IN therapeutic dentistry Various types of fillings are used, which differ in their composition and purpose. When choosing consumables For the final filling, the doctor pays attention to the location of the tooth - aesthetics is important for the front tooth, and strength and abrasion resistance are important for the chewing molar.
There are two main types of dental fillings:
A temporary filling is placed on a tooth for a short period of time (several days or weeks) and performs protective function in cases where treatment takes place in several stages. For example, when treating deep caries, when the doctor needs to make sure that the tooth cavity is cleaned efficiently during prosthetics to create an antimicrobial barrier.
The quality of the material for a dental filling is a determining factor not only for filling technology, but also for the cost of the procedure:
It should be noted that before filling, a number of preparatory procedures are carried out (mechanical and medicinal treatment, caries treatment), so the final cost of the service will be higher.
These periods can be increased or decreased depending on the type and manufacturer of the material, the presence of individual structural features of the teeth, and the extent of damage to the crown.
The filling procedure takes place in several stages:
The final stage - surface grinding - is carried out selectively in cases where it is necessary to correct the shape of the crown.
The choice of one material or another depends not only on the nature of the tooth damage, but also on the age of the patient.
For filling children's teeth, they try to use light-curing compounds, not so much for economic reasons, but for psychological ones (to minimize the discomfort from the procedure). For the same purposes, the ability to choose the color of the filling is used.
Children are usually fitted with structures that have a biologically active, non-toxic composition (for example, glass ionomers).
After installation, glass ionomer cements release fluoride, thereby promoting enamel remineralization. However, due to rapid abrasion, they are most often used to seal fissures (grooves between the cusps of teeth).
In adult patients, the range of options is wider, but the factors of individual intolerance are more pronounced (fragility of enamel, allergic reaction to components of chemically cured compositions).
If the patient complains that the tooth hurts when pressed, it is too early to talk about the occurrence of complications. Painful sensations usually pass within a day. Their cause is irritation of dental tissues caused by exposure to mechanical instruments.
If the pain does not subside and is accompanied by an increase in temperature, then you should quickly seek help. Usually the problem is solved by repeated cleaning and filling, sometimes with replacement of the consumable composition (when the inflammation is caused by an allergic reaction).
Today, dentists can offer their patients a variety of filling options that are both effective and affordable. All they have to do is find a clinic and make an appointment.
For most people, dental fillings are their first dental procedure. It allows you to preserve the organ, its aesthetics and functionality. The latter is especially important for molars. The inability to chew food normally affects a person’s general well-being, not to mention possible diseases gastrointestinal tract. This means that fillings for molars must meet special requirements. In order to choose the most suitable one from several materials offered by modern dentistry, it is worth knowing the types of fillings, as well as the qualities they require.
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Dentists have several materials at their disposal different properties, quality and price. Which one to use for chewing teeth, is determined by many circumstances, including the size of the cavity being filled.
Sometimes it makes sense to install a tab. But if it is possible to get by with filling, then the choice is made among cement and composite materials, which also come in several types.
Such fillings have been used for a long time, since there are three subtypes of them, satisfying the requirements to varying degrees modern dentistry:
Relatively new materials for filling have already received their share of recognition among dentists and patients.
There are also several subspecies, each of which has its own advantages and disadvantages:
Acrylic-containing. They contain a toxic compound, which is why they are not suitable for everyone. This feature becomes common cause pulpitis, since acrylic has a very negative effect on this part of the tooth. The material is quite durable, wears out slowly, but absorbs everything that happens in the oral cavity. This increases the risk of caries not only for the filled tooth, but also standing nearby. Acrylic fillings tend to quickly become deformed and “eaten”; 
Epoxy. Less poisonous and also resistant to abrasion, but break quite easily. The advantage of such fillings is their rapid and uniform hardening, which allows them to fill large cavities in the teeth. But this same quality can be considered negative if an inexperienced dentist does not manage to install it correctly within a certain time. In addition, epoxy resin fillings release substances that can destroy the pulp. It will last for 3-4 years, provided there is no heavy load on the tooth;
Light-curing. They are quite durable due to the fact that their final appearance is obtained as a result of polymerization under the influence of ultraviolet radiation. They tend to shrink over time, although not as much as other composite fillings. Only 70% hardened. To ensure they last longer than 5 years, careful grinding and polishing is required during installation.
