Nowadays, dental fillings and inlays are available in a wide variety of designs. The most common type of dental filling is probably the tried and tested amalgam, followed by composite fillings. Each of these filling materials has its specific advantages and disadvantages. It therefore depends on the individual case which filling is the most suitable.
Here you will find further information and selected specialists for dental fillings and inlays.
Dental fillings and inlays are used to close a tooth defect.
A hole often remains in the tooth substance after caries has been removed. This must be filled by the dentist so that cavities cannot form again in the tooth.
Sometimes a tooth defect leaves nerve endings of the tooth exposed. A filling is then used to prevent pain and inflammation.
A dental filling or inlay can also restore the full chewing function of the dentition. This is particularly important for molars. Correct chewing function prevents irregular abrasion of the tooth enamel.
Various filling materials and techniques can be used to fill teeth. Which of these is best in each individual case depends, among other things
financial situation or insurance status.
Which material is most suitable depends on
The dentist will advise you on these options.
Typical materials for small fillings are
The choice is greater for large fillings. Typically, amalgam is still only used in the posterior teeth.
Composite and ceramic are used for all teeth. These materials are particularly popular on the front teeth due to the esthetic properties of composite.
Cement is still used for all children's teeth. However, it is also used as a base for a crown or a gold inlay.
Gold inlays are usually only used in the posterior region due to their aesthetics.
Composites are tooth-colored filling materials. They are also known as plastic fillings. They are often confused with ceramic fillings due to their nature and composition.
Most composites consist of acrylate-based plastics, which are used as a filling material with
are added.
Composite fillings are available in several colors. If the color is chosen carefully, composite fillings can hardly be distinguished from the natural color of the surrounding teeth.
Like amalgam fillings, composite fillings are plastic fillings. It consists of a paste that is applied in portions to the prepared hole in the tooth and processed. Composite shrinks during the curing process. It must therefore be applied in layers. Dentists use a polymerization lamp (a so-called cold light lamp) for curing.
The advantages of composite fillings are
Although the material is more expensive than amalgam, it is cheaper than comparable tooth-colored ceramic inlays. The cost per composite filling is around €160. Statutory health insurance companies only cover the costs
completely. Otherwise, the health insurance company only pays a subsidy equivalent to the cost of an amalgam filling.
However, a clear disadvantage of composite fillings is their lower durability and corrosion resistance. Here, composite performs worse than amalgam and other metal fillings. With good composite material, the filling is expected to last around 10 years.
The shrinkage of the composite during the curing process creates small gaps between the tooth surface and the filling, particularly in the lateral areas of the teeth. Caries can easily form again in these gaps.
Occasionally, the fillings also become discolored due to frequent tea, coffee or tobacco consumption. As a result, the esthetic effect of the composite is lost.
Left: tooth affected by caries, right: after treatment and a composite filling © Сергей Кучугурный | AdobeStock
Dental cements are produced by mixing a powder and a liquid. The result is a malleable mass. The dentist applies it directly to the defect, where the cement hardens.
There are many different cements that are used in dentistry depending on the type and location of treatment. Cements are the most common filling materials for children today. They are inexpensive and absolutely meet the requirements of children's teeth. There are no adverse health effects. Therefore, a cement filling is usually the best choice for growing children and adolescents.
In most cases, cement is used as a temporary solution for adults. Cement is used, for example, as a temporary filling in two-stage treatments. In the first session, the tooth is prepared for a gold or ceramic inlay, but the final inlay must first be fabricated. Cement can fill the hole in the tooth until the inlay is fitted.
Cement is also often used as an additional filling material for particularly large and deep defects. These so-called underfillings under the actual filling are intended to prevent toothache. They protect the tooth nerve from chemical stimuli and insulate it from high and low temperatures.
The amalgam filling is a silvery-gray dental filling made of mercury alloys. For this purpose, approx. 50% pure mercury and approx. 50% of a specific filing mixture are mixed together. This filing mixture consists of
together. This amalgam mixture owes its name to the large proportion of silver: silver amalgam. Due to the high silver content, the amalgam mixture is more resistant to corrosion than earlier amalgam fillings, such as copper amalgam. Today, this mixture is the only amalgam filling material that is still used.
The advantage of amalgam as a dental filling material lies in its relative ease of processing, even under difficult conditions. Its durability is also a major advantage. To date, no other filling material can match the durability of amalgam. It is expected to last up to 10 years, with good oral hygiene even up to 20 years and longer.
