Different types of dental restorations are designed to do specific jobs. Often the type of restoration recommended is directly dependent on how much healthy tooth structure is remaining after excavation of the pathology. Here is a breakdown of the most common restorations:
1. Sealants- White filling materials in a "flowable" form. Used to fill the decay-susceptible grooves of the back teeth. Usually utilized in children between 6-18 years as a preventative measure.
2. Fillings- Composite or white fillings. Placed directly into the prepared tooth. Used where the existing fillings or areas of decay are small enough that the remaining tooth structure has not been overly compromised.
3. Porcelain Inlays- Used in similar situations as fillings except a pre-made piece of ceramic material is bonded into the tooth. This results in superior physical properties, possibly providing a lifespan of 2 to 3 times longer than a composite filling. Inlays are a top-quality alternative to the composite filling.
4. Porcelain Onlays- Used in situations where the tooth is fractured or has been severely decayed, the onlay is similar to the inlay described above except that the ceramic covers the entire or most of the biting surface. An onlay is more conservative in preparation than a crown, it does not cover the entire visible tooth structure, so there is no need to grind away all sides of the tooth unless there is a specific reason.
5. Crowns(caps)- A crown, the largest single tooth restoration, sometimes cannot be avoided. It covers all sides of the tooth as well as the end. It is used when there is limited tooth structure left, when an existing crown must be replaced, or when the tooth is an "anchor" tooth for a fixed bridge.
6. Veneers- Thin porcelain facings that cover the front side of teeth. Used cosmetically to change the length, color and shape of teeth. Can be preformed with minimal tooth preparation and an excellent choice for a cosmetic make-over.
7. Bridges- Used to replace missing teeth when sufficient "anchor" teeth are available on each side of the gap. Numerous systems are available, including fiber-reinforced ceramics, Zirconium-based ceramics and porcelain fused to metal bridges.
8. Implants-Titanium posts surgically placed into the jawbone. After placement the bone grows around the implant through a process called osseointegration (usually three-six months after placement) and later the restorative phase can begin. Implants are used to support various dental prosthesis ranging from single crowns to a full denture. Given the choice between a bridge and an implant, an implant is considered the superior choice since it doesn't require preparation of adjacent teeth and there for more conservative.
9. Removable Partial Dentures- Used to replace missing teeth when insufficient teeth remain to support fixed bridges or a patient is not a good candidate for dental implants. Partial dentures can be metal or acrylic-based.
10. Removable Complete Denture- Utilized when no teeth remain and implants are not an option due to case specifics. By today's standards this is basically a last resort.
