Restorative Dentistry focuses on the “restoration” of the teeth and the occlusion (bite)
What is Restorative Dentistry?
A dental crown is a restoration that completely caps an existing tooth or an implant. Dental crowns are fabricated within a dental lab in order to mimic the surrounding anatomy of the teeth and provide as close to a transparent solution as possible. The ceramic material that is used ensures that the restoration is extremely durable and can withstand the rigors of daily use.
When used to cover an existing tooth, dental crowns protect the remaining natural tooth surface from recurring decay better than most other restoration technique available. The primary disadvantage associated with a tooth covered by a crown is the significant “preparation” (reduction in size) required to be done on the natural tooth. What this ultimately means is that the procedure is irreversible and the tooth covered will always need to be protected by a dental crown in the future.
Inlays & Onlays
Inlays and onlays are two types of dental restorations that are used when there is decay on the natural tooth surface. The main difference between an inlay and onlay is whether or not the “filling” covers, or re-creates, the tooth’s cusps (tooth’s protrusions). Unlike traditional “fillings”, inlays and onlays are designed and crafted in a dental laboratory. This requires the use of temporary restorations and a second visit. The main advantages of inlays and onlays over traditional “fillings” are durability and improved protection against recurring decay.
Historically, fillings were made of amalgam or gold due to the metals’ inherent durability. Although these materials were functionally efficient, they did not blend in seamlessly with the surrounding teeth. Aesthetically, they left much to be desired. Fortunately, technology continues to advance and dental practices now have access to composite resins that have comparable durability and life expectancy as the traditional amalgam and gold materials. The main difference is that resins can be tinted to match the surrounding teeth and create virtually transparent dental solutions.
Ottawa Sedation Dental Group exclusively use composite resin materials that match the natural tooth’s anatomy. This creates fillings that are practically undetectable to the untrained eye. If you currently have any amalgam fillings that you would like to replace to create an all-white smile, please ask your dentist or hygienist during your next visit. They will be happy to discuss the options available to you.
A dental bridge is a restorative technique that allows the dentist to replace one or more missing teeth with a fixed prosthetic solution. A bridge is essentially a fixed partial denture which is securely and permanently attached to the neighbouring natural teeth. It is generally a preferred solution over a removable partial denture due to its overall better functionality but it does have some disadvantages when compared to an implant supported bridge.
First, in order to support and attach the bridge, the adjacent natural teeth have to be “prepared”. This entails the removal of some of the tooth’s surface which can, over time, create undue stress on the supporting teeth.
A second disadvantage is that the area below the bridge where the teeth are missing will gradually begin to suffer from bone resorbtion (attrition). This occurs because there is no root system in place to prevent the jaw bone from “receding”. Bone resorbtion can lead to jawbone fragility in later years.
Finally, it is possible for food and bacteria to collect beneath the bridge which can lead to problems such as gum disease and decay.
Although we invariably discuss with our patients the benefits of an implant supported bridge, we do realize that each patient’s circumstances can dictate a differing course of treatment.
Implant dentistry typically involves two phases: the placement of the dental implant and subsequently its restoration. The placement of dental implants involves the surgical insertion of a titanium component resembling a screw into the bone in the area of the missing tooth (teeth). Once placed, the bone in the area begins to grow around the implant securing it firmly in place (osseointegration).
Once the area is fully healed and the implant is successfully integrated into the bone, it is ready to be restored. The restoration of the implant refers to the placement of a dental prosthetic to replace the missing tooth (teeth). This can take the form of a dental crown, a dental bridge or a denture.
The use of dental implants has three main advantages over other restorative solutions. The first, and arguably most important, is related to improved functionality. The prosthetic replacement tooth (teeth) is firmly secured in place, allowing for normal, or close to normal, functionality and bite. The second advantage is related to the diminished bone resorbtion (attrition) that would normally occur in an area of jaw bone with no natural root system in place. The implant acts in lieu of the natural tooth’s root and prevents the resorbtion of the bone in the affected area. This prevents the jawbone from becoming visibly recessed and significantly more fragile than the rest of the jaw. Finally, the use of dental implants eliminates the preparation of neighbouring teeth as would be required when preparing a traditional dental bridge. It is always preferable to avoid the removal of natural tooth surface whenever possible. Dental implants allow for that.
Complete & Partial Dentures
Patients with most or all of their teeth missing require partial or complete dentures to restore the functionality of their mouth. Both types of dentures can be “fixed” or “removable”. Fixed partial dentures are essentially dental bridges. These are permanently attached to either the neighbouring natural teeth of to dental implants.
Removable partial dentures are kept in place with metal clasps and this design allows dentures to be removed and inserted without professional assistance. Complete dentures can also be fixed or removable. The only fixed restorative option is an implant supported denture. We highly recommend this treatment alternative, however, we do realize that individual circumstances may dictate that a removable solution be used instead.
Removable solutions typically have two main disadvantages over their fixed counterparts. The first, and most concerning disadvantage, is the overall functionality. Patients with removable, complete dentures frequently experience difficulties when biting or chewing certain foods. The second disadvantage is related to the bone resorbtion (attrition) that takes place when there is no natural root system in place. The bone structure within the jaw becomes more fragile and visibly recessed when the denture is removed.