One of the most common misconceptions we find
in dentistry is that most people think all white fillings are the same. This is far from
the truth. There are fundamentally two different types of white fillings; porcelain and resin.
We often compare the difference between porcelain fillings and resin fillings like the difference
between your plastic picnic plates verses your fine china dinner wear. They’re like
chaulk and cheese; totally different products. In terms of terminology, plastic white fillings
can be referred to as composite or resin. Porcelain fillings are often called inlays,
ceramic or Cerec restorations. Both types of restorations utilise the same blue light
that is used to set hardened cement material. The resin is placed in soft and set hard with
the light, whereas the porcelain restoration is a hard prefabricated filling that is bonded
into the cavity. When a filling is on the larger side requiring corners or what are
termed as cusp replacements, we always recommend porcelain reconstruction of the tooth to ensure
that you are not back in the dental chair fixing the same tooth again any time soon.
The porcelain filling is no doubt more expensive, but when you consider you may have to replace
a plastic resin filling over and over, the cost differential may prove to be a lot less
than first envisaged. At Smile Solutions both options of white fillings are readily available.
It’s a matter of working out with you which option best suits your expectations and budget.
I would like to introduce you to Dr Thorsten Dannheimer who is considered by his peers
at Smile Solutions to be an expert in the field of Cerec dentistry.
How are you Dr Thorsten? Very well. And you?
Very well, thank you. So tell me, I believe you’ve been using this technology for some
time and you’ve done quite a lot of fillings? Yes I have. I started using this technology
in 2001 and since then I’ve probably done around 5,000+ of these restorations.
And I believe there’s lots of other dentists here that also do the same type of work.
Yes. I’m lucky to be with Smile Solutions where we have a very large group of specialists
and other Cerec users as well in the practice. Yeah, we come together once a week to discuss
cases and really further our knowledge and share whatever information we’ve got with
each other. And tell me, what’s the difference between
a Cerec porcelain filling and a composite resin filling?
Cerec fillings are obviously made out of porcelain, alright, which is very hard, and the resin
fillings are normally out of plastic. For bigger restorations at the back of the mouth
we normally use a porcelain, which is quite strong. And for smaller fillings, like smaller
cavities in the front of the mouth, we normally use plastic or resin fillings. For removing
or replacing of the amalgam fillings, Cerec is probably one of the best choices to use
then. And what are the benefits and advantages of
having a Cerec porcelain filling as opposed to a normal, white filling? It’s a single
visit procedure. The nice thing is we numb you up once, it gets done in 90 minutes and
you’re out the door and it’s all done. We just take impressions, send them to the lab,
get it back. So it’s at least two weeks out of your time and two visits. So it makes a
lot more sense, especially with people nowadays that don’t have the time anymore. The other
thing is it’s a lot more superior. It’s a lot harder, it’s really more natural looking
than resin. It blends in very well with the surrounding tooth structures. Also another
thing is conservation of healthy tooth structure. With modern bonding techniques that we use
today there’s no need to remove a lot of tooth structure. We just remove what’s necessary
and replace that with a ceramic inlay. Thorsten, can you run through what happens
in a procedure? First of all we do an examination, we take
x-rays, we see what needs to be done. What we do is we numb the patient up, we remove
all the decay and the filling that needs to be replaced. And once that’s done we clean
uo the mouth and everything. We then take an infrared camera and take photos of the
tooth. So we’ve got an inter-oral camera, which is a 3D camera, and we put it on the
tooth and actually take pictures. And you can see the picture’s coming up on the screen,
on the Cerec unit, and that basically forms the model. From that model we then actually
design your new restoration with the help of a computer. And the nice thing about that
is we can actually change and make the filling bigger, make it any shape you want, until
we’re happy, until the patient’s happy. And then we actually put in a block of ceramic
into the metal unit, which is probably in the room or somewhere next door, and start
milling the restoration out of the block. And then it comes out exactly the right size,
yeah? It comes out exactly the right size. And all
we do is we just polish it, make it all nice and shiny, glue it in, check the bite, that’s
it’s all good, that it fits well, and there you go.
Well thank you so much for all that information Thorsten.
It was great chatting to you.