odontoiatria conservativa

DENTAL FILLINGS

Preserving our smile in the long term

Dental filling mainly regards the treatment of dental cavities and its aim is to preserve decayed and fractured teeth or those presenting any other damages. Its goal is to remove the decayed tissue and restore the tooth’s original shape and function.

It is a disease caused by bacteria normally present in the oral cavity and which, with a high concentration of sugars, can damage the tooth’s hard tissues and cause cavities.
If treated in time, it is possible to save the tooth but, if ignored, bacteria can reach the tooth core and pulp and then a root canal treatment is necessary or it might also be impossible to save the tooth which will have to be extracted.

If the cavity is at its initial stage, the patient does not feel any pain. Dental check-ups will verify if any cavities are present and therefore intervene quickly. The patient will feel pain only when the cavity reaches a certain depth. This usually happens when it is exposed to hot and cold and the patient can then feel pain during chewing or when ingesting sour and sweet foods.
If the cavity is ignored, it will keep on damaging the tooth until it reaches the pulp thus causing an intense and spontaneous pain (pulpitis).

The orthodontist will diagnose the presence of cavities during an accurate check-up session by using specific enlarging glasses, Bite wing X-rays or quadrants and DIAGNOCAM, a new instrument present in our Orthodontic Center which can easily see the presence of cavities. Through tooth transillumination, cavities are visible as dark spots. This innovative instrument enables us to early diagnose the presence of cavities and therefore treat them without feeling pain and preserving the teeth essence. In order to reduce the chance of cavity presence, we remind the importance of an accurate oral hygiene together with the professional hygiene session and dental check-ups (which will be able to early locate any cavities).

The dentist will have to remove the decaying tissue. He will proceed with anaesthesia by isolating the area with a rubber dam, thus guaranteeing that the intervention is in a clean area without any risk of bacterial contamination.
Thanks to enlarging technologies, it will remove the damaged tissue in a precise and systematic way and then evaluate the tooth health conditions in order to define the entity of the reconstruction work. If the interested area is narrow, he will proceed with a direct restoration (meaning directly in the patient’s mouth), while if the damaged area is wide and the tooth is exposed to risk fractures during chewing, he will proceed with an indirect restoration (outside the patient’s mouth) which can be partial (inlay) or total (crown).

It is an orthodontic procedure which uses composite materials and allows us to reconstruct damaged tooth parts caused by cavities or traumas. It can be done on both anterior and posterior teeth. The materials used are defined composites. Thanks to their color and consistency, it is possible to reproduce the aspect of a tooth in a natural way. If used on anterior teeth, it is even possible to reconstruct damages involving 40% of the tooth. On posterior teeth, they are usually used to substitute old fillings, which became too dark for a dazzling smile.

It is a therapy in between a filling and a crown.
It enables us to reconstruct very damaged teeth and save their intact dental tissue.
This technique is used before doing a crown since it saves healthy dental tissue.
Patients with old fillings often decide to substitute them because they are unaesthetic and they choose one of the new materials on the market, like zirconium or composite.
Inlay is considered a filling to perform on cuspids and bicuspids when these are so damaged that a traditional filling is no longer possible. Inalys are prepared in the lab based on dental impressions which have been prepared inside the mouth by using mills (it requires a preparation able to make it retentive on the tooth when it is cemented).
Inlays are divided into onlay when they cover the entire occlusal part of the tooth and inlay when they are included inside the tooth’s shape.

It is an alloy of mercury and metals such as silver, tin and copper which has been used until some years ago for dental fillings. Our dental office has not used it for more than 10 years.

The endodontic treatment

Endodontics takes care of the “inner part of teeth” consenting the maintenance of dental elements in the mouth which would otherwise be extracted.
After the necessary X-rays which highlight the real conditions of the tooth, the endodontic treatment removes the infected dental pulp and the disinfection of the inner cavity.
Once the disinfection is complete, the orthodontist proceeds with the sealing through biomaterials and then with the temporary or definite restoration of the stimulated chewing area.

At the end of the treatment, he proceeds with an X-ray in order to verify the final sealing of the inner part of the tooth. In order to avoid a dental fracture, it is often necessary to act a total (crown) or partial (inlay) prosthetic restoration.

Endodontic treatment, or devitalization, is necessary when the dental pulp is either inflamed or infected due to a deep cavity, a tooth fracture (of a violent trauma) or repeated orthodontic interventions. If there is not an adequate intervention, the tooth may hurt severely and persistently and cause recurrent abscesses.

Apart from cases of unclear symptomatology, the patient usually feels pain during chewing, develops hypersensibility to hot and/or cold, registers a possible tooth uncoloring and, during the acute phase, swelling and pus.

In most cases the aim of the therapy is to eliminate acute pain caused by the inflammated dental pulp. In any case, most patients do not feel any pain thanks to anaesthetics and technologies in use. After the therapy it is possible to feel some pain which, if intense, can be alleviated by using the most common anaesthetics, always following the dentist indications.

Until the tooth has been completely rehabilitated with a definite restoration, it can break more easily than a healthy one, so it is important to not chew hard foods on the tooth undergoing the therapy.  After the complete restoration, its functionality will be complete and it will be sufficient to perform a correct oral hygiene and regular dental check-ups.
Thanks to endodontic therapy, most teeth will have a long life as healthy and natural teeth but, in some cases, the infection can persist and reoccur after a long time, thus making a new endodontic therapy necessary.
Reinfection can occur even as a cause of new fractures, present cavities or because the sealing does not carry out its function correctly.

Most teeth can be successfully treated and carry out their function for years but, if the tooth is severely fractured or it is not possible to access the deepest part of the root or if it does not present an adequate bone support, it is not possible to intervene with an endodontic therapy.

Gingival recession or receding gums.

Some patients present a consistent gingival recession in the teeth cervical area. The main causes are: wrong dental brushing, lack of oral hygiene and periodontitis. The consequences are: dentin hypersensitivity and deterioration of the general aesthetic aspect of the face. Gingival recession changes the proportion between the tooth and the gum, especially at incisor, canine and bicuspid level. It is therefore necessary to reconstruct the damaged part of the tooth with a composite material. At this point, micro surgery is needed to graft the connective tissue which reconstructs the gum and covers the dental root, thus protecting sensitive teeth.