At the same time, amalgam is considerably cheaper than other modern filling plastics. This is why amalgam is the only material that is fully covered by statutory health insurance.
However, a clear disadvantage of amalgam fillings is their conspicuous silvery-grey color. If the amalgam remains in the tooth over a large area for several years, the tooth around the filling often turns gray.
For purely aesthetic reasons, many patients nowadays decide against amalgam fillings. Instead, they usually opt for a composite filling, although this is associated with additional costs.
One of the main components of amalgam fillings is toxic mercury. The first discussions about possible health risks therefore arose very early on. These discussions have continued for well over 200 years. However, none of the scientific studies carried out to date have shown any significant health risks.
The body does not absorb more mercury through dental fillings than through daily food. Both are classified by the WHO as not harmful to health. Amalgam is the best-researched dental filling material in the world. On this basis, amalgam fillings are considered safe and reliable.
Gold inlays are a high-quality alternative to composite fillings, although they do come at a price.
The gold inlay is not made of pure gold, as this is too soft to be a suitable tooth replacement material. It is merely a gold alloy. It consists of about three quarters gold and one quarter silver, copper or platinum.
Unlike amalgam or composite fillings, gold fillings are not plastic fillings. Instead, it is an inlay filling. It is made outside the dental practice by a dental technician.
At least two sessions are therefore required to fit and insert a gold filling. In the first session
In the second session, the dentist first removes the temporary filling. He then inserts the gold inlay and fixes it in place with a special adhesive cement.
The main advantage of gold inlays is their long service life of up to 20 years. The gold alloy is hard, corrosion-resistant and virtually indestructible. Gold inlays
One disadvantage of gold inlays, however, is the esthetic aspect. Especially in the front area or the outer sides of the teeth, the gold stands out with a very strong glitter.
Gold hammer fillings have become a rarity nowadays. They are the forerunner of gold inlays and have been used since the 17th century.
Gold hammer fillings are a very complex type of filling. It can only be used for small defects. In contrast to inlays, pure gold is used here, either in foil form (gold leaf) or as a small sponge. The dentist applies the gold to the tooth layer by layer using a tapping technique. This seals the defect.
Due to the easy malleability of the gold, so-called cold fusion occurs during the hammering of the gold. The material is inserted into the defect under pressure. It therefore exerts a slight elastic tension on the edges of the defect. If the tooth is now deformed under load (e.g. during the chewing process), no marginal gaps occur. Instead, the gold deforms elastically with the tooth.
This property distinguishes the gold hammer filling fundamentally from all other filling techniques and materials. It is also the reason for its enormous durability of up to 30 years.
The ceramic inlay is just as high-quality a type of filling as the gold inlay. They are fitted and inserted in two sessions, just like gold fillings.
First, caries is removed, the hole is cleaned, an impression is taken and a temporary filling is inserted. Like the gold filling, the ceramic filling is produced by a dental technician using the dental impression. It is then fitted in the second session.
In contrast to the gold inlay, no cement is used to secure the ceramic filling. Instead, a complex bonding technique is used. This prevents gaps from forming between the tooth and the inlay.
This opens up further applications for ceramic inlays. Some teeth are not stable enough to be cemented with a gold inlay, for example. In these cases, a partial crown would be necessary. The special bonding technique of the inlay gives the tooth new stability from the inside.
Ceramic is considered the ultimate in filling technology. It comes close to the natural tooth substance
closest. A well-fitted, professionally fabricated ceramic filling is virtually indistinguishable from a natural tooth. It blends seamlessly into the human dentition. With a good ceramic inlay and good oral hygiene, the inlay is expected to last around 10 years.
However, ceramic inlays also have disadvantages. Their durability does not come close to that of gold inlays. Large inlays in particular often break. They are therefore completely unsuitable for patients who often grind their teeth.
Replacing broken ceramic inlays is very time-consuming due to the special bonding technique. In addition, a large amount of healthy tooth substance has to be removed. Furthermore, irritation or allergic reactions to the adhesive used can occur in individual cases. The ceramic inlay must then be removed immediately.
Ceramic inlays are by far the most expensive dental filling. Depending on the size and quality of the filling, you can expect to pay between €400 and €700.
The Leading Medicine Guide's quality assurance is ensured by the following acceptance prerequisites.
