EN
TR EN DE

Restorative Treatments (Filling)

Restorative Treatments (Filling)

When there is material loss or tooth decay in the teeth due to various reasons, filling treatment is applied.
Teeth with decay, fractures, or cracks that cannot function properly or have aesthetic issues due to material loss can be repaired with fillings. All materials used for the restoration of the tooth are called dental fillings.
When filling a tooth, the problem is first identified. After detecting the issue, the most appropriate type of dental filling for that case is determined and recommended by our dentists.

 

How is a Dental Filling Done?

Before applying fillings, preparation is required.
In the first stage, if there is decay, it must be cleaned; if there is an old filling, it is removed, and the tooth is cleared of all foreign substances.
In the second stage, based on the tooth's position, function, aesthetic requirements, and the size of the filling to be done, the appropriate material is chosen and the tooth is filled. During these procedures, local anesthesia is usually applied to numb the tooth so that the patient does not feel pain.
In the final stage, the compatibility and height of the filling with the other teeth are checked. If there are excesses that may disturb the patient, they are adjusted. Then, the filling is polished.

 

Types of Dental Fillings

Dental fillings vary depending on the application area, purpose, and material used. Various materials are used in dental restorations. The materials used in fillings are carefully selected according to their intended use and placement.
Composite filling, amalgam filling, and porcelain filling are the most commonly used materials in permanent restorations. Glass ionomer filling is preferred in more specific situations.
When making deep fillings or working in an area close to the nerve, a temporary filling is applied first to prevent pain, followed by a permanent filling material.
If the person to be filled is a child or very young and the nerves are exposed while cleaning the decay, and the tooth has not yet fully developed, MTA filling is preferred.
There are also different materials for temporary fillings.
The concept of "best dental filling" begins with choosing the right material for the right place.

 

Amalgam filling is a type of filling that can acquire a silver color or darken over time due to the metal components in it. It is commonly known as "black filling" or "metal filling" and is considered the oldest filling material.
One of its biggest disadvantages is the presence of mercury. Additionally, its mechanical adherence to the tooth does not provide adequate support against breaking forces. As a result, the breaking or dislodging of amalgam fillings is more common than with other filling materials. In some cases, the breaking of the filled tooth may result in tooth extraction.
Amalgam fillings may cause a grayish color change in the teeth they are applied to and are toxic due to the mercury content.
However, their most well-known advantage is that they are more resistant to "secondary decay," which refers to new decay around the filling. However, due to the superior properties of newer composite materials, amalgam fillings are not preferred today.
Our clinic does not apply amalgam fillings.

 

Composite filling is an aesthetic treatment method used to repair tooth decay. These fillings can match the color of the tooth and provide a natural appearance. After the decay is cleaned, the composite material is placed into the tooth and hardened with UV light. This method is also preferred for tooth fractures and cracks. Composite fillings, which offer a quick and effective solution, provide both functionality and aesthetics.

In Which Problems is Composite Filling Applied?
Today, composite filling is applied for tooth decay, cracks, fractures, and damage to the tooth enamel. Due to its aesthetic appearance, it is especially preferred for front teeth to provide a natural integration and to remain unnoticed. The common situations where composite fillings are applied are as follows:

  • Restoration of cracked or broken teeth to their original form.
  • Correction of tooth color issues.
  • Filling the spaces left after cleaning decay.
  • Lengthening short teeth.
  • Placing a crown to protect the tooth root due to gum recession.
  • Converting dark-colored fillings like amalgam into a more aesthetic appearance.

 

Glass ionomer fillings are generally preferred as transitional or temporary fillings. If there are no suitable conditions for permanent restoration in young children, they are applied for a period of 6 months to 1 year to buy time.
In adult patients, if there is a risk of tooth fracture between root canal treatments, glass ionomer fillings can be used as a temporary filling. It is also preferred for treating teeth with developmental anomalies, defective enamel, or calcified teeth.

 

The material known as Mineral Trioxide Aggregate (MTA) is a filling material used in specific treatment protocols. Its main areas of use are root canals, root ends, and pulp and surrounding areas where blood vessels and nerves are found. It is preferred in canal fillings, root ends, and filling areas. However, due to its inability to withstand chewing forces and saliva, it is not used as a permanent filling material.

In children and young individuals, if the decay has reached the nerve in a non-inflamed tooth, MTA fillings may be preferred as a base filling. In young individuals whose root development is not completed, if the pulp is not infected, the nerves and blood vessels are not fully cleaned. Thus, the tooth retains partial vitality and its root development is not hindered.

Methods of Applying MTA:

  • In very deep cavities where the nerve has not been exposed but the reflection of the pulp is visible, a protective barrier (coffin) is applied to the filling area as a protective barrier.
  • After the cavity is cleaned, if the pulp is exposed and the nerve-vessel package is damaged, the living tissues in the crown section are cleaned, excluding the roots. The tooth is amputated, and MTA is applied to the canal entrances, preserving the vitality of the roots.
  • If root development is not completed in young individuals, MTA is used as a root apex filling to seal the roots and maintain the continuity of tooth development when a root canal treatment is required.
  • In teeth treated with root canal therapy, if a resection surgery has been applied due to root cysts and inflammation, MTA is preferred as the root apex filling.

 

In very deep cavities where the filling is very close to the tooth's nerves, a protective barrier is applied between the filling and the nerves. This procedure is called the cofferdam procedure. The success rate is not very low and, in suitable cases, it is applied at the discretion of the doctor.

 

In very deep and difficult fillings, it may sometimes not be possible to make a permanent filling on the same day after cleaning the decay. In this case, a temporary filling is used to restore the tooth until the proper conditions are met.

There are some important points to consider with teeth that have temporary fillings:

  • Since temporary fillings are not very durable, the filling falling out is the most common problem.
  • Additionally, since these fillings cannot support the tooth sufficiently, problems such as the tooth breaking can also occur.

When a temporary filling is placed in the mouth, the following precautions should be taken until the permanent restoration is performed:

  • Chewing should not be done on the affected area.
  • The filled area should be carefully brushed and kept clean.