Dental amalgam (silver amalgam or simply amalgam) is a metallic, polycrystalline restorative material originally composed of a mixture of silver–tin alloy and mercury. Current alloys that are amalgamated with mercury are silver–tin–copper.
The search for an ideal esthetic material for restoring teeth has resulted in significant improvements in resin-based composite materials. Although these materials are referred to as resin-based composites, composite resins, and other terms, this book refers to most direct esthetic restorations as composites.
This chapter discusses dental biomaterials with the practicing dentist and dental student in mind. As such, it is not meant to be an in-depth review of materials that would be of interest to material scientists. The chapter discusses dental biomaterials from the perspective of the clinician trying to make a decision about, for example, what composite resin material, dental adhesive system, or impression material is best for his or her practice in order to provide optimum care for patients.
Dental caries is a preventable, chronic, and biofilm-mediated disease modulated by diet. This multifactorial, oral disease is caused primarily by an imbalance of the oral flora (biofilm) due to the presence of fermentable dietary carbohydrates on the tooth surface over time. Traditionally, this tooth-biofilm-carbohydrate interaction has been illustrated by the classical Keyes-Jordan diagram.
Dgital technology, computerized dentistry, and digital dentistry are general terms used to describe the clinical application of computer-assisted design, computer-assisted machining (CAD/CAM).The restorative dentistry application of CAD/CAM technology is the fabrication and delivery of permanent restorations for teeth and implants.
Teeth require intervention (i.e., need some type of preparation) for various reasons: (1) caries lesion progression to the point that loss of tooth structure requires restoration; (2) tooth fracture compromising form and function with or without associated pain or sensitivity; (3) congenital malformation or improper position in need of reestablishment of form or function; (4) previous restora-tion with inadequate occlusal or proximal contact, defective (open) margins, or poor esthetics; or (5) as part of fulfilling other restorative needs. Every effort must be made to limit the risk of iatrogenic damage to adjacent tooth surfaces while seeking to prepare and restore caries lesions or defects.
The changes towards more conservative approaches to managing carious lesions in the permanent dentition have been mirrored for primary teeth. Prevention is key to treatment planning for the child with a carious primary dentition as the presence of the disease means that prevention has failed at some stage.
A thorough understanding of the histology, physiology, and occlusal interactions of the dentition and supporting tissues is essential for the restorative dentist. Knowledge of the structures of teeth (enamel, dentin, cementum, and pulp) and their relationships to each other and to the supporting structures is necessary, especially when treating dental caries.
In this chapter, focus is extended on the local cariogenic environment within deep stages of carious lesions. When examining various stages of deep lesions in many patients, a systematic pattern of clinical signs are exposed, that quite often are specifically related to changes of the local cariogenic environment, e.g., the undermined enamel has been brokendown. When following the same carious lesion overtime, a number of clinical variables can be taken into account, in particularly when carious dentin is clinically detectable, to assess lesion activity.
Direct gold is a gold restorative material that is manufactured for compaction directly into prepared cavities. Two types of direct gold are manufactured for dental use: gold foil and powdered gold. These gold materials differ in their metallurgic structure.
This chapter presents conservative esthetic procedures in the context of their clinical applications. The principles and clinical steps involved in adhesive bonding for the treatment alternatives discussed in this chapter are similar to those described in other chapters in this textbook. Only specific conservative esthetic clinical procedures or variations from previously described techniques are presented in this chapter.