Jonathan Coronado

ISM-Period 7

Terry, Douglas A., Karl F. Leinfelder, and Will Geller. Aesthetic and Restorative Dentistry:
Material Selection and Technique. Stillwater, MN: Everest Pub. Media, 2009. Print.

Factors that affect which tooth restoration to be used: destruction of tooth structure,
esthetics, plaque control, financial support, retention
If the amount of destruction needs the restoration to strengthen and protect the tooth, cast
metal or ceramic is recommended over amalgam
Esthetics: if the tooth to be restored is in a very visible area or it makes the patient
uncomfortable looking at the tooth a crown will be needed to cover up the visible
amalgam filling.
Plaque control: for a filling to be used it requires a good treatment plan. The decision to
use a filling rather than a crown depends on the patients readiness to follow the treatment
plan. If the tooth is in an unhealthy environment a crown must be used to prevent further
damage to the tooth.
Financial consideration should always be put into effect. Crowns are more expensive than
fillings so insurance and the cost out of pocket should be considered in the decision
making process.
General considerations for preparations and restorations include minimizing tooth
removal, maintaining a margin of enamel, rounding internal line angles, and placing
enamel bevels
Minimize tooth removal: a more conservative approach can be used when using an
adhesive restoration.
Mainting a margin of enamel: the presence of enamel on the periphery is an important
part to the adapting and sealing of the tooth restoration
Round internal line angles: round internal line angles allow for no radical changes in the
shape of the preparation. This allows changes to be more resistant by increasing stress
distribution
Place enamel bevels: bevels provide a more predictable seal along with increasing surface
area to the tooth.

There are many different types of tooth restorations that can be used but the right one to be used
is decided through many factors that can affect the way the tooth maintains itself along with how
the tooth is prepared to create the tooth restoration.

"Dental Fillings: Gold, Amalgam, Composite, Ceramic and More." WebMD. WebMD, n.d. Web.
27 Mar. 2016. <http://www.webmd.com/oral-health/guide/dental-health-fillings>.

First step for filling a tooth is using anesthesia to numb the area of the tooth
Next a drill will be used to take out the decayed area
Next the tooth colored material will be applied in layers.
After the dentist will shape the material and polish the material to make the material look
good
There are many different types of fillings
Cast gold is a good material because it does not corrode along with it is appealing to the
eye
Disadvantages of cast gold are that it can cost up to ten times more than other fillings
The cast gold can cause a galvanic shock when put next to an amalgam filling because it
causes an electric field to occur
Amalgam(silver) filling is beneficial because it is durable, strong and relatively cheap
Amalgam usually outlasts composite(white) filling
Amalgam is less expensive than composite filling
Disadvantages of amalgam are the color, space, cracks and fractures along with allergic
reactions
Amalgam fillings dont match the natural teeth
Amalgam fillings usually have to destroy healthy parts of the tooth in order to make
enough space for the new filling
Amalgam filling can create more expansion and contraction in comparison to other
materials which can causes cracks
Composite fillings have similar shades to the existing tooth
Composite fillings bond to the tooth which provide more support
Composite fillings require less tooth structure to be removed
Disadvantages for composite fillings are that they do not last as long as other fillings
Composite fillings can cost up to twice the cost of amalgam fillings.

There are many benefits and disadvantages to each type of filling that allow the patient to choose
the most effective type of dental filling whether it is cast gold, amalgam, or a composite material.

"Learn Exactly What to Expect During a Dental Crown Procedure." About.com Health. N.p., n.d.
Web. 31 Mar. 2016. <http://dentistry.about.com/od/cosmeticdentistry/ss/What-To-ExpectDuring-The-Dental-Crown-Procedure.htm#showall>.

The dental crown process is a complex procedure requiring two visits: one for a
temporary crown and the other for a permanent crown
Dental crowns are used when there is a very large filling
The first step to making a crown is numbing the patient using anesthetics
Next an impression must be taken to be sent to the lab
The impression must take accurate models of the maxillary and mandibular arches
Next an alginate impression will be taken which will be used to make the shape for the
temporary crown
The dentist then uses a shade guide to record the color of your tooth
Next the tooth must be prepared to allow the crown to fit the tooth
This process also prevents infection because it can clear a previous fillings infection or it
can seal the cavity to prevent the spread of bacteria
Preparing the tooth involves removing small amounts of tooth to shape the tooth in a
way that the crown would fit in,
Since the crown is like a cap the tooth is lower than the other surrounding teeth and is
more round than other teeth
The dentist must remove around 1 mm to 2mm depending on the type of crown that will
be used
After this a final impression must be taken. This is needed to record the shape of the new
prepped tooth so that the lab can send an accurate crown
After this the temporary crown is prepared by using the alginate impression to put acrylic
resin material
The acrylic resin material is then placed on the tooth and then set to dry
After the material hardens the dentist then scrapes off the extra material and also fixes the
shape of the tooth if necessary
Any rough or sharp edges must be changed to prevent the temporary crown from
chipping
The temporary crown is important because it serves as a barrier to the tooth
Since the tooth has been prepped it is considerably more frail than before.

A temporary crown is an important part of dentistry that not only repairs the previous damages
and prevents infection from spreading but also serves as a placeholder for a permanent crown
which comes from a dental lab

Shillingburg, Herbert T. Fundamentals of Fixed Prosthodontics. Chicago: Quintessence Pub.,

1997. Print.
Finishing and cementing is an important part to securing the tooth.
If the restoration is not cemented properly or finished properly the restoration is likely to
fall off or be chipped/damaged
Polishing materials are extremely hard
The polishing material must be considerably harder than the tooth it is cutting into to
allow an easy cut.
Diamond is the hardest type of abrasive which is used for the enamel or porcelain
Silicon carbide is a commonly used abrasive that is used to make many shapes and points
Emery is a mixture of aluminum oxide and iron oxide used on gold or porcelain
Different burs or heads of the drill are used to for different purposes: some are better at
cutting, some are better at sculpting, while some are better at polishing
Adjusting the proximal contact or the space in between teeth is an important part of
dentistry
If the proximal contact is too tight it will not allow the restoration to be placed on the
tooth
To remove proximal contact the side of the tooth can be flossed with a diamond flosser or
it can be removed with a straight chisel which is a straight hand held stick with flossing
material at the end
The different types of wrong margins are overextended, under extended, thick, along with
open
Occlusal adjustments or adjustments to the grinding or biting surface of a tooth can only
be done when the tooth has been completely seated
The dentist can have the patient bite on shim stock to show where the patient bites and
how hard the patient bites in order to be able to precisely determine precisely how much
tooth to shave off
The dental cement is used to glue the restoration to the tooth
The different types of cements can bond through nonadhesive luting, micromechanical
bonding, or molecular adhesion
Nonadhesive luting is used primarily to fill the gap in between the tooth and the
restoration and prevent entrance of fluids
Micromechanical bonding creates a very strong cement which allows for less restorative
procedures to be used
Molecular adhesion involves physical force and molecular bonds to hold together the
paste. Most of these cements are not as strong as the other two groups.

Finishing and cementing have multiple options to choose how to finish and cement the object;
this process is one of the most important parts to ensure that the restoration lasts.

Roberson, Theodore M., Harald Heymann, Edward J. Swift, and Clifford M.

Sturdevant. Sturdevant's Art and Science of Operative Dentistry. St. Louis,
MO: Mosby, 2006. Print.