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Composite Restoration

Tooth Restoration, Cavity Filling in tooth

also known as Composite filling in tooth / tooth colored restoration

A dental restoration is also called a filling. It is the repair of a damaged or decayed tooth, restoring it back to its normal shape, appearance and function.

The name of the material that is used to repair a tooth is often the name given to the repair process.

FAQ

1. How much time is needed for one tooth filling ?

Usually it takes single appointment for single filling. we need total 30 mins to 1 Hour of working time.

2. What is Amalgam tooth restoration ?

Dental amalgam is a metallic restorative material composed of a mixture of silver–tin–copper alloy and mercury.
The unset mixture is pressed (condensed) into a specifically prepared undercut tooth form and contoured to restore the tooth's form and function

3. Do we still perform amalgam restorations ?

Amalgam has been used in dentistry since about 150 years and is still being used due to its low cost, ease of application, strength, durability, and bacteriostatic effect.

But due to innovations of upgraded & advanced materials like resin based cements ( Composites ) use of amalgam has reduced drastically.

4. What are Other materials available for tooth restorations ?

1. Zinc Oxide Cement
2. Glass Inomer Cement
3. Zinc Phosphate Cement
4. Zinc Polycarboxylate Cement
5. Composite Resin Cement
6. Resin modified glass-ionomer cement (RMGIC)
7 . Compomers
8. Cermets
9. Indirect restorative materials - Porcelain Inlay

5. Why Composite tooth coloured restorations are so popular ?

"The superglue of dentistry"
Composite resin is a plastic tooth-coloured material that is used as a filling. It is also called a white or plastic filling. The process of fusing the filling material to the tooth is called bonding.

It is placed into the cavity in layers until the tooth is restored to its original form. An ultraviolet light is used to harden it, and it can be chewed on immediately after it has been completed. This is an advantage it has over amalgam.

The filling bonds or sticks to the tooth. This characteristic is a major advance for dentistry. There is no longer the need to cut a slot into a tooth to hold a filling in place, as is necessary for an amalgam filling. As a result, less tooth needs to be cut away for a filling.

6. What is Life span of any filling ? & Do they Fail ?

Fillings have a finite lifespan and avoiding new cavities is probably a more important factor than the material chosen for the restoration.
composites appear to have a higher failure rate than amalgam over five to seven years.

Other Factors also come in picture -
1. How well people keep their teeth clean.
2. What are food habits of patients ( soft / hard / sticky )
3. Type of filling ( Class 1 / Class 2 / Class 3 / Class 4 / Class 5 ) - note- ask your doctor for help here.
4. Following Post operative care instructions.
5. Shelf life of any material used inside oral conditions for longer durations.

Pre-Operative :-

1) Patients should have heavy breakfast or meal 1 hr prior to coming for treatment.

2) Kindly refrain from using any kind of make up or cosmetics on the day of procedure. It may lead to contamination.

3) If you have any symptoms of Covid 19 ( Cough, Fever, Body ache, Difficulty in breathing, Diarrhea, Vommiting, Rash ) just cancel the appoinment.

4) Call at Clinic before leaving from home for final confirmation of appointment.

5) Patient should be present in clinic premises 15-20 mins before the procedure timing to avoid anxiety.

Kindly Note - description here is for single tooth filling. Charges of multiple fillings will be in multiple of number of teeth considered as carious.

Phase 1 - Cavity Removal

Step 1


Inspection of caries spread on tooth surfaces.

Carefully see extent and depth of cavity ( Caries )
If requied take RVG X ray if you feel cavity is deep inside and close to pulp of tooth. ( to avoid RCT - root canal therapy )

Caries Extent
Caries Extent 1
Caries Extent 2
Case study

Step 2


Removal of carious part of tooth.

with help of high speed air roter make a small hole on tooth surface to remove decayed part of tooth

Step 3


Check for sensitivity, if any ?

if caries are shallow then it is ok.

