Fillings are methods of reconstructing hard dental tissues affected by caries or fractures.
They were made of amalgam in the past, while nowadays they are made of composite materials that very well imitate the color of the missing tooth tissues. Depending on the degree of coronal destruction, the missing dental hard tissue can be replaced with inlays, which are prosthetic pieces made in the laboratory based on a prior scan of the tooth preparation.
There are several situations in which we should change old fillings:
- when the patient shows sensitivity at the level of a tooth with an old filling, we can suspect the existence of secondary caries or marginal infiltration. The treatment, in this case, consists of removing the old filling, cleaning the decayed dental tissue where applicable and applying a pulp protection material (it helps to carry out the process of neodentinogenesis), followed by the application of the composite material to restore the tooth's morphology.
- when the color of the tooth or filling changes. Fillings are normally made with tooth-colored composite materials. If the obturation was not perfectly adapted or the isolation conditions were not respected at the time of its realization, marginal infiltration may occur over time. In this case, the treatment consists in removing the old filling, decayed dental tissues and making a new filling in optimal conditions.
-when the old filling has deteriorated, the edges of the teeth or even the filling has fractured, then it will need to be replaced. Depending on what percentage of the tooth is affected, it is decided whether the reconstruction with the help of composite materials will be sufficient or whether an inlay will be needed. The latter is done when the remaining walls do not provide enough adhesion for the composite material or we need a cuspid protection (we protect the tooth from fracture when too much of it is missing).
To make the inlays, 2 sessions will be necessary:
- a first session in which the old filling is removed, the decayed dental tissue is cleaned and the preparation thus obtained is scanned;
-another meeting in which the prosthetic piece is cemented in the previously prepared cavity.
Another criterion for changing old fillings is aesthetic: when patients present old amalgam fillings (gray material) and want to replace them with physiognomic composite materials.
The treatment consists in removing the old amalgam filling and making a new physiognomic filling.
In order to check the integrity of the fillings and determine whether or not their replacement is necessary, a check-up in the dental office is needed.
If the fillings were made in optimal isolation conditions, they were well adapted in the oral cavity, the materials used were of high quality, the patient regularly presents himself for check-ups and has good oral hygiene, then the fillings can last up to 5-10 years in the oral cavity.
Article written by Dr. Diana Geladin – Dentist, prosthetics, endodontics.