The approaches and options available for supplying fillings have undergone a fundamental transformation over the last 10 years. In the past, only amalgam or gold was used for fillings in the posterior region and the teeth were usually prepared very generously for preventive reasons. Nowadays, at least in our practice, amalgam is no longer processed, although it should be mentioned that the material-physical properties of this material were excellent – but nothing more!
The treatment of caries pursues various approaches. To avoid larger defects, carious damage is already treated in the initial stages and in keeping with its “maturity”. If the tooth decay is only affecting the enamel, a runny synthetic liquid may be able to do the job entirely without drilling. This re-stabilizes the porous enamel and closes the diffusion paths for the acids that damage the enamel. And if the area is kept clean so the process can’t start all over again, there’s no need to drill!
If the caries has penetrated more deeply, the diseased substance is removed and then replaced by a filling by means of specially developed instruments. The colour variety of our teeth helps to render the filling “invisible”. Using specially developed MIFT instruments (minimally invasive filling therapy), only as little tooth substance as absolutely necessary is removed. Further measures for caries reduction and prevention are thereby rendered obsolete. The main area of application is the treatment of initial fissure caries (pitting caries in the tooth grooves), as well as in the area between the teeth (interdental space) and at the necks of the teeth. Due to the large variety of tooth shades, the industry also offers corresponding resins which enable “invisible” filling restorations.
Very extensive defects may call for an inlay. However, there is a certain restriction regarding the size. With increasing volume, the risk of local gap formation increases. In addition, plastic fillings are more difficult to clean, as they facilitate the accumulation of special deposits, especially in the interdental area. The best treatment option available in this case are ceramic inlays. The high gloss of their fired surfaces makes hygiene so much easier. Even bacteria will slip off this kind of surface, and the accumulation of food pigments is also drastically reduced. Gold inlays and onlays are not superior to ceramic restorations and are hardly ever used today. They are also, quite apart from the aesthetic point of view, much more expensive, but unbeatable!
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