But if it is deep then you may feel sensitivity while working with high speed air-roters * upto 1 lakh RPM * as it causes tremendous friction and ample heat generation which further increases sensitivity even when we are in dentin.

caries removal with air roter
Sensitivity 2

Step 4


If more sensitivity is der ? Just Stop.

with help of diagnostic RVG X ray cross check depth of cavity. ***remember for any X ray - it gives 2D image only, so you have to rely on your doctors technical and hand skills here as cavity spreads in 3D ( length, width and depth )***

Step 5


Final Inspection of Cavity Prepared.

Try to remove all caries * * * Score as less as possible... * * *

Score 5 - Black portion - as it is most active area of disease.

Score 4 - Dark Brown - Try to remove as it may create post operative sensitivity if left behind.

Score 3 - Light Brown - Freshly spead cavity / caries - Try to remove but can be left if you feel too much of sensitivity.

Score 2 - Dark yellow still visible - means max possible caries are out now ------------ > Time for filling then.

Note here - Score 1 - Yellow - similar to other part of dentin is actually healthy dentin.

Caries Extent Deep

Kindly Note -

As a Dentist / Dental doctor - It requires lots and lots of patience to fill tooth in steps and maintain natural contours by Hand Carving, which depends on time given, skills and expertize of your dentist.

As a Dental Patient - You Co-operation is expected as it may take 10 to 15 mins for completing filling process and for that time you need to keep your mouth open, even your jaws may pain for a while due to wide opening for longer durations & be prepared for it.

Phase 2 - Tooth filling

Light Cure Gun

Step 6


Filling of Tooth.

It involve eatching of prepared surfaces,

application of bond with brush, curing bond &

with help of choice of your material fill tooth in small small increments &

Cure to regain its all contours, form & Functions.

Composite fillings 2
Interdental Matrices

Phase 3 - Finishing & Polishing

Step 7


Removal of Excess material & High points.

with help of high speed air roter merge all borders of filling,

use Abrasive burs to finish the sufaces of filling &

Finally polish with advanced polishing kits.

Finishing & Polishing Kits

Phase 4 - Follow Up

Good work Vs Excellent work

Step 8


Revisiting doctor after every 6 months.

just to consult and see if any issues with old fillings you had.

Kindly Note - Many patients fail to undergo these IMP & mandatory actions which negatively impacts success of procedure.

Phase 5 - Maintainence

Step 9


Scaling of all teeth

Maintaing oral hygeine is very important for longevity and success of fillings so it is advisable to get scaling done every 6 months for lifetime

Step 12


Self - Care of tooth

Avoid biting any hard stuff from perticular tooth &

Avoid sticky food.



Post-operative Do’s & Don’ts

1) Avoid eating till the effect of anaesthesia goes off completely ( If given due to high sensitivity ) as patient may end up biting lips, tongue or cheeks accidentally.

2) Do not touch the operated site with fingers, tongue or by any other means.

3) Patient should avoid all types of health hazardous habits like tobacco chewing / smoking, as it may leave stains on teeth and fillings.

4) Maintain good food habits.

5) Do not eat too hot / too cold / too Sweet / too hard / too sticky food from operated side of mouth.

6) Slight pain & discomfort to jaw & joint areas is common.

7) In case of deep cavities mild to moderate sensitivity to heat and cold is expected.

8) In case of too much sensitivity or pain, Visit your doctor urgently as you may need root canal procedure & Crown to save that perticular tooth. ( Charged Separately )

9) In case of failure of filling - it fractues or dislodges or comes out completely, Visit your Dentist asap to refill or see for other options. ( Charged Separately )

What is cost of Composite restoration in single tooth ?

Class 1 cavity Composite restoration
Including Sterilization + Disposable accessories
Rs. 3500
Class 2 cavity Composite restoration
Including Sterilization + Disposable accessories
Rs. 4500
Anterior Composite restoration
Including Sterilization + Disposable accessories
Rs. 6000