Pro and Cons of Dental Restorations
Types of dental restorations
- Cavities and Old Fillings
- Tooth that require Crown
- Missing Tooth
Cavities and Old Fillings
When a tooth has cavities, the decay is removed from the tooth and the tooth is prepared to accept filling material. Amalgam fillings, composite resin fillings or inlays/onlays are options that can be chosen in filling the removed cavity area.
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Solutions to Cavities
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Pros
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Cons
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| Amalgam Fillings |
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Longest clinical track record
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Familiar technology
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Inexpensive with no additional laboratory fees
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Quick procedure done within one visit
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Generally does not cause sensitivity
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- May contain mercury
- Rare allergic reaction to metal alloys may occur
- Color does not match teeth
- Fillings are not cemented in
- Some healthy tooth structure is removed
- Overall tooth sturcture can be weakened
- Material has high rate of expansion and contraction
- Possibility for decay under and around an amalgam filling as filling is not sealed
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| Composite Fillings |
- Tooth-colored material matches teeth and looks natural
- Good clinical track record
- Reinforces tooth: can regain up to 95% of original tooth strength
- Quick procedure done in one visit
- Sealed to tooth, prevents additional decay
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- Additional costs relative to amalgam filllings
- Condition of mouth may determine success of procedure
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| Inlays and Onlays |
- Strengthens and supports tooth
- most exact replication of tooth form as custom-built to match existing tooth structure
- Natural looking as custom-matched to tooth color and form
- Good track record
- Produced in a laboratory for more consistency
- Less tooth structure is removed compared to crowns
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- Requires additional appointments
- Additional laboratory costs and other costs relative to amalgam and composite fillings
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Tooth that requires crowns
Crowns can support and protect a tooth that already has substantial fillings or cover a discolored or misshapen tooth such as chipped tooth, irregularities in teeth. The dentist prepares the tooth, makes an impression and sends it to the laboratory. The crown is created and upon delivery, the permanent crown is fitted onto the tooth.
There are different types of crown materials such as a full metal crown, a porcelain fused to standard/base alloy crown, a porcelain fused to semi-precious alloy crown, a porcelain fused to precious alloy crown or an all-ceramic crown.
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Solutions to Crowns
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Pros
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Cons
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| Full-cast metal crown (Gold) |
- Longest clinical track record
- Strong, durable material
- Good wear performance
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- Does not match teeth
- If fit is incorrect, the crown must be re-cast from beginning
- Thermoconductivity transfers heat and cold to tooth underneath
- Rare allergic reaction to metal alloys may occur
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| Procelain fused to precious alloy crown |
- Good track record
- Color matches existing teeth
- Strong, durable material
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- Ceramic can be abrasive to other teeth
- Metal-ceramic interface can be weaken or fail over time
- Can cause sensitivity in some patients
- Metal core prevents translucency, so not completely natural-looking
- Thermoconductivity transfers heat and cold to tooth underneath
- Rare allergic reaction to metal alloys may occur
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| All-ceramic crown |
- Good track record
- Most exact replication of tooth color as custom-built to match existing tooth structure
- Natural looking as custom made to tooth color and transluency
- Strong, durable material
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- Higher costs with laboratory fee
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Missing Tooth
When a tooth is missing, there are several options that can be considered assuming that there is surrounding healthy tooth structure to support the solution.
A bridge is composed of units of crowns attached to surrounding teeth filling up the missing tooth/teeth. An implant is where a metal post is inserted below the gum where it attaches to the bone in the jaw. Replacement tooth is then placed on the post. Removable partial denture acts as one or more replacement teeth attached to a gum-colored base.
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Solutions to Missing Tooth
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Pros
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Cons
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| Bridge |
- Longest clinical track record
- Strong, durable material
- Good wear performance
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- Requires removal of adjacent tooth structure to secure bridge in place
- If fit is incorrect, the crown must be re-cast from beginning
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| Implant |
- Permanent and almost like real tooth
- Reduces change of bone loss
- Can be flossed and maintained same as real tooth
- No removal of adjacent tooth structure required to secure bridge in place
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- Requires surgery
- Additional costs
- Healing time required
- Rare allergic reaction to metal alloys may occur
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| Removable Partial Denture |
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- Not permanent or fixed
- Looks artificial
- Weaker than other options
- May require adjustments
- Requires special care and cleaning
- Removable thus vulnerable to loss or damage
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