Bonded Composite Restorations are the safest, most biocompatible and conservative way of restoring decayed, fractured and/or worn teeth; returning the tooth back to health, and function as well as providing a highly aesthetic appearance.
Composite restorations are versatile tooth coloured filling materials composed of strong plastic and glass particles that are used by dentists or dental therapists to seal deep fissure, fill cavities, and restore sometimes extensively broken down teeth. Excitingly these restorations may be used as less invasive alternatives to more traditional crowns and inlays which require the more extensive preparation of teeth, and can be used to make cosmetic changes to teeth.
After removing decay and preparing the tooth, the restoration is bonded into or onto the tooth, layer by layer, using a special strong LED light source to set the material. When the process is complete, the restoration is shaped and polished. A hermetic seal to the tooth is important, and is made possible by carefully keeping the prepared tooth dry, and with the use of special dental adhesives.
Bonded composite restorations are available is a wide range of tooth coloured shades, allowing the appearance of the filling to closely match the adjacent tooth structure. These types of adhesive filling materials bond directly to the remaining tooth structure, allowing tooth preparation to be kept to a minimum, and also most importantly reducing the likelihood of further breakage of remaining tooth structure. Unlike older mercury-containing amalgam restorations, the materials can increase the strength of the restored tooth, and avoid the darkening of the remaining tooth structure resulting from the silver material showing through.
Image 1: Extensive decay with weakened tooth structure. Image 2: Careful moisture control to secure strong adhesive bond. Image 3: Tooth coloured restorations reinforcing the weakened tooth structure
When a tooth is already heavily broken down, a bonded restoration may be extended as a more conservative alternative to a crown for a highly compromised tooth. However, this must be in the knowledge that if the tooth subsequently fails a crown would then be required. Similar materials are also used as cements to retain crowns, veneers, inlays and bridgework. Bonded composite materials replace the use of silver amalgam materials which have not been used in our practice for more than 15 years.
As with any restorative procedure, patients may experience transient post-treatment sensitivity. Teeth that have suffered from tooth decay in the past may have an inflamed or scarred dental nerve. When a dental nerve is highly compromised in this way symptoms may become persistent, the nerve may deteriorate, and a root canal treatment may become necessary.
Before image:patient dislikes the visible 'gaps' between her side teeth. After image: gaps closed with bonded composite.
Over time, the shade of the material may change, especially if you drink tea, coffee, or red wine, or eat staining foods. This superficial staining may sometimes be polished off the surface and the appearance maintained by seeing the hygienist for regular maintenance. The restorations will eventually wear down and need to be replaced. In our experience a moderately sized filling will last about 5-10 years before needing replacing.
Sometimes, we prescribe these treatments as a provisional restoration for a tooth, which will eventually anyway need further treatment such as a root treatment or a crown. Whilst a bonded restoration may strengthen the tooth and seal the cavity, the restored tooth is not immune from further damage as a result of grinding, clenching, fracture or further tooth decay.