis, and the damage can spread to neighboring teeth.
Resin materials are quite fragile, but less susceptible to abrasion than the previous version. However, they are not that toxic. The main disadvantage of such materials is their darkening several years after installation.

Price

Patients often choose one filling or another based on the cost of the filling material. And many people mistakenly believe that a good filling is expensive. This is not true because it exists whole line factors determining the final cost of treatment.
If you want to get a little guidance on prices, here are some approximate data:

• The cost of tabs ranges from 3 to 14 thousand rubles.
• Compomers will cost you 600-1000 rubles.
• The price of chemically cured composites is 650-800 rubles.

When choosing a filling, you must listen to your dentist, who, after assessing the situation, will help you choose the most suitable option. Otherwise, the need for filling may return later. a short time, and as a result, you will spend much more than if you initially installed a quality filling.

Watch thematic video

Dental fillings: what are they and why are they needed?

In dentistry, a filling is a material that is used to fill holes in teeth, which are usually formed during treatment, or when part of a tooth falls off on its own (hit, fell, and other mechanical options).
A dental filling is needed to isolate the sensitive tissues of our teeth in order to prevent microbes from getting here (the place where the hole or fracture has formed).

What types of dental fillings are there?

Dental fillings are divided into two types - temporary and permanent.

Doctors place temporary fillings most often in some kind of medical or diagnostic purposes, for example, when the doctor is not entirely sure whether the dental nerve is affected or not. In such cases, a temporary filling is placed: if the tooth begins to hurt while wearing such a filling, then there is a problem with the nerve and its removal is required.

Also, therapeutic fillings are often worn in various useful medicines, which need to be deleted after a certain amount of time. The temporary filling will not fall out on the 3rd day after the doctor installed it, it is simply much easier to remove it by the doctor who placed it. Such fillings are also placed when arsenic is covered.

Dentists have been placing permanent fillings for years and even decades.

Today doctors have in their arsenal the following “ Construction Materials» for filling teeth.

Types of dental fillings:

Cement fillings come in several types. Most often, silicate cements, phosphate cements and glass ionomer cements are used for their production.

Silicate cement began to be used in the 19th century. The composition of the cement powder includes aluminosilicate glass, which, interacting with the liquid in the form of a mixture of phosphoric acids, forms a structured gel.

A positive property of this material is the release of fluoride ions, which helps to avoid secondary caries. The disadvantage of the filling is the fact that silicate cement releases free phosphoric acid, which negatively affects the living pulp. Therefore, it is not recommended to install these cements without a liner.

Fillings made of silicate cement allow you to choose different shades.

Phosphate cements are a cheap material that has weak fixation, wears off quickly and does not adhere well to the edges of the tooth, which leads to the penetration of microbes. Therefore, in order to strengthen the strength of such a filling, various fillers (most often silver) are added to the cement.

Unlike phosphate cements, glass ionomer cements are chemical properties similar to tooth tissues. Hardening of these fillings occurs under the influence of ultraviolet radiation, which gives the doctor time to slowly make the filling while it is soft, and only then “harden” it.

Thanks to components containing fluoride, such a filling will help avoid secondary caries; they are more durable. However, glass ionomer cements also have rapid abrasion and brittleness, and the addition of food coloring for coloring does not make the tooth look natural.

Metal fillings are made from amalgam (silver amalgam consists of apillar containing 60% silver, 20% copper, 4-5% others (tin, silicon, etc.) with mercury). Despite its strength, durability and low cost, it is used less and less in modern dentistry.

Metal fillings have a shiny color that contrasts sharply with the tooth enamel. It is acceptable to place an amalgam filling only on the back teeth, while maintaining the thick walls of the tooth.

Contraindications: presence of a metal structure in the oral cavity (to avoid galvanism); upon receipt by the patient radiation therapy V maxillofacial area; filling of anterior (front) teeth.

Composite plastics are plastic masses the color of tooth enamel with a glass filler (silicon dioxide). Introduced in 1960, they were used exclusively on the front teeth, because their strength did not allow them to withstand the loads experienced by chewing teeth.

Since that time, composite materials have improved so much that they can now be used on chewing teeth. Composite materials are used not only to restore teeth after caries, but also in for cosmetic purposes to change the color of a tooth or its shape.

How is a composite filling placed?