There is an even more modern subtype - nanocomposites. The material consists of tiny particles that provide reliable adhesion to tooth tissues and the strength of the filling itself. This is the most suitable option for treating molar chewing teeth. Dentists consider it universal.
This material took the best from composite compositions and glass ionomer cements, from which it received its name. Compomers consist of monomer, resin and polyacrylic acid, benzoyl peroxide and amine. When installing such a seal polymerizes evenly, which gives it density and provides uniformity regardless of size.
Despite this, compomers are mainly used for filling anterior teeth. The load falling on the chewing teeth is too great for them. Therefore, dentists are confident that This filling material is not suitable for molars..
To decide how to heal chewing teeth, it is necessary to highlight what qualities fillings for them should have:
Strength. We are talking about resistance to fracture, minimal deformation over time and low abrasion. The mechanical load on molars is high, so the listed properties are of paramount importance;
Tight fit. The presence of this quality will ensure the safety of the tooth, since it is almost impossible for infection, food debris and development secondary caries;
Unaffected by saliva. The filling should not be easily soluble;
Neutrality of the material. Chewing teeth Dentists prefer not to depulpate, if possible, in order to save them longer. A seal that releases harmful compounds for nerve endings, nullifies these efforts.
It is believed that to receive decent dental treatment By compulsory medical insurance policy impossible either in the state, much less in private clinic. Sometimes this corresponds to reality. But in fact, in the “List of medications for the provision of free outpatient dental care” there are several names composite and cement filling materials , which may well be used in the treatment of chewing teeth.
The first include:
These are the materials light curing, characterized by small wearability and shrinkage. Properly installed photocomposite filling will last up to 10 years. In addition, its aesthetic qualities are beyond praise: There is large selection shades, the structure after polishing is similar to enamel.
To ensure that the appearance of the filling remains the same, this procedure is recommended to be done every six months. But since we are talking about molars, for which aesthetics of great importance does not have, it is not necessary.
The list of filling drugs that medical institutions must provide to patients free of charge includes glass ionomer cements:
Such materials are good adhere to the walls of the cavity, not susceptible to rapid washable, not afraid of wet environments. Among the disadvantages we can name them external unattractiveness, but for molar chewing teeth this is not so important.
Unfortunately, among the free drugs there are no strengthened glass ionomer cements, as well as nanocomposites. But if the patient does not have the opportunity to pay for filling out of his own pocket, it makes sense to choose one of the listed materials for the treatment of molar chewing teeth.
On the list of drugs for dental treatment, for which the Compulsory Medical Insurance Fund pays, there are also silicate cements Silitsin and Silidont. In the absence of other possibilities, it is permissible to use them in filling primary chewing teeth in children. It is better not to put such a filling on adults. Even if it lasts longer than 3 years, caries will probably develop underneath it.
Hard dental tissues, unfortunately, cannot regenerate (recover). For this reason, fragments of enamel and dentin affected by caries or broken off need to be replaced with artificial materials. Restoration can be done by placing fillings or making inlays. Significant defects require orthopedic treatment.
Filling has two main purposes:
All materials used to restore dental crowns must meet the following requirements:
Please note:A correctly placed filling should ideally be completely invisible (at least for a non-specialist).
Before placing a filling, a series of preparatory work which include:
Direct filling involves:
What are fillings needed for? The answer to this question in the video review is given by a dentist:
According to their purpose, all fillings can be divided into temporary and permanent. The former can serve for temporary isolation of the cavity into which the medicinal drug(some materials contain medicines). A temporary filling can also be placed if the dentist is not completely sure that pulpitis will not develop (such fillings can be called “diagnostic”).
Temporary fillings differ from permanent fillings in their composition. Less durable materials are used for their manufacture, which allows the doctor to easily remove such temporary fillings after 1-3 days during the patient’s next visit. A common material for such fillings is artificial dentin, which is mixed with water. With its help, in particular, the arsenic paste necessary for devitalization (destruction, removal) of the pulp (neurovascular bundle) of the tooth is fixed and isolated.
Important:arsenic is a toxic substance. A small amount of a drug containing arsenic is introduced into the tooth cavity to “kill the nerve.”
Permanent fillings, made of high-quality material and installed in compliance with all rules, are designed to last for many years and even decades.
