filling materials

Comparison of direct restoratives

Click here to go to general info on fillings

Click here to see comparison of indirect restorative materials

Click here to learn about dental composites and cements

Click here to see a page on castable dental alloys, their composition and why they are made that way.

Direct restorative materials are what patients normally call fillings. Decay is removed from the tooth, the cavity preparation (the hole where the decay used to be) is refined in order to retain and support the filling, and a semi liquid or paste material is deposited into the preparation. The paste hardens and then is formed into the correct shape so the form and function of the original tooth is recreated.

Notice that composites may be either direct or indirect. Direct composite restorations are placed at the time that the cavity preparation is cut. Indirect composite restorations are built in a laboratory from a model made from an impression that the dentist takes on the day of the cavity preparation. They are then inserted on a subsequent visit.

Comparison of Direct Restorative Dental Materials

Factors	Amalgam (silver)	Composites Direct and Indirect	Glass lonomers	Resin lonomers (compomeres)
General Description	A mixture of mercury and silver alloy powder that forms a hard solid metal filling, Self-hardening at mouth temperature,	A mixture of submicron glass filler and acrylic resin that forms a solid tooth-colored restoration. Self- or light-hardening at mouth temperature.	Self-hardening mixture of fluoride containing glass powder and organic acid that forms a solid tooth-colored restoration able to release fluoride.	Self- or light-hardening mixture of sub-micron glass filler with fluoride containing glass powder and acrylic resin that forms a solid tooth-colored restoration able to release fluoride.
Principal Uses	Dental fillings and heavily loaded back tooth restorations.	Esthetic dental fillings and veneers,	Small nonload-bearing fillings, cavity liners and cements for crowns and bridges.
Leakage and Recurrent Decay	Leakage is moderate, but recurrent decay is no more prevalent than other materials.	Leakage low when properly bonded to underlying tooth; recurrent decay depends on maintenance of the tooth-material bond.	Leakage is generally low; recurrent decay is comparable to other direct materials, fluoride release may be beneficial for patients at high risk for decay.	Leakage is low when properly bonded to the underlying tooth; recurrent decay is comparable to other direct materials, fluoride release may be beneficial for patients at high risk for decay.
Overall Durability	Good to excellent in large load-bearing restorations.	Good in small-to-moderate size restorations.	Moderate to good in nonload-bearing restorations; poor in load-bearing.
Cavity Preparation Considerations	Requires removal of tooth structure for adequate retention and thickness of the filling.	Adhesive bonding permits removing less tooth structure.
Clinical Considerations	Tolerant to a wide range of clinical placement conditions, moderately tolerant to the presence of moisture during placement.	Must be placed in a well-controlled field of operation; very little tolerance to presence of moisture during placement.
Resistance to Wear	Highly resistant to wear. Brittle, subject to chipping on filling edges, but good bulk strength in larger high-load restorations.	Moderately resistant, but less so than amalgam.	High wear when placed on chewing surfaces.
Resistance to Fracture	Brittle, subject to chipping on filling edges, but good bulk strength in larger high-load restorations.	Moderate resistance to fracture in high-load restorations.	Low resistance to fracture.	Low to moderate resistance to fracture.
Biocompatibility	Well-tolerated with rare occurrences of allergenic response
Post-Placement Sensitivity	Early sensitivity to hot and cold possible.	Occurrence of sensitivity highly dependent on ability to adequately bond the restoration to the underlying tooth.	Low	Occurrence of sensitivity highly dependent on ability to adequately bond the restoration to the underlying tooth.
Esthetics	Silver or gray metallic color does not mimic tooth color.	Mimics natural tooth color and translucency, but can be subject to staining and discoloration over time.	Mimics natural tooth color, but lacks natural translucency of enamel.
Relative Cost to Patient	Generally lower; actual cost of fillings depends on size.	Moderate; actual cost of fillings depends on size and technique.
Average Number of Visits to Complete	One	One for direct fillings; 2+ for indirect inlays, veneers and crowns.	One	One

Click the button above to email Doctor Spiller.

Your browser must be Java enabled to use the email button.
If the email button does not work on your browser, click here.

I do not answer LONG emails. If you don't receive a reply, then your letter was too long. Make your questions short and precise. I don't have time to answer rambling, multiple questionnaires.
I cannot diagnose something I cannot see. Don't ask about sores in your mouth. See a dentist.

Please do not inquire about fees. See this page instead.).

I DO appreciate your help in correcting typos and broken links.

No dental insurance?
What is dental
insurance and how
does it work?

Are your fillings
killing you?
Is mercury ruining your
life??

Is Fluoride poison?
Should it be illegal?

Do Root Canals cause
multiple sclerosis or
other diseases?
Click here to find out.

Are dentures better
than real teeth?
Should you have all your
teeth pulled and get
false teeth?

Bad breath?
What is causing your bad
breath, and how can you
treat it?

Cure your dry mouth for
Free
Click here to find out how.

Copyright 2000 by Doctor Martin S. Spiller, DMD
Please click here to see the terms of fair use.

Check out another family website!
San Francisco Desktop Guy.
Free BIG desktop images for multiple monitors.

Copyright 2000 Martin S. Spiller, D.M.D.

All material on this web site is protected by copyright and is registered with the US Copyright office. All personal uses, including public and academic presentations, are permitted. This fair use permission applies to oral and written reports, dissertations and theses for students in public and private schools, elementary and high schools, colleges and graduate schools. It also applies to teachers wishing to print this material for classroom and course work. Acknowledgement of this website as the source for this material during presentations is not required, but would be appreciated. Any dentist or other professional who finds this material useful is welcome to print and distribute it to patients, or to refer their patients to this website.

Written requests for publication on the internet or other mass media (including printed publications) will be considered on a case-by-case basis. Internet and printed publication IS permitted (without permission, but with attribution) if it is part of a qualified academic dissertation, but any other internet or mass media use of this material without written permission is STRICTLY prohibited. Requests for such usage may be forwarded to me using the email button in the right shared border. If permission is granted, you must credit me for the use of the material and link to this website prominently from your own. Dentists and web developers who cut and paste content and/or images from doctorspiller.com into their own websites and claim them as their own are forewarned that this may result in legal action.

Web developers may NOT copy the content or images from this website for use in developing commercial websites for other dentists or health care providers. This activity is strictly illegal! Copyright law provides that owners of registered copyrighted material may sue for monetary damages. This website is registered with the US Copyright office in its entirety (Certificate of Registration: TX0006443750), and copies are regularly updated and maintained at the Library of Congress.
Click here for more information concerning the copyright on this material.

DISCLAIMER: Statements made on this web site are for informational purposes only and are not intended to be substituted for the advice of a medical professional. Information and statements have not been evaluated by the American Dental Association or any federal regulation agency and are not intended to diagnose, or treat any disease or medical condition. This is a personal website written by an individual dental professional whose intention is to enlighten the public with generally accepted, mainstream medical/dental information. I do not claim to represent the opinions of all dental or medical professionals. No website is a substitute for a visit to a living, breathing dentist or physician who can deal with you personally.