After preparing the tooth, the filling is placed in layers with each layer highlighted. After the process is completed, the dentist grinds the composite filling according to the shape of the tooth. The filling is then polished to extend its life.

How long does it take to place a composite filling?

It takes 20 minutes longer than an amalgam filling. The duration of the procedure is affected by the size of the filling and its location in the oral cavity. The larger the filling, the longer it takes.

What is the cost of such a filling?

The price may vary, but usually it is 1.5-2 times higher than amalgam fillings. Most insurance companies cover the cost of composite fillings up to the cost of amalgam fillings, leaving the rest to the patient.

But, as composite materials are constantly being improved, the likelihood of more complete reimbursement of the costs of composite fillings increases.

What are the advantages of composite fillings?

After installation of a composite filling, the patient may experience increased sensitivity. The color of the filling may change slightly if the patient drinks tea, coffee or other caustic drinks. The doctor may cover the filling with a transparent film to avoid discoloration if this aspect is important to the patient. Composite materials tend to wear out faster on larger fillings compared to amalgam fillings.

How long does a composite filling last?

Studies have shown that, on average, a composite filling lasts 7-10 years, while the service life of an amalgam filling is slightly longer.

Compomer material used for filling small cavities, wedge-shaped defects, baby teeth, restoration of teeth that do not bear a large chewing load and creating inlays. It combines the strength of composite fillings, protection against caries, like glass ionomers, and good aesthetic properties.

Compomer inlays are used in cases of severe tooth decay, when virtually only the walls remain. The inlay is made from an impression in a dental laboratory and then glued into the tooth. Such fillings are more expensive, but they are durable and aesthetically pleasing.

An inlay is, surprisingly, also a filling, only made not in the patient’s mouth, but in a laboratory. Even a composite inlay made from conventional filling material is free from the disadvantages described above that are inherent in a filling made in the mouth. If we talk about a ceramic inlay, it generally significantly surpasses any other in its properties.

The fact is that of all the materials used in dentistry, ceramics are closest in their properties (strength, light reflection, etc.) to tooth enamel. A porcelain inlay glued to the tooth almost completely restores its strength. Therefore, where there is extensive tooth decay, it is preferable to place an inlay rather than a filling.

In many cases, when the destruction of the coronal part of the tooth is great, and the tooth is still alive, the only thing that allows you to avoid depulping and covering the tooth with a crown is an inlay.

The impetus for the development of this technology was the improvement of the mechanism for gluing (or adhesion) of fillings to the tooth. If previously fillings were held in the cavity due to their geometry, now doctors have begun to create microscopic irregularities in the enamel, into which the glue that connects the filling to the tooth flows.

Today, dental adhesives (they are called adhesive systems) of the fourth and fifth generations penetrate micropores in all layers of the tooth, both enamel and dentin.

Penetrating into all the microscopic irregularities, of which there are a huge number, the glue (adhesive) creates such a connection between the filling and the tooth that in an experiment, when trying to tear off the filling, it comes off along with part of the tooth. Thanks to the creation of dental miracle glues (adhesives), it became possible to glue not only composite fillings to teeth, but also porcelain, metal, and many other materials.

Human factor

Of course, the role of the doctor in dental treatment is undeniable. Without him it is simply impossible to do this. And the doctor is also not insured against mistakes due to his inattention or dishonesty, lack of time or desire to do everything correctly, or perhaps due to ignorance (surprisingly, this also often occurs).

The main possible reasons for the rapid loss of a filling from a tooth:

• Insufficient cleansing of the carious cavity from affected tissues. Simply put, when a doctor leaves decay in a cavity and “seals” it under a filling. Only the process of tooth destruction continues and, as a result, a decrease in the strength of attachment of the filling to the walls and bottom of the formed cavity, a disruption of the connection between the material and tooth tissue.
• Incorrectly formed cavity for filling. There are specific rules for each case of the location of the carious lesion. According to Black's classification, carious cavities are not only divided depending on their location, but also the principle of formation of each of them is clearly defined. And these rules must be followed.
• Many materials used for filling teeth are very sensitive to moisture and when saliva gets into the prepared cavity, they greatly reduce the chances of the filling lasting a long time. This is relevant when treating baby teeth in children, as well as in the case of limited mouth opening, excessive salivation in the patient, or the location of a carious cavity near the edge of the gum.
• Light-curing filling materials harden after being introduced into the prepared cavity only under the influence of light of a certain wavelength (450-500 nm). For this purpose, dental polymerization lamps are used, powered either by a battery or from a dental unit. It is important to monitor the battery charge level, otherwise the depth of light penetration and its strength are sharply reduced. The filling can only harden on the outside, while the inner layers will remain soft. This means that such a filling will soon fall out of the cavity.

