Restorations and Root Canal Treatment

RESTORATIVE DENTISTRY (FILLINGS)

Tooth decays and substance loss occur due to improper tooth brushing, insufficient dental care, and malnutrition. For the treatment of caries, the decay is removed, and the cavity is filled with a material that is suitable for the tooth and its surrounding structures. Increased sensitivity to hot and cold food, and pain are symptoms of tooth decay. Tooth decays are usually noticed during dental examinations and if not treated in a timely manner, the decay can spread to the root and the tooth may need to be removed. If the decaying teeth are treated immediately, tooth loss and severe pain can be prevented.

Depending on the severity of caries and substance loss, your physician will recommend one of the following treatment options described below.

Amalgam (Black) Fillings

Dental amalgam is a mixture of silver, copper, mercury, and tin and has been in use for over 100 years. Its physical properties make it resistant to the biting forces of occlusion. The metallic color of amalgam does not blend with the natural tooth color. Amalgam fillings may become tarnished over time. Dentists recommend patients who had amalgam fillings installed to wait at least 2 hours before eating or drinking. Otherwise, the filling may fracture or fall off. Amalgam fillings in permanent teeth should be polished after 24 hours. You are responsible for any complications that may occur if you do not show up for a follow-up visit. An amalgam filling lasts 7 years on average. Inadequate oral hygiene can produce more cavities around the margins of the filling. In this event, your physician will not be liable.

Glass Ionomer Cement (GIC)

GIC is made of acrylic and fluoroaluminosilicate. Despite closely matching tooth color, glass ionomer fillings are not as successful as composite fillings. Resin-modified glass ionomers are better than GIC at matching tooth color. Some cases do not require the complete removal of the decay. For this reason, fillings are easy to apply in children. Glass ionomer cements release fluoride and help to preserve the tooth from decay. Glass ionomer fillings bond directly with the tooth surface, which prevents leakage and reduces the possibility of future decays. That said, conventional glass ionomer is very weak compared to composite fillings. It is associated with a much higher risk of fracture. Conventional glass ionomers cannot match tooth color like composite fillings. Resin-modified glass ionomer cement needs to be applied in thin layers. Each layer is hardened using a special blue light before placing the next. This provides a stronger result but prolongs treatment duration.

Composite (Tooth-Colored) Fillings

These fillings are used to restore cosmetic appearance or function in anterior and posterior teeth that have lost substance due to caries. Dental composites are a mixture of plastic, acrylic, and fine particles of glass. Special adhesives are used to bind these composite fillings to dental tissues. Unlike amalgam fillings, composite fillings do not require the removal of a lot of tooth substance. The acid used for dental etching may rarely cause chemical burns on the tongue or lips. They are not as resistant to biting forces as amalgam fillings. Although they are tooth-colored, they may not always match the natural color of the tooth one hundred percent. These fillings last 4-6 years on average. They may become discolored by smoking, drinking coffee, etc. After the intervention, there may be some pain or tenderness which can last for a while. Inadequate oral hygiene can produce more cavities around the margins of the filling. In this event, your physician will not be liable.

Glass Carbomer Cement (GCC)

GCC is a glass ionomer-type filling material with nanoparticles but is separated from other filling materials due to its fluorapatite and hydroxyapatite crystal content. Fluorapatite and hydroxyapatite are found in nature, especially in shark teeth, which are known for their ability to self-repair. GCC is based on this principle and helps the tooth to repair itself. Due to its zero metal and toxic monomer content, it has very high biological compatibility. It is usually used in small fillings or root surfaces. It is used as a filler and fissure sealant in deciduous teeth, as well as a base material in other fillings. It does not blend in with tooth color as well as composite fillings and has limited resistance to biting forces. These factors limit the application of GCC.

ENDODONTICS

The visible part of the tooth above the gum is called the crown, and the invisible part embedded in the bone is called the root. The number of roots for each type of tooth varies. It is a soft center of both the crown and the root that gives the tooth vitality is known as the dental pulp, also commonly referred to as the nerve of the tooth. Endodontics is the branch of dentistry concerned with the diseases and treatment of the pulp. Endodontic therapy is popularly known as root canal therapy.

Endodontic treatment (i.e., root canal treatment) treats deep caries and inflammation and traumas in the pulp due to fractures and cracks in the teeth. In pulpitis, the infection manifests in the form of redness or swelling around the tooth, sensitivity to chewing, and long-lasting pain after hot or cold. The purpose of canal treatment is to preserve the tooth and its function in the mouth in patients with these symptoms and to prevent the need for an implant or dental bridge.

Stages of a Root Canal Treatment

1. Local anesthesia of the tooth and surrounding tissues,
2. Removing the decay and the infected pulp to clear root canals,
3. Measuring root canal length with an apex locator and radiography,
4. Root-canal shaping with manual and rotary files,
5. Flushing the root canal with disinfectants to remove any microorganisms,
6. Filling root canals and restoring the crown.

Root Canal Treatment Success Rate

The success rate in root canal treatment depends on the amount of tissue remaining after the decay is removed, the pressure exerted during chewing, selection of the correct restoration after root canal treatment, and even oral hygiene. Technologic advances have increased the success rate of root canal treatment to 90-95%, provided that the treatment is performed correctly and for the right indications. It should be noted that root canal treatment is the final treatment option before tooth extraction, and there is always a risk of complications that may be beyond the skill of the physician.

Endodontic Treatments Offered in Our Clinic

• Treatment of damaged pulp (direct or indirect pulp capping and vital amputation),
• Root canal treatments,
• Endodontic treatment of traumatized teeth,
• Root canal retreatment, correction of problems from the previous treatment,
• Restoration of endodontically treated teeth (post and core),
• Endodontic treatment for continued root formation and apical closure (apexogenesis and apexification),
• Endodontic surgery,
• Whitening of endodontically treated teeth,

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