The fillings

The fillings - the restoration of the anatomical form of the tooth with the help of a seal.
In the process of treatment of teeth using temporary fillings, which closed cavity of the tooth at imposing of medicinal substance. For temporary fillings used artificial dentin, mixed with water or vegetable oil; can be used plaster oxide or zinc with eugenol.
For permanent fillings use the following sealing materials: cement (phosphate, silicate, arkodent), amalgam (silver and copper), quick-hardening plastic, epoxy and tabs dental (see). Cements consist of different composition of the powder and almost the same composition of the liquid. Fosfateren used for filling milk teeth, as isolating pad for other filling materials, for sealing channels, as well as strengthening teeth fixed prosthesis. Fosfateren no harmful effect on the pulp of the tooth, but it is unstable in relation to the saliva and not solid. For sealing of the front teeth apply silication with considerable hardness. Seal of silication similar in color to the enamel of the tooth, but it is fragile and can have an irritating effect on the pulp (mandatory insulating lining from Hospitalet). Arkodent (silicophosphate) combines quality phosphate and silication, but it is poorly suited to the color of enamel, so it is used for sealing of the front teeth, when the cavity is located on the lingual surfaces. The amalgam is an alloy of the metal (silver or copper) with mercury is used for sealing of multi-rooted teeth, but you should always do insulating lining from Hospitalet. Seal of amalgam is very durable, but it has high heat conductivity changes the color of the tooth and cause corrosion of gold crowns, may occur mercury intoxication. Widely used quick-hardening plastic (butacas, sokis, norcryl and others) for sealing of all teeth. They possess good adhesion, mechanical and chemical resistance, are well suited to the color of the enamel, but have toxic effects on the pulp (a lining from Hospitalet). Epoxy compositions created recently; they consist of resin, hardener and filler, are a good filling material.
To seal long and well kept, it is necessary carefully to fulfill a number of requirements. The carious cavity should be carefully handled correctly formed (to give a box-like shape) and well dried.
Filling material should be used in strict accordance with the indications and to cook properly: excessive or insufficient content of mercury in amalgam, improper preparation of cement seals worsens the quality.
Filling material should be introduced in a cavity of a tooth in parts and seal it (condensing) filling instruments. Should not be allowed into filling material in interdental space, as overhanging the edge of the seal will injure the gingival papilla. After imposing of seals it must be isolated from saliva (to cover the molten wax, petroleum jelly or a special varnish). After the final hardening of the seal (preferably the next day) her grind carborundum head, polished by polishing or special pastes.
It should also be borne in mind that the dentin and after processing cavity forest remains positive, especially with deep caries, when in order to avoid injuries pulp sometimes you have to leave some softened dentin. Therefore, before the imposition of a permanent seal on the bottom of the cavity impose therapeutic strip - pastes, including antiseptics, antibiotics or calcium hydroxide.
After treatment of pulpitis and periodontitis (see Teeth) produce a root canal filling. When pulpitis better to fill the root canal with antiseptic paste or Hospitalna approximately 2/3 tightly close the mouth of the channel. When periodontitis after processing 2% solution of bleach or other methods of root canal should be filled with Hospitalna all over from the mouth to the top or held resorcin-formalin method of treatment of root canals (molars). As a filling material for tooth canal apply paste, fosfateren and epoxy resin, and the pins of the gutta-percha, plastic, metal. Filling materials introduced into the tooth canal by means of root needle or Canaanites.
Cm. also Dental tools.

A tooth filling - closing the carious cavity in the tooth foreign filling material in order to restore the history and functions of the tooth.
The fillings are completes the treatment of both uncomplicated and complicated caries of teeth (see), pulpitis (see) and pericementitis (see). Made in compliance with the necessary requirements, filling saves the tooth for many years.
The technique. The fillings begins with the revelation of the cavity. This entry hole expands so that you can command the whole cavity and make it available processing tools. Hard-to-reach cavities in approximal surfaces of the molars are usually open from the chewing surface. Saped edge of enamel shall be removed, as enamel, deprived of the support of the dentin, become brittle and easily breaks when chewing, creating in place broke off conditions for recurrence of caries.
The danger of a relapse of caries is available in cases when the boundary of the cavity passes through the favorite places of localization of the disease - fissures, the contact area with the adjacent tooth. In these cases it is advisable to sacrifice a part of healthy tissue and expand the boundaries of the cavity within the "immune" to the caries areas of the tooth surface. Such preventive extension shown mainly where there is a pronounced tendency to decay.

the fillings
Fig. 1. The formation of a cavity: 1 - box-like cavity in a section; 2 - cutting; 3 - bases.

Over the disclosure cavity should remove softened dentin, after which it is given such a geometric form, which provides a solid mechanical fixing of a seal (the formation of a cavity). The best is box-like form in which the cavity is limited, with sheer walls and a flat base. In cases where this form does not provide reliable fixation of a seal or it cannot be created (proximity pulp, pain dentin), resort to various utilities commit to cuts, points, additional sites adjacent to the cavity of the tooth surface, giving them dovetail etc. (Fig. 1). For formation of their used primarily obratnojajtsevidnye forests.


Fig. 2. Mowing the edges of the cavity.

For snug fit filling material to the edges of the cavity is important final stage of preparation. It consists of the cutting edges of the cavity (Fig. 2) to remove enamel prisms that are not based on the dentin, and in the subsequent smoothing them with a hog with fine thread (Fedorov), paper disks, enamel knives. The carious cavity before filling should be thoroughly dried. Introduced in a cavity filling material is condensed in order to close against the wall and especially the edges of the cavity. Shape the contours of the tooth. Recovering convex form of approximal surfaces and contact with the adjacent tooth requires prior strengthen the tooth special matrix (Fig. 3). After hardening the seal must be carefully polished.
To isolate pariament from the content of macro - and micro-channels (microorganisms, toxins, the decay products) is the filling of root canal filling material, which use special paste, phosphate cement, metal and gutta-percha pins. Filling of root canal up to the top of the hole not only prevents the admission of infection in the periapical region and the development of the pathological process in Permanente, but often leads to reverse existing pathological focus. However, this full obturation is only possible when sufficient clearance root canal.


Fig. 3. Matrix (1) and die-holder (2).