Please note: if the filling was lost after just a few months, then either there was a violation of the technology, or the doctor did not take into account the mechanical loads (i.e., an artificial crown was required).
Metal fillings are made from amalgam - alloys of certain metals with mercury. Until recently, silver amalgam was the most common. Before placing such a filling, the doctor had to thoroughly mix fine silver powder with mercury. Working with this health hazard required compliance with particularly stringent rules. To be fair, it should be noted that the finished amalgam is almost non-toxic ( tobacco smoke contains much more mercury).
The disadvantage of this type of filling is the likelihood of developing the “galvanism” effect (the appearance of a weak current) if present in the mouth metal crowns or bridges. Disadvantages can also be considered the presence of the filling against the background of the tooth (characteristic metallic shine), the duration of curing (up to 3 hours) and the expansion coefficient, which differs significantly from that for natural tooth tissue (chipping may occur when eating cold and hot food). Obvious advantages are the ability to place metal fillings in a damp cavity, their negative shrinkage and fantastic wear resistance. To this day, dentists can find amalgam in a patient’s mouth that was placed in the last century.
Several types of cements are used in dentistry, but for fillings, as a rule, either phosphate or glass ionomer are used.
Please note: cements are two-component materials. When kneading, the powder and liquid are mixed.
Until relatively recently, phosphate cement fillings were placed on everyone as part of the provision of free dental care. The undoubted advantages of materials in this category are their low cost and ease of use. Mechanical strength, i.e., abrasion resistance leaves much to be desired and, in addition, there is a poor “edge fit” to the walls of the formed cavity. As a result, a gap gradually forms between the filling and the walls of the crown defect, into which food leftovers, and secondary caries develops. To increase the mechanical strength, finely dispersed silver powder was often added to the composition of such cements, but this did not solve the problem of poor marginal fit.
A much more advanced material is glass ionomer cements, which are characterized by quite high degree affinity with hard tissues tooth They contain fluoride ions that promote enamel remineralization. Due to this circumstance, glass ionomer fillings are often placed on children’s baby teeth. The adhesive properties of such cements are much higher than those of phosphate cements, which partly solves the problem of marginal adhesion. However, fillings in this category are not characterized by high mechanical stability and no additives have helped to radically solve this problem.
All cements have a very short "working time". After mixing the composition, it is necessary to introduce it into the cavity and form a filling within a matter of minutes. Then the material begins to quickly “set”, that is, lose the necessary plasticity.
A breakthrough in dentistry was the appearance of plastic and composite fillings. Most filling plastics are based on acrylic acid compounds. The material has high mechanical strength, which ensures the durability of the fillings, provided they are installed correctly. Another advantage is the ability to choose the material by color. In some cases, after grinding and polishing, plastic may be indistinguishable in appearance from healthy enamel.
But plastic fillings have many disadvantages. During polymerization, it is formed huge amount microscopic pores, which later becomes the cause of the development of secondary caries. The porous surface is an excellent basis for the proliferation of microorganisms that contribute to the development of a number of oral diseases. Aesthetic advantages also fade away quite quickly; the material tends to darken, especially under the influence of food coloring and nicotine. A serious disadvantage is the toxicity of acrylic plastics. Aggressive chemical compound affects the pulp. If a filling is installed on a tooth from which the nerve has not been previously removed, then even with a high-quality insulating cement lining, the likelihood of developing pulpitis is very high.
Two-component (“paste-paste”) composite materials based on epoxy resins have significantly fewer disadvantages. Toxicity of the composition does occur, but it is not as pronounced as with acrylic polymers. Composite fillings wear out even more slowly, but their fragility is somewhat higher. They are perfect, for example, for filling a defect on the chewing surface of a crown, but cutting edge It is not recommended to restore them.
Photopolymers (solar fillings, light fillings) are the most modern materials. Compositions with a paste-like consistency tend to harden under the influence of ultraviolet radiation, the source of which is special dental lamps.
The doctor can take his time in the process of introducing material into the cavity and final formation of the filling, which, among other things, ensures high quality filling There is no need to sand off a significant amount after curing; All you need to do is polish with fine abrasive attachments to add shine. The widest range of shades allows you to achieve a perfect match between the color of the filling and the color of the surrounding healthy enamel. Even a specialist cannot always detect a well-placed and polished photopolymer filling. High aesthetic properties make it possible to use such composites for the restoration of the frontal (most noticeable when smiling or during a conversation) group of teeth. The toxicity of the material is minimal, as is the degree of shrinkage. Abrasion is also low, so light-curing fillings can last for many years.
