1. Dental Restorations
Dr Huda Yaser

2. The Dental Restoration
Is a dental restorative material used to restore the function, integrity and morphology of missing tooth structure
The structural loss typically results from
Caries
External trauma.
It is also lost intentionally during tooth preparation to improve the aesthetics.

3. Properties of any restorative material
ADA: criteria for a new material
Must not be poisonous or harmful to the body.
Must not be harmful or irritating to the tissues of the oral cavity, (BIOCOMPATIBLE)
Must help protect the tooth and oral tissues of the oral cavity.
Must resemble the natural dentition.
Must be easily formed and placed in the mouth.

4. Tooth Preparation
The process of preparation usually involves cutting the tooth with special dental burrs, to make space for the planned restorative materials, and to remove any dental decay or portions of the tooth that are structurally unsound.

5. Preparations may be
Intracoronal : all classes of cavity preparations for composite or amalgam, as well as those for gold and porcelain inlays
Extracoronal: Crowns and onlays, as well as veneers.

6. Dental restorations Direct restorations Indirect restorations
eg: Amalgam ,Composite, GIC,Zinc oxide euginol…
Indirect restorations
eg: Inlay,Onlay ,Crown ,veneers….

7. Direct restorations
This technique involves placing a soft or malleable filling into the prepared tooth and building up the tooth before the material sets hard.
Can be placed in a single visit.
As the fillings become larger, indirect restorations may be the best choice in some cases.

8. Direct Restorations Amalgam
Silver amalgam (mainly consists of mercury and silver )
Today amalgam is used most commonly in the posterior teeth. It is one of the oldest filling materials and has been used (and improved) for more than 150 years.
But need removal of much tooth structure
Concern of mercury toxicity has existed since the invention of amalgam. It is banned or restricted in Scandinavian countries.

9. Direct restorations Dental composites
Are also called white fillings or tooth colored restoration.
They are more estheticaly acceptable than amalgam
Need less tooth structure removal
Their strength and durability is not as high as porcelain or metal restorations and they are more prone to wear and discolouration.

10. Direct restorations Direct Gold
Although rarely used, due to expense and specialized training requirements, gold foil can be used for direct dental restorations.

11. Direct restorations Glass ionomer cement(GIC)
Is one of the commonly used materials in dentistry as filling materials and luting cements.
Have two main advantages : they bond chemically to dental hard tissues and release fluoride for a relatively long period.
Only used in low-stress areas such as smooth-surface and small anterior proximal cavities in primary teeth. (Lower strength than composite)

12. Direct restorations Intermediate Restorative Materials (IRM) used:
eg: Zinc-Oxide Eugenol
These are inserted as a temporary measure only. They are too soft to use as permanent fillings.
used:
As a first-aid measure to relieve pain
When there is insufficient time to complete the cavity and insert a permanent filling in one visit

13. INDIRECT RESTORATIONS
In this technique the restoration is fabricated outside of the mouth using the dental impressions of the prepared tooth.
Common indirect restorations include inlays and onlays, crowns, bridges, and veneers.
Usually a dental technician fabricates the indirect restoration

14. CAD/CAM Restorative Procedure
(Computer-aided Design And Computer-aided Manufacturing) to improve the design and creation of restorative materials especially indirect restorations
The prosthesis can be luted or bonded the same day.
But the chair side for CAD/CAM often involves extra time on the part of the dentist (because of the digital impresion and miling by the machine), and the fee is often at least two times higher than for conventional restorative treatments using lab services.

15. INDIRECT RESTORATIONS
Inlays
Is an indirect restoration (filling) consisting of a solid substance (as gold, porcelain or less often a cured composite resin) fitted to a cavity in a tooth and cemented into place.

16. INDIRECT RESTORATIONS
Onlays
Is the same as an inlay, except that it incorporates a replacement for a tooth cusp by covering the area where the missing cusp would be.

17. INDIRECT RESTORATIONS
Crown
‪is a tooth-shaped "cap" that is placed over a tooth -- to cover the tooth to restore its shape and size, strength, and improve its appearance.‬
Crowns are onlays which completely cover all surfaces of a tooth.
Crowns as metal-free "Jacket crowns” made of Porcelain (ceramics)

18. INDIRECT RESTORATIONS
Crown
Another type is known as porcelain-fused-to-metal, which is used to provide strength to a crown or bridge. These restorations are very strong, durable and resistant to wear, because the combination of porcelain and metal creates a stronger restoration than porcelain used alone.

19. INDIRECT RESTORATIONS
Dental Bridge
A bridge is a fixed dental restoration (a fixed dental prosthesis) used to replace a missing tooth (or several teeth) by joining an artificial tooth permanently to adjacent teeth or dental implants

20. INDIRECT RESTORATIONS
Veneers.
A veneer is a very thin shell of porcelain or composite that can replace or cover part of the enamel of the tooth. In order to apply a veneer, we have to shave away a substantial portion of the tooth enamel
Full-porcelain veneers are particularly desirable because their color and translucency mimic natural tooth enamel

21. INDIRECT RESTORATIONS
LUMINEERS
Are thin Full-porcelain veneers
There is no need to grind or shave the teeth because LUMINEERS are as thin as a contact lens, or roughly half the thickness of veneers.