Porcelain fillings and composite fillings: What are the differences and what costs are involved?

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General Dental Care
BChD (Pret), Dip.Odont (Oral Surgery) (Pret)

One of the most common misconceptions we find in dentistry is that many people think all white fillings are the same. This is far from the truth. There are fundamentally two different types of white fillings – porcelain and resin.

We often compare the difference between porcelain fillings and composite fillings like the difference between your plastic picnic plates verses your fine china dinner wear. They’re like chalk and cheese. In terms of terminology, plastic white fillings can be referred to as composite or resin. Porcelain fillings are often called inlays, ceramic or Cerec restorations.

Both types of restorations utilise the same blue light that is used to set hardened cement material. The resin is placed in soft and set hard with the light, whereas the porcelain restoration is a hard prefabricated filling that is bonded into the cavity. When a filling is on the larger side, requiring corners or what are termed as cusp replacements, we always recommend porcelain reconstruction of the tooth to ensure that you are not back in the dental chair fixing the same tooth again any time soon.

The porcelain filling is no doubt more expensive, but when you consider you may have to replace a plastic resin filling over and over, the cost differential may prove to be a lot less than first envisaged. For bigger restorations at the back of the mouth we normally use a porcelain, which is quite strong. And for smaller fillings, like smaller cavities in the front of the mouth, we normally use plastic or resin fillings. For removing or replacing of the amalgam fillings, Cerec is probably one of the best choices to use then.

At Smile Solutions both options of white fillings are readily available. It’s a matter of working out with you which option best suits your expectations and budget. The benefits and advantages of having a Cerec porcelain filling as opposed to a normal, white filling is it’s a single visit procedure.

The nice thing is we numb you up once, it gets done in 90 minutes and you’re out the door and it’s all done. So it makes a lot more sense, especially with people nowadays that don’t have a lot of spare time.

The other thing is it’s a lot more superior. It’s a lot harder; it’s really more natural looking than resin. It blends in very well with the surrounding tooth structures.

Another thing is conservation of healthy tooth structure. With modern bonding techniques that we use today there’s no need to remove a lot of the tooth structure. We just remove what’s necessary and replace that with a ceramic inlay.

In terms of the procedure itself, first of all we do an examination, we take x-rays, we see what needs to be done.

Then we numb the patient up, we remove all the decay and the filling that needs to be replaced.

We then take an infrared camera and take photos of the tooth. So we’ve got an inter-oral camera, which is a 3D camera, and we put it on the tooth and actually take pictures. And you can see the picture’s coming up on the screen, on the Cerec unit, and that basically forms the model. From that model we then actually design your new restoration with the help of a computer. And the nice thing about that is we can actually change and make the filling bigger, make it any shape we want, until we’re happy, until the patient’s happy. Then we actually put in a block of ceramic into the metal unit, and start milling the restoration out of the block so that it comes out exactly the right size. Then we just polish it, make it nice and shiny, glue it in, check the bite, and there you go.

As an expert in the field of Cerec dentistry I started using this technology in 2001 and since then I’ve probably done around 5,000+ of these restorations. I’m lucky to be with Smile Solutions where we have a very large group of specialists and other Cerec users as well in the practice. We come together once a week to discuss cases and really further our knowledge and share whatever information we’ve got with each other.

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