If your financial situation allows, then, of course, we recommend giving your preference to photopolymer fillings. IN in this case the costs will be completely worth it!
You can see how composite fillings are installed by watching this video review:
Inlays are a cross between a filling and a small dental crown prosthesis. Essentially, this is a finished filling, made in a dental laboratory and then fixed by a doctor in a prepared cavity using a composite material. The installation process is very similar to fixing a crown.
According to the materials from which the structures are made, there are: the following types tabs:
According to manufacturing technology, it is customary to distinguish the following varieties:
In the first case, after preparing the tooth, softened dental wax is introduced into the cavity. Then an inlay is completely formed to replace the defect, and the wax model is transferred to the foundry workshop at the clinic, where exactly the same metal structure is cast from it.
In the second case, after preparing the cavity, an impression is taken from the tooth using an elastic silicone-based material. Based on the impression, a plaster model is cast, on which a wax inlay is already modeled and the model is “translated” into the required material (plastic, composite, etc.). A ceramic inlay can also be created on the model.
Such “microprostheses” have many advantages over traditional ones and fillings.
They fit perfectly to the walls of the cavity, unlike fillings, in which the formation of the so-called. “undercuts” due to insufficient compaction during installation. Ceramic models are characterized by excellent aesthetic properties, thanks to the translucency of the material and a wide range of colors.
Using inlays, you can create an anatomically perfect “contact point” between adjacent teeth. The abrasion of inlays is even less than that of healthy tooth enamel, not to mention composite fillings. Models with overlapping cusps can be an excellent alternative in some cases artificial crowns, requiring thorough preparation of all dental surfaces. In addition, there is no need to pre-depulpate the tooth, since modern ceramic “microprostheses” are completely non-toxic.
Placing a filling is the final stage in the treatment of many tooth pathologies, be it caries, restoration after a chip, or restoration of enamel after.
Modern dentistry has a wide arsenal various types dental fillings However, using each has its own advantages and disadvantages.
What types of dental fillings are there and which ones are best used in each specific case?
The photo shows a cement filling on a tooth
Because cement fillings have excellent adhesion, that is, they adhere perfectly to the surface of the tooth, they are very common in dentistry. These are durable, non-fragile elements that can stand for a long time.
There is one caveat: the density of such fillings is higher than the density of tooth enamel, and over time, the part of the tooth that surrounds the filling wears out. As a result, a vulnerable zone is created along the edge of the filling, and secondary caries occurs.
The compositions of cement fillings are divided:
Silicate cement is more similar to natural color tooth and has a shiny surface. transparency. Since it is a very hard material, it is suitable for filling front teeth.
For deep fillings, silicate cements are not used, as they have a negative effect on soft fabrics pulp.
From a mixture of the above types, ercodont cement is formed. also suitable for different types of filling.
To improve the quality of fillings, silver powder is added to phosphate compounds. These compositions are used for, they are very inexpensive materials.
Plastics used in dental technologies harden quickly, have high hardness, strength, are chemically stable and do not irritate the tissues of the oral cavity. 
The problem with their use is the reduction in their volume; over time, a person feels that the filling has sagged, slightly decreased in size, which gradually leads to tooth destruction.
Plastic fillings also tend to stain and do not retain their original color for long. Such fillings include acrylic oxide and carbondent.
The quality of amalgam fillings, which are an alloy of mercury and metals, is very high.
Amalgams may contain silver, tin, copper, zinc, and mercury. These are very plastic, well-adhesive materials that have great strength and last for several decades.
A negative quality is that the material remains with a metallic sheen, so it is placed only in inconspicuous places. The body does not receive mercury poisoning. The most commonly used is silver amalgam.
The photo shows ceramic inlays on a plaster model
Ceramic fillings have high hardness and do not lose their size over time - shrinkage does not occur.
Ceramic fillings do not change their color, do not acquire dark shades or spots. This is, one might say, an ideal filling.
The filling is made in the form of an inlay based on an impression of a treated and disinfected tooth. Thanks to its configuration, the inlay distributes the load more evenly across the tooth during chewing and holds on more firmly.
