Caries is one of the most common diseases in people around the globe, which occurs in both children and adults. Treatment of caries takes place according to a certain algorithm: removal of the affected enamel, dentin, restoration of the anatomical shape of the tooth with the help of filling materials. Despite improvements in materials, dentists often recommend dental inlays as an alternative. What is it, what is their advantage over fillings, when can you refuse and when not, and are there any particularities of care? MedAboutMe will answer all your questions.
Caries as a cause of tooth decay
Recall that caries is a pathological process of tooth decay. In foreign literature, it is considered as one of the causes of tooth loss and all the ensuing consequences and complications.
If you believe the data of experts, then about 70% of the time of the dentist’s work falls on the treatment of caries, the rest — on its complications. In different countries of the world, the prevalence of caries represents different numbers, but the United States, Russia and some European countries remain the leaders.
Caries is insidious: even if only a small carious cavity is visible on the enamel, when it is opened, an extensive lesion of dentin, the main substance of the tooth, can be found. To save the patient from caries and prevent complications, the dentist must remove all infected enamel and dentin. At the same time, focusing on color, signs of damage, using caries detectors. As a result, after opening the carious cavity from the tooth (if it is a chewing group), only one wall can remain.
In their practice, dentists strictly follow the rules, and the most important of them is to save a natural tooth and prevent its loss. And we are talking about the preservation of the crown part. Depending on the size of the carious cavity, the dentist may recommend a filling, an inlay, a crown, or a post-stump structure to restore lost tooth tissue.
To determine the type of recommended design, the dentist focuses on the index of destruction of the occlusal surface of the tooth (IROPZ). Determining the area of the lesion and correlating it to the remaining tissues, the doctor suggests treatment:
- with minor carious cavities — filling;
- carious cavities that have communication with each other, differing in a larger area, are recommended to be restored using tabs;
- extensive cavities, when only the walls remain from the tooth, filling and making a crown are recommended;
- if only a viable root or one of the walls remains from the tooth, the dentist may recommend post-stump constructions and subsequent prosthetics.
The choice of design is carried out on an individual basis and largely depends on the area of the lesion. But recently, dentists have begun to expand the indications for filling, as well as for the manufacture of inlays. This condition has become possible due to the improvement of the materials used, as well as the increased requirements for aesthetics. But still, which is better: an inlay or a filling?
Carious cavity filling is a classic treatment. Dentists have a wide range of filling materials at their disposal. Choosing among them, the dentist restores the tooth so that it is indistinguishable from natural enamel and dentin. Playing with translucency, the color of the restoration, the teeth are indistinguishable from natural ones even in the area of increased aesthetic requirements.
The evolution of filling materials is going by leaps and bounds, but despite this, filling has a number of disadvantages:
- sometimes it is very difficult technically to achieve a strong fit, and no dentist can guarantee the absence of micro-leaks and micro-cracks that form in the area of contact between the filling and enamel. It is known that it is their presence that can cause secondary caries, which can lead to a number of complications and even tooth loss;
- any filling material, despite the quality of polishing after filling, becomes porous and is able to accumulate pigments. Over time, this will lead to discoloration of the restoration. Such changes occur especially quickly in patients with bad habits, as well as those who abuse various coloring foods and drinks;
- Restorations with filling materials require high qualifications and skills from the dentist in order to recreate the anatomy of the tooth and “get” the color.
Dentists on the benefits of tabs
Inlays are micro-prostheses designed to restore lost enamel and dentin. If we talk about the real possibilities of inlays, then with their help you can restore up to 50% of the crown part of the tooth. Their manufacture takes place exclusively in a dental laboratory: with the help of classical casting or using high-tech equipment, which will produce inlays of the desired type and size with jewelry precision, eliminating errors associated with the human factor.
The dentist can offer several types of tabs, which will differ in appearance, material of manufacture:
- compositional. In fact, these are the same fillings with all the advantages and disadvantages, which are distinguished by greater accuracy and better marginal fit, as they are made in a dental laboratory;
- ceramic — are recognized as the most reliable and highly aesthetic type of dental inlays. Fully merge with the color of the natural tooth, perfectly withstand chewing pressure;
- zirconium. To date, zirconium dioxide is a revolutionary material, which in some qualities even somewhat surpasses ceramics;
- metal-ceramic, recommended for the chewing group of teeth in order to increase the strength of ceramics. Due to the introduction of metal, they lose somewhat in aesthetic terms, but this is not noticeable on the chewing group of teeth.
The main advantage of an inlay over a filling is manufacturing accuracy, thereby achieving a better marginal fit, therefore, the risks of developing caries and its complications are reduced to zero. The accuracy of the fit also ensures that the restoration does not chip and is able to withstand greater chewing pressure.
Another advantage of inlays is the lack of porosity, therefore, they are less prone to staining.
Tab care rules
Caring for your teeth when setting tabs is no different from the usual. Patients are also recommended to brush their teeth twice a day using standard and additional hygiene care methods: toothpaste, brush, floss, irrigators, rinses.
Restoration care has its own peculiarities when it comes to fillings. Carrying out professional oral hygiene — removal of dental deposits in the dentist’s chair, the doctor evaluates the condition of the fillings and additionally polishes them. Such actions make it possible to preserve the color of the restoration for a longer time, as well as to deprive the bacteria that cause caries of their habitat. Installing tabs will not require such additional manipulations.
Inlays win over fillings in many ways, especially when it comes to significant loss of enamel and dentin: minor risks of complications, more accurate restoration, play of color, care and much more.
Dentists / Ed. Bazhanova N.N. — 2008
Comparative evaluation of the marginal adaptation of the filling material after cavity preparation with various IN VITRO instruments / Makeeva I.M., Mikhailov D.G. // Dentistry — 2011 — T. 90 No. 4