Invisible Fillings in Cosmetic Dentistry

Cosmetic dentistry does not just mean smile design. The materials and technologies developed for cosmetic dentistry also benefit other procedures in less visible areas. The best cosmetic dentists can only achieve predictable and permanent results by meticulous observation of technique, a thorough understanding of physical, chemical, and biological properties of dental materials, and "discipline." With "discipline" is meant that a dental practitioner should not just know how to establish an optimum operating field, but also do it. There is no way you will have long-lasting and beautiful treatment outcomes, if somewhere along the line a step was omitted, a "corner cut", or a material not properly applied, while observing the bigger picture, i.e. your oral health, facial proportions, and the condition of your TMJ.

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1. Unnatural-looking and black-appearing amalgam restoration at a back tooth.
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2. Rubberdam placed prior to procedure to protect oral cavity of debris and to avoid exposure of tooth to saliva.
aesthetic fillings in cosmetic dentistry san francisco
3. Molar and bicuspid after removal of old fillings.
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4. Teeth checked for caries with 1% Acid Red in propylene glycol base (red).
cosmetic dental procedures
5. Application of etchant (blue) to create a penetrable collagen-fibril network, which allows the diffusion of hydrophilic resins into the outer tooth structure.
cosmetic dentistry at a molar
6. Placement of a hydrophilic methacrylate monomer (primer) that facilitates the bonding of the resin of the filling material to the tooth. The primer creates a hybrid layer in the surface dentin that protects the tooth to acid attacks (as caused by decay-causing lactic acid released by bacteria).
cosmetic dental layering
7. The first layer of darker composite material is placed to create a natural-appearing deeper layer.
cosmetic dental final layer
8. Fillings prior to their final adjustments.
cosmetic dentist final result
9. The fillings after their final adjustments and after removal of the rubberdam.

Tooth-colored fillings consist of variations of polymethylmethacrylates (PMMA's). They commonly consist of a resin-based oligomer matrix and an inorganic filler such as silicon dioxide. There are large variations in the composition and application of composite materials.The inorganic filler gives it wear resistance and translucency. A coupling agent such as silane is used to enhance the bond between the filler and the matrix. The example above describes the use of one of such composites in combination with bonding agents. Due to the delicate timing of the chemical processes that take place during the procedure, strict adherence to the treatment protocol is necessary.