Thanks to modern advances in dental materials, patients have many choices when it comes to repairing missing, worn, damaged or decayed teeth. The choice of restoration depends on where the material is placed and the function of the tooth. Prior to a restorative treatment, Dr. Vessel thoroughly discusses with patients the different options available.
Such restoration options are usually classified as “direct” or “indirect.” A direct restoration is treated in one visit and includes composite (white) fillings, dental amalgam (alloy) or glass ionomer tooth-colored fillings. Indirect restorations include gold or porcelain crowns, veneers or bridges. The latter options require two visits: one to prepare the tooth and take an impression; another to seat the final restoration. For all restorations, our office uses high-quality materials and avoids base metals that can rust or tarnish.
Direct restorations are most often used to replace areas of decay. We remove the decay and place the material where the decay resided. Composite resin fillings depend on bonding the resin to the tooth, whereas amalgam fillings depend on the shape of the cavity.
With indirect restorations, a crown or cap restores the tooth to its normal shape, size and function. Crowns are the restoration of choice when the tooth has a cavity too large for a filling, or when the tooth is cracked or broken. Old, fractured fillings or teeth that had root-canal therapy can function with a crown.
Indirect restorations are a staple of cosmetic dentistry and include full ceramic crowns and veneers. Because all-ceramic restorations do not contain a metal understructure, they transmit the color of adjacent teeth, giving them a chameleon-like quality. Both the shape and the shade of the tooth can be changed by using crowns and veneers. Additionally, ceramic crowns can appear to alter a tooth’s positioning.
Indirect restorations can also be used to replace missing teeth. After a tooth is extracted, other teeth may drift into the position of the lost tooth. This can eventually change the patient’s bite, causing stress on the remaining teeth and jaw-joint pain. A dental “bridge” uses the teeth next to the missing tooth as “abutments,” and the tooth is replaced with a “pontic.” Bridges can be extremely aesthetic and help upright previously tipped teeth.
Lastly, implants are another option to replace missing teeth, and they are restored using conventional crowns and bridges. The implant acts as a root and supports an “abutment,” which is then fitted with a crown. The tooth is replaced with no damage to any other teeth.