Metal Free Restorations
Metal Free Fillings
- There are 2 types of metal free fillings, Glass ionomers and composites.
We generally consider Glass ionomers as medium-term fillings or perhaps for very small fillings. They are also used as “lining” under a filling or as a cement to stick-on crowns. They chemically bond to the tooth and can help to remineralise decayed teeth due to realising Fluoride directly into the tooth.
We understand some people have concerns regarding Fluoride. We agree that ingesting Fluoride can affect the gut biome, which is essential for health.However, from our understanding, the levels released from glass ionomers are not harmful, and we feel the benefits far outweigh the concerns. We also have a situation where we have to use something to fill a tooth, and out of all the current materials, we feel glass ionomers are the safest. When used with a disinfection and remineralisation protocol, we reduce the number of teeth that need to be root treated or removed.
Composite materials are resins which are filled with a ceramic or glass particles. They are either a paste or flowable materials which are set by a special light.
Composites require the use of a bonding agent (glue) to stick them to the tooth.
Before we place the composite, we remove any restorations and decay. Deep decay is left over the nerve, disinfected using ozone or Riva Star. The tooth is conditioned to improve the bond strength.
In deep cavities, we usually use some type of glass ionomer lining to reduce the chance of injury to the nerve and to help remineralise any remaining
decay. A bond is placed and set, and the composite material is used to restore the cavity. The use of composite is very technique sensitive and requires time to do well.
Studies have shown that the bond between the tooth and the composite breaks down over time. Some people suggest composites be replaced after 5 to 8 years.
We feel with modern materials and good techniques they can last much longer. We use a variety of composite brands, depending on what we are trying to achieve. In general, the composites we use are considered biocompatible.
Mercury fillings may continually release mercury vapour after they’ve been placed, despite being branded as ‘stable’. However, the BPA compound released from a composite isn’t something which continues after its initial placement. Research shows the highest BPA release comes just after the composite has been put in the tooth, with no detectable traces found in a patient’s saliva after the first 24 hours.
The human body can remove BPA as long as exposure to it doesn’t continue. Despite concerns about its effect on people’s health and the environment, it’s still widely used today. This means exposure the BPA on a daily basis is often much higher than the one-off contact of receiving a composite filling.
Metal Free Crowns
We believeporcelain and zirconia crowns are not only superior in terms of biocompatibility, but they are also far superior cosmetically too.
The gum health around all porcelain and zirconia crowns is generally much better than a metal-containing crown. With modern materials, the tooth reduction is less than compared to a porcelain bonded to a metal support crown.
If a tooth has a crown already, we will remove the crown in a safe way. If a tooth is too badly broken down to have a filling, a crown may be recommended.
Any decay is removed from the tooth, and the tooth is built up and strengthened with composite or glass ionomer (“core build”).
The tooth is shaped and polished, and an impression or scan is made, which is sent to the laboratory for a crown to be made.
A temporary crown is placed onto the tooth between visits.
Porcelain fillings/inlays and onlays
Porcelain can be used as a filling material instead of composite. Some people have a preference for this.
We usually recommend this when a tooth is cracked or has a very large filling, but doesn’t require a crown.
We believe in affordable specialty healthcare for all.
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