Due to the increasing teeth problems, the demand for specialized treatment has risen. Ways have been modified to ensure that those experiencing these problems are given a chance to enjoy good health. There has therefore been intensified research on how different materials can be chemically combined to suit the tooth makeup. Even though appropriate solutions were found, it was discovered that the materials need to be modified further to improve their efficiency. Depending on the kind of materials used, their period of functioning also varies. Below is an evaluation of the different dental fillings, their composition, and how they can be appropriately applied.
Glass ionomer types of cement, composite resin, and compomers are dental products that are used as fillings on the teeth. They may be used if a tooth is having some medical problem or simply to enhance the appearance of the teeth. These materials are composed of well-balanced chemicals to suit their purpose. They can also be modified to suit a desired color and size. Depending on their physical properties, they are used for specific teeth classes and periods. Necessary precautions need to be followed when they are being fixed and also maintained to serve their desired purpose. The antibacterial nature of these dental materials helps to improve and restore the teeth. (Graig, 2001)
The properties of these products differ according to their chemical makeup; glass ionomer cement also known as dental cement is composed of powder from silicate glass and polyanionic acid. This chemical combination makes them appropriate for use as fillings to repair and restore a sick tooth. (McCabe, 1999)They are classified into five categories namely; conventional, resin-modified hybrid ionomer, tri-cure, and metal reinforced. The materials of these fillings have a similar color as that of the tooth but this may vary depending on the kind of finish used by the dentist. Because of the hydrophilic nature of the monomers, they may easily stain and discolor if they are not taken care of.
Glass ionomers take an average of six minutes for them to be set and applied on the patient, the process can however be prolonged by placing the mixture on a cold surface. Although this method is appropriate, it weakens its capabilities due to too much exposure. (McCabe, 1999) Glass ionomers may be used in four different types; first, for luting liners, is because it releases ions of fluoride that provide protection by insulating the pulp cavity, the fluoride produced makes it suitable for use as bases, which help in minimizing decay and reduce the appearance of carriers. They are also used as fissure sealant which is done by mixing the materials into fluid that will allow easy penetration into the posterior teeth. Glass ionomer cement can be used for both permanent and temporal reasons depending on their strength and the skill of the dentist. (Combe, 1999)
Glass ionomer cement may be preferred over other dental fillings because of the following advantages; it is intrinsically adhesive due to its chemical composition which makes it compatible with the tooth, it releases fluoride which provides protection from tooth decay. The use of these ionomers may also face the following drawbacks; it is very sensitive to water during its first stage of setting and protective measures need to be employed for them to be appropriately fixed.
It is brittle and is bound to crack if correct procedures are not followed; they are very soluble and need to be protected from saliva for at least twenty four hours after fixing. Compared to composite-resin, GIC is not very reliable for completely covering enamel margins. They are weak compared to composite resins and can therefore not handle occlusal load without the support of the tooth structure. They cannot be used in long term restoration of primary molars and are bound to exfoliate within two years. (Graig, 2001)
Composite resin is a plastic mixture of silicon dioxide that has been colored to match the desired color of the tooth. They were earlier used only for the front teeth due to their incapability to handle the pressure of the back teeth, but now they have been modified and can be used in all classes of the teeth. Composite resins are used to restore decayed teeth, enhance their color and also to give shape to the disfigured tooth. To fix it in its place, the dentist places the composites in layers and hardens them using a special light. They are then polished to protect them from stain and wear. This process generally takes an average of twenty minutes. (Graig, 2001) The main advantage of composite resins is that they can always be modified to suit the color of the teeth.
They also bond well to the tooth structure to avoid breaking and act as an insulator. Hybrid composites can be polished easily and are resistant to wear and fracture. Following their modification, they can be used for posterior and anterior applications. The disadvantages of these filling materials are that, they are easily stained after their application process, the patient may feel some sensitivity on the affected area, and it also wears out faster when compared to silver fillings. Composites can last up to ten years when the correct fixing procedure is followed. (Combe, 1999)
Compomers are made up of two chemicals that are of different composition, the external one is the matrix and the inner one is the filler. They are insoluble and perfectly bond together to form a structure that blends well with the tooth. They are basically composite resins that have been modified to be suitable for use especially in children’s teeth. They are composed of hydrophilic material that absorbs water to enhance cure. Depending on their shape, compomers can be classified as spherical if they take a round shape, fibres if they are long or flakes if they are wide.
They were introduced to combine the properties of composites and glass ionomers. Compomers cannot bond firmly with tooth tissues and have lower fluoride levels compared to GICs. (Gladwin, 2004) The compressive strength of compomers reveals that they are more resistant to abrasion compared to other dental fillings. They also show a lower polymerization degree which makes them be of perfect and acceptable cure. Compomers are more resistant to wear compared to glass ionomer cements. Compomers can best be used for molars and are recommended for class III and V cavities.
In comparison of the three dental materials, glass ionomer cement has more fluoride release; the compomers are second and then the composite resin produces the least amount. It has also been discovered that the PH surrounding the materials had a greater influence on the amount of fluoride released, the more the PH the more the quantity of fluoride released. Composite resins and glass ionomers are the best fillers that provide protection against pulp injury and bacterial infection. Different dental materials are used for different classes of teeth. Due to the pressure of the molars and premolars, fillings that can sustain abrasion should be preferred.
A dental material that has similar make up with the tissues surrounding the affected area should be used to prevent any complications from arising. The properties need to be biologically tested so as to ascertain their appropriate application. This can be done by researching on the components used in the various dental materials available in the market and classifying them in terms of their chemical make up. This will enable the dentists not to rely on assumptions provided but to offer treatment according to how the tests reveal. (Gladwin, 2004)
Dental fillings have provided a lot of relief and solution to problems associated with the teeth. They have also been modified over the years so as to meet various needs. The fillings have different chemical compositions, each with its advantages and disadvantages. The side effects of the materials may differ from patient to patient and their effects may also depend on the skill of the dentist and how the teeth are generally taken care of after their application. Dentists should take proper analysis of the teeth structure and ensure that the right measures are taken in fixing it because; materials react differently on patients. There is no preferred dental filling, care should instead be taken and appropriate dental advice sought before deciding on the most appropriate one. (Combe, 1999)
Dental fillings should be used only as alternatives to correct teeth malfunction and cannot provide them a permanent solution. Frequent check ups and proper maintenance of teeth especially at their tender age will save us the pain of applying dental fillings. Everybody should be encouraged to take good care of teeth by keeping them clean all the time in order to prevent infections that result because of failing to maintain cleanliness. Food that causes decay should be avoided such as, sugary food to prevent breeding places for bacteria. (Gladwin, 2004)
Graig G. (2001): Restorative dental materials: C.V Mosby pp. 33-39.
Gladwin M. (2004): Clinical aspects of Dental materials: Lippincott pp. 52-56.
McCabe F. (1999): Applied Dental Materials: Blackwell science pp. 14-18.
Combe E (1999): Dental Biomaterials: Kluwer Academic Publishers pp. 23-29.