There are different types ceramics, for example, containing zirconium oxide - transparent and durable; pressed ceramics, metal ceramics.
Dental fillings made from light-hardening composites are also called “light” fillings. Polymerization reactions of substances included in such fillings occur under the influence ultraviolet irradiation. Healed teeth will shrink over time, but at first the fillings look perfect.
These materials are well polished, microphiles are used on the front teeth, macrophiles on the more massive back teeth.
Self-hardening material with silicon and zirconium particles is used to restore the surface of chewing teeth. For hard-to-reach areas, fluid-flowing composites are used.
When placing the filling, each layer is illuminated, starting with the adhesive coating. The filling can cost upwards of $100 and must last at least 5 years.
Installation and characteristics of composite fillings:
This group of materials contains a significant amount of fluorine, which prevents the occurrence of tooth decay and is good for healing teeth in children.
The fragility of the resulting material is considered a negative property. These cements can be either self-hardening or light-hardening; the dentist is provided with comfort when working with such material, and there is no rush to install.
Glass ionomer fillings, as in the photo on the right, do not always match the color of the tooth; you have to cover it with a composite material.
The cost of such fillings may vary depending on the complexity of the work and the use of light-curing composite materials.
The main component of such compositions is porcelain, which determines the hardness and durability of the installed fillings.
Polymerization shrinkage, which is a disadvantage of these fillings, is compensated with the help of additional adhesive preparations that improve adhesion to tooth tissue and prevent secondary caries.
The main advantage of chemically cured composites is that curing occurs evenly throughout the entire depth of the cavity.
When treating a diseased tooth, after establishing a primary diagnosis, the doctor removes the softened dentin, clearing the tooth surface of affected tissue. 
Already at this stage, patients sometimes require. At deep defeat put medical pad with calcium to relieve inflammation.
An insulating gasket made of high-quality materials with maximum adhesion is placed under the aesthetic surface of the filling. The next stage is placing the filling; if the material is light-hardening, then each layer of the filling shines.
Application modern technologies using expensive medicinal materials and filling compounds, the use of expensive equipment and high level the skills of a dentist represent significant costs.
Comfortable treatment of infected teeth costs a lot of money. The price for treatment, for filling canals if necessary, for installing a filling consists of different parameters.
In each individual case, the treatment is individual; sometimes the tooth can be healed in one visit, and sometimes the doctor and patient have to meet three times.
All stages of treatment in brief:
Prices for all these stages are in the clinics’ price lists.
The cost of filling a tooth can also vary greatly. Composite and light fillings can be an order of magnitude more expensive than cement fillings.
Filling the tooth canal itself, of which there are several in a tooth, also consists of separate stages - this is biological treatment each channel, closing the existing enlarged hole, covering the surface with a light-curing composite. Pricing in each clinic is based on the quality of the drugs used for treatment and filling, the range of which varies.
Approximate current prices for fillings in Moscow:
Children's orthodontics and placement of fillings on children's teeth in some cases differs qualitatively from adults; installation of fillings for children is usually faster than for adults and the price does not exceed 2,000 rubles.
Removing an old filling will cost about 400 rubles, applying a therapeutic or insulating pad will cost from 700 to 2000 rubles.
Restoration of a tooth with deep damage with the installation of a light filling includes many parameters, and the filling itself will cost from 4,000 rubles. Anesthesia when working with a tooth costs 300-400 rubles, and the same amount costs to perform x-ray jaw area.
Not all patients dental clinic wondering what materials exist for filling a tooth. But this factor directly affects how long the filling will last. In addition, the health of the tooth, as well as the level of complexity of the treatment process, depends on the type of material. Today we will talk about how to choose a material for a filling. We will also discuss types of fillings, their advantages and disadvantages in this article.
First of all, let’s define: what is a filling in dentistry? This is a medical material characterized by viscosity and plasticity, which over time or under the influence external factors hardens in the tooth cavity.
There is a certain list of requirements for any types of fillings:
In modern dentistry they use various materials for placing a dental filling. Each of them has both advantages and disadvantages. Some materials are offered in free public clinics, while others are quite expensive. So, what are the main types of fillings? At the moment there are three of them:
Each type includes subspecies, depending on the substances included in the material for filling the tooth.
