Is composite the ideal filling material for our teeth ?
Would you like to avoid an amalgam filling or a temporary denture made of dental cement? Then you are not alone. The classic dental filling material for cavities is becoming less and less important in the anterior and posterior regions. Tooth-coloured composite material is available as filling material for the teeth, a plastic material that is used today as standard for dental fillings in the front tooth area. In the posterior region, composites are used with very good results thanks to advanced technology in the field of bonding between tooth and composite filling. Composite plastic is used in modern dentistry as an “adhesive” for fixing ceramic inlays, crowns and root posts.
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What is composite?
Compomer is a material used for dental fillings in cavities. Composite is based on an initially liquid acrylic resin, which is mixed with fine to microscopic ceramic, glass or quartz particles of different sizes, depending on the application.
Modern composite fillings are light-curing: the plastic part solidifies under blue light. The light waves cause the molecules of the liquid base to organize into long chains. After removing the caries and creating a retentive tooth cavity, the plastic, malleable composite is bonded in layers by the dentist.
UV Light and Composite
The process of internal bonding (polymerization) is started by irradiating the compomers with the UV light of a polymerization lamp. The light energy with a certain wavelength in the area of visible blue light activates a starter in the composite.
Together with an accelerator, this combines the chemical linking of the plastic so that the monomer is converted into a polymer in the organic phase. The so-called starter or initiator forms the necessary radicals, which lead to the chemical bonding and curing of composite.
Light-curing composite and chemical composite
The advantage of light-curing composites over chemical composites is their higher degree of polymerization. Light-curing composites are also more stable against abrasion or discoloration in the mouth. An advantage is the better shade stability and the overall better esthetic results. This filling technique requires considerably more time and material than the placement of an amalgam filling.
Composite fillings and restorations
Composite fillings are not suitable for all restorations. If the defect is extensive and the damage extends below the gum level, it is more difficult to place a plastic filling. Here you and your dentist have to think about alternatives (such as inlays).
The fully cured filling is shaped and polished by grinding. As it solidifies, the filling material contracts, creating small gaps between the filling and the tooth. As these gaps represent a caries risk, they should be minimized by the layer-by-layer build-up of the composite filling in composite restorations.
Tooth embellishment thanks to composite filling?
The adhesive technique of tooth embellishment with composite is suitable for any faulty tooth shape or tooth surface, since there is no need to grind the natural tooth substance as with a veneer or crown. The adhesive technique with composites on the tooth makes it possible:
- the closing of tooth gaps in the anterior region (diastema),
- the transformation of oblique or malformed front teeth (cone teeth),
- the beautification of irregular tooth substance defects
- Covering of caries-free, discoloured plastic fillings in the anterior region
- Covering of exposed tooth necks in case of gingival recession
Read more about this topic here:
- Veneers – beautiful teeth through ceramic shells
How does a composite filling adhere to the tooth?
The adhesive technique ensures that the composite filling adheres to the tooth. Before the filling is placed, the dentin is roughened with phosphoric acid and prepared by applying a pure flowable plastic layer. Similarly, the tooth is prepared for the “bonding” of an inlay, veneer or the placement of a crown.
Absolute dryness during the processing of the composite material increases the durability of the filling. Cotton wool rolls absorb the saliva, even better is the stretching of a rubber membrane (coffer dam) around the tooth to be treated. After completion, the surfaces are smoothed with a polisher.
Advantages of a composite filling
Composite fillings are “invisible” compared to amalgam fillings. Composites are available in various tooth shades and remain inconspicuous. In addition, composite fillings are less expensive than inlays and can be inserted with comparatively little effort.
Plastic fillings of the front teeth are financed by the statutory health insurance funds. In the case of holes in the molar tooth, additional payments for composite are due without additional dental insurance. In the case of children, pregnant women and people with metal allergies, the health insurance funds make an exception for these filling materials.
Disadvantages of a composite filling
Composite fillings are not always as durable as amalgam fillings. However, with good, dry processing, plastic fillings can also easily last eight to ten years. Although they were introduced as a harmless alternative to amalgam, composite fillings are no longer above criticism. Some of the chemicals used (e.g. formaldehyde or bisphenol A) can have a toxic or mutagenic effect in higher concentrations, trigger allergies or have a hormone-like effect. However, there are no reports of actual damage caused by composite fillings in the medical literature.
During curing, composites shrink by two to four percent due to polymerization shrinkage. Due to this polymerization shrinkage, there is a risk that the closure to the tooth of the fillings is not completely sealed (marginal gap formation). This promotes the formation of new marginal caries. Thanks to the latest technical developments in composites for polymerization in dental technology, however, marginal gap formation can be minimized. In the posterior region (molars), composites are only suitable to a limited extent, since the occlusal surfaces can be subjected to excessive stress when chewing. Therefore, composites are used in the posterior region only in less stressed cavities such as the anterior region.
Would you like to know more about the possibilities of a composite filling or other filling materials for the anterior or posterior region in our oral surgery?
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