This information is provided to help you make better decisions about the use of
materials as tooth restorations in your mouth. Many types of metals are
used in dentistry for the replacement and rehabilitation of oral
structures. Most of these metal are considered to be inert when placed
in the body, while others have been criticized as potential toxins or
allergens to some people. Plastic and ceramics are used commonly as
tooth restoratives, and these have not had adverse biologic response.
Which type of tooth restorations are best
for you? The following information is provided to help you make that
decision.Restoration of Parts of Single Teeth ("fillings")
Silver amalgam (an alloy which contains silver,
tin, copper, zinc, and about 50% mercury) has been used for about 160
years for the restoration of teeth. It has been highly successful but
unsightly material. Use of mercury in the body has been criticized since
its inception, but amalgam use it still supported strongly by the
American Dental Association and other groups worldwide. Some people in
the overall population may be allergic to the elements in silver
amalgam. However, you do have several options.
Your Choices for Fillings
- Silver Amalgam. Average longevity
about 15 years, silver color, low initial cost, best in small-to-medium
size restorations of posterior teeth.
- Gold Inlays and Onlays. Average longevity 20 years to life,
gold color, moderate-to-high initial cost, may be used in any size
restoration in any location where metal in not displayed.
- Resin Composite (plastic). Average longevity 10-15
years, tooth-colored, moderate cost, best used in small-to medium
size restorations for any teeth, direct one - day placement.
- Resin (plastic). Average longevity (expected) 10-15 years,
tooth-colored, moderate to high initial cost, best in medium-sized
restorations for posterior teeth, indirect two-appointment
placement.
- Ceramic Indirect. Average longevity 10-15 years,
tooth-colored, moderate to high initial cost, best in moderate sized
restoration for any teeth, two-appointment placement.
Crowns or Fixed Prosthesis ("bridges")
Gold alloys have been used for many years for
the construction of crowns or fixed bridges. They provide excellent,
strong, long-lasting service. Three major types of alloy are now
available:
- High Noble Metal. Mostly gold, also palladium, silver,
occasionally platinum, zinc, copper.
- Noble Metal. Mostly palladium, also silver and gold.
- Base Metal. Mostly nickel, also chrome or cobalt and other
base metals.
All of the above metals are used either as
the sole constituent of a crown or as a base on which porcelain is fired
(baked). Most people have no biological response to the base metals. The
cost of those is somewhat higher than base metals. Bridges (fixed
prosthesis) are strongest when metal is used with or without porcelain
on it.
Your Choices for Bridges
- Metal Alone. (high-noble, noble, or base metal).
Longevity 20 years to life, gold or silver color, moderate-to-high
initial cost, may be used in any area where metal display is not
objectionable.
- Porcelain Fused to Metal. Longevity 10-20 years,
tooth-colored, moderate-to-high initial cost, may be used in any
area where extreme stress or grinding habits are not present.
- Ceramic Non-Metal containing crowns (bridges constructed
from ceramic alone are not advisable). Longevity 10-20 years,
moderate-to-high initial cost, may be used in any area where extreme
stress or grinding habits are not present.
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