These types of dental fillings are usually prepared from powdery substance and liquid acid. As a result of mixing the components, a chemical reaction occurs, during which a paste-like mixture is formed, which tends to harden after a certain period of time.
Cement fillings, in turn, are also divided into subgroups depending on the substances contained in the composition, namely:
The first four subtypes of fillings are chemical. And the latter can harden both under the influence of acid and with the help of light waves.
Cement fillings have the following advantages:
These fillings also have significant disadvantages:
All subtypes of cement fillings, except glass ionomers, have such disadvantages to a greater or lesser extent. This material is widely used in modern medicine, including in private clinics. This filling is non-toxic. Contains fluoride inclusion, which protects the tooth from further spread of carious areas. In addition, the material not only physically fills the space of the tooth, but also enters into contact with the enamel. chemical reaction. Due to this process, the glass ionomer filling lasts for a long time.
What are metal types of dental fillings? These are so-called amalgams - metal-based solutions that have the property of hardening. There are silver, gold and copper.
They are highly durable and do not dissolve under the influence of saliva. Despite this, such material is practically not used in modern dentistry. What are the disadvantages? There are several of them:
What kind of fillings are used in modern dentistry? There are different types of fillings, so the doctor chooses those that will perform their function most effectively in a particular case. But experts are increasingly recommending plastic materials to their patients. Although just a few years ago such a filling was an innovative alternative to metal. Why didn’t plastic maintain its high rating among popular materials for installing dental fillings?
The thing is that such a solution quickly wears off, shrinks in volume, and changes color. In addition, plastic fillings often cause severe allergic reactions in the form of a rash, redness in the mouth. In addition, such materials are toxic.
A common type of fillings are composites. They contain both organic and inorganic substances. Hardens when exposed to chemical processes, as well as under ultraviolet radiation.
Placing composites requires a specialist to know the technology of preparing the tooth for this procedure. Since if any processes are disrupted, the quality and durability of the filling is significantly reduced.
An undoubted advantage is the availability of a wide color palette of such materials, which allows you to dental procedure and for aesthetic purposes.
Often, thanks to advertising brochures, potential clients of a dental clinic are first introduced to the concept of photopolymers. What is it really? Everything is very simple - these are the same composites or glass ionomers, which are installed using a special UV lamp. These types of fillings are used more often than others in dentistry.
Today it is difficult to find a clinic that does not offer a service such as photopolymerization. What advantages do these types of dental fillings have?
Photopolymers are used to restore the front teeth. The properties of the material allow you to “sculpt” the correct beautiful shape, and then fix the result absolutely painlessly with the help of ultraviolet radiation. Thus, the procedure can be performed on several teeth in just one appointment.
But it is quite difficult to fill distant teeth using this method - it is simply impossible to reach with a lamp required area oral cavity.
Often, a dentist needs to install a temporary filling for therapeutic purposes. The requirements for such material are not high: it must close the hole in the tooth for a period of several days to a week, after which such a filling could be easily removed.
Temporary fillings crack, fall out, and shrink, so they are not installed for a long period.
Often these materials add medicines. Therefore, it is possible that bad taste or bad breath.
The types are as follows:
What do children use to fill their teeth?
Many parents don’t even think about the fact that a child, just like an adult, needs preventive examination dentist Why treat teeth if they will soon fall out anyway? In fact, the health of baby teeth directly affects the condition of permanent teeth. Therefore, children need to have their teeth filled as soon as indications for this procedure arise.
In this case, it is important to choose safe materials. In pediatric dentistry, fillings containing fluoride are used (to prevent further caries formation). It is much more convenient to use materials that harden under the influence of ultraviolet light; such fillings are most often used when treating children. Types of fillings that are very popular in children's rooms today dental practice, are represented by glass ionomers and composites.
Multi-colored children's dental fillings have become a novelty in dental practice. The types of such materials are determined by the manufacturer.
Bright plasticine-like fillings arouse genuine interest, thereby reducing the fear of the dentist in children.
This material is also highly durable. In most cases, it lasts in children until teeth change. In addition, the colored filling is easy to polish, it is flexible, and its installation takes a short time.
Which fillings to choose? Types of fillings required in each specific medical case, should only be recommended by a specialist. Since it is necessary to professionally assess the situation, various factors and determine what material fits better just for this patient.