The dentist has a large selection of materials with different properties in his arsenal. They can be chemically cured (the filling becomes hard when two pastes are mixed for several minutes or hours), light-cured (hardens immediately when illuminated).

There are also materials for temporary fillings that harden in the mouth under the influence of body temperature and saliva moisture over several hours.

This means that the recommendations that the doctor gives to the patient depend on what the filling is made of. For example, not eating or chewing gum for 2 hours.

There is another characteristic of materials - shrinkage, i.e. a decrease in volume of the filling over time. U different materials this figure is very different. When placing a filling, the doctor takes into account the degree of possible shrinkage of the material, reducing the risk of cracks, the appearance of the filling-tooth boundary, or its loss.

By the way, this mechanism explains the fact that over time such a border becomes noticeable even to the patient; it becomes stained with plaque and turns yellow. In this case, it is better to change the filling. If this is not done, then it is in this place that, as a rule, secondary (recurrent) caries begins around the fillings.

Individual structural features of enamel and dentin:

The tissues from which teeth are formed are formed already in the 7th week of intrauterine development; this moment can be considered the beginning of their development. Depending on the impact of adverse factors on the body expectant mother or child (at the time of formation permanent teeth), the strength of enamel and dentin will be different.

Toxicoses of a pregnant woman, lack of calcium, fluorine and other elements, viral infections and medications taken greatly affect the development of teeth in a child. Likewise, at the stage of formation of permanent teeth, many factors affect the future features of the structure of dental tissues.

For example, when fluoride enters the body in excess, the enamel does not develop properly. The mechanism of action of fluoride is based on the fact that it is integrated into the structure of hydroxyapatite crystals (the main building element of enamel), replacing calcium, as a result of which areas of such enamel become less dense and more fragile, and change color.

Distinct white spots are visible on the teeth; the enamel of such teeth is prone to chipping; fillings do not hold well due to the disruption of the enamel structure. The structure of enamel can change with the development of hypoplasia, disruption of amelo- and dentinogenesis (formation of enamel and dentin), and hereditary diseases.

The thickness of the tooth tissue also matters. At pathological abrasion this indicator decreases, and after the filling is placed, the process does not stop at all, reducing over time the degree of fixation of the material to the tooth.

Dental materials for filling temporary teeth must meet many requirements. One of the main ones is non-toxicity and safety for children. Due to the absence of chemical effects on dental tissue, such materials are fixed in the cavity only due to mechanical adhesion forces.

Simply put, they are connected like puzzle elements, matching each other in shape and size. There is no chemical bond. And such materials harden within 1-2 hours, remaining sensitive to moisture, which makes the filling vulnerable during this time.

Such fillings wear out over time and shrink in volume. Yes, and in principle the difficulty of treatment baby tooth in a child it is obvious to everyone (it is difficult to create ideal conditions for the work of a doctor).

Let's return to the properties of materials for fillings. If they do not harden immediately, but some time after being placed in the tooth, then the doctor gives clear recommendations to the patient. For example, do not eat for 2 hours and do not chew gum. But the patient is not always so obedient, especially a small child.

For adults important factors, allowing to extend the durability of the filling are:

• oral hygiene (bacteria live and actively multiply in dental plaque, softening the enamel due to the acids produced)
• quality of nutrition (aggressive foods that destroy enamel, reduce the degree of fixation of fillings). This includes sodas, products with various acids, sweets, flour products, sharp changes food temperatures from cold to hot and vice versa. The lack of calcium in the body also plays a role, which compensates for bone and tooth enamel.
• bad habits (for example, frequent consumption of seeds, crackers, nuts leads to the appearance of microcracks in the enamel structure, which gradually deepen, causing either chips of the enamel or loss of the filling).

Timely treatment of caries determines not only success in preserving healthy teeth, but also prevents the loss of already placed fillings.

You need to take care of your teeth on time and not wait for toothache to remind you of their existence. Putting a filling is only half the battle. How long it stays in the tooth depends not only on the doctor and his professional qualities, but also from the patient himself.