Adhesive tooth restoration

September 4, 2023 Reading time ~ 5 min Number of reads: 5972

Adhesion is a special, molecular bond between the surfaces of two different materials. It is the advent of adhesive systems in dentistry that has made it possible to restore teeth with methods that combine efficiency and aesthetics.

As a result of the use of adhesive compositions, a hybrid layer is formed which, due to micromechanical and chemical bonds, provides a strong bond.

Direct adhesive tooth restoration

Dental fillings, build-ups, and artistic restorations are performed using the direct method. This means that the dentist restores the tooth directly in the patient’s mouth, without taking impressions.

Indications for the direct method are restorations of:

• Cavities; Cavities destroy hard tissue, creatingcavities of varying sizes. They are filled with filling material using adhesion.

• Non-carious lesions of enamel; Technology is used to correct the color, position and shape of teeth.

This technique is used to install composite veneers.

Composite materials will not be able to hold on the smooth surface of the enamel. Teeth are necessarily prepared – remove the top layer for veneers or make bevels in the reconstruction of the tooth. Then the adhesive system is applied, and only then – the composite material. The layer-by-layer application allows the dentist to model the shape of the tooth directly during the work.

For the patient, the direct method is convenient because the appearance of the teeth can be restored in one appointment.

High skill is required from the doctor, because he is limited in movement and must have not only qualifications, but also artistic taste. Only then will the restoration look like a natural restoration.

Indirect adhesive tooth restoration

This technology involves the fabrication of veneers and inlays in a dental laboratory, based on the patient’s impressions. These microprostheses last longer than classic fillings or composite veneers.

Inlays

These are orthopedic constructions, which are used in case of significant destruction of the tooth walls. They exactly repeat its anatomical shape, perfectly replenish the missing parts of the walls, preventing microfractures.

Most often inlays are made of ceramic. As a result, the patient receives a microprosthesis that:

• Does not oxidize;
• Does not absorb pigments;
• Does not succumb to shrinkage;
• Possesses increased wear resistance;
• Totally invisible in the mouth;
• Lasts at least 10 years (if the technology is followed);

Adhesive systems ensure that the hard tooth tissue is completely bonded to the ceramic so that it can only be removed with a diamond bur.

Types of inlays in adhesive restorations

The American Dental Association system is used to categorize inlays, so they all have English names.

Inlays come in:

• inlay; This is the simplest type of prosthetic. The prosthesis is like lying inside the tooth. There is no need to restore the cusps.

• onlay; This type of microprosthetic restores the destroyed cusps, which are locatedon top of the tooth. The main difference from the next type is that some of the natural cusps are preserved.

• overlay; Used when all the cusps have been destroyed. The overlay covers the entire chewing surface and differs from a crown only in that the side walls do not reach the gingival margin.

Veneers

Special inlays on the front surface of the teeth – veneers – help to restore the appearance of the frontal units.

They, as well as inlays, are made according to accurate impressions of the teeth. The use of digital technology ensures an exact replication of the tooth anatomy. Adhesive systems are responsible for the tightness of the fit. As a result of bonding, the hard tissues of the tooth and the veneer become a single, seamless structure.

Veneering is the most modern way to restore the aesthetics of the smile.

The materials for onlays are ceramic and zirconium dioxide. Zirconium wins due to its durability, ceramics leads the way in terms of aesthetic properties. E-max ceramics maximizes the optical properties of natural enamel. Porcelain veneers are becoming a thing of the past, as their durability is much lower than the other materials.

How adhesive tooth restoration is performed

The technology is slightly different depending on which method, direct or indirect, the dentist uses. However, the basic algorithm of actions is the same:

1. Preparation of the tooth. The dentist removes diseased tissue and treats the edges of the cavity for fillings and inlays. For veneers, the preparation involves removing a thin layer of enamel for better adhesion.
2. Obtaining impressions. Used in indirect technique.
3. Fabrication of microprostheses. Ceramic veneers and inlays are made in the laboratory, using models made of wax and plaster.
4. Placement.

• etching of the surface; As a result of interaction with acid, micropores (5-10 microns) are formed in the enamel;
• removal of the acid with water;
• drying;
• application of adhesive components (primer, bond);
• photopolymerization of components;
• layer-by-layer application of composite material or fixation of veneer, inlay.

5. Polishing of composite fillings or veneers.

Advantages of adhesive restoration

• Durability and strength;
• Modern adhesive systems are capable of adhesive action for decades.
• High level of aesthetics;
• Composites, ceramics imitate tooth enamel with great accuracy.
• The possibility of restoring defects of different degrees, from small chips to 50% of destroyed tissues.
• Availability of different options;

You can choose a cheaper direct method or a more expensive indirect method.

Disadvantages

• Requires careful adherence to technology;
• A slight violation of the recommendations affects the quality of adhesion.
• The need to mix the components before application;
• Human factor can affect the violation of proportions.
• Artistic restoration with composite materials implies changes in the diet;
• It is necessary to limit pigmented products, refuse hard (candy, breadcrumbs) and sticky treats (nougat, toffee);
• Composites need regular polishing;
• Composite restorations do not last more than 5 years.
• Ceramic restorations are expensive.
• Teeth must be prepared for adhesion to take place;

Opinion of the doctor