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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Unnatural-looking and black-appearing amalgam restoration at a back tooth.

cosmetic dental fillings in san francisco

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

Molar and bicuspid after removal of old fillings.">

aesthetic dentistry san francisco

Teeth checked for caries with 1% Acid Red in propylene glycol base (red).

cosmetic dental procedures

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

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 within the surface dentin that protects the tooth to acid attacks (as caused by decay-causing lactic acid released by bacteria).

cosmetic dental layering

The first layer of darker composite material is placed to create a natural-appearing deeper layer.

cosmetic dental final layer

Fillings prior to their final adjustments.

cosmetic dentist final result

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.


Wikipedia: Dental Composites.

Recent Advances and Developments in Composite Dental Restorative Materials.
Cramer NB et al. J Dental Res. 2011 Apr; 90(4): 402–416.

Dental Composites: Types and Recommendations.
Lavigne C. Spear Education 2017.

Biological aspects of modern dental composites.
Samuelsen JT. et al. Biomater Investig Dent 2023; 10(1): 222-223.

Micromechanical interlocking structure at the filler/resin interface for dental composites: a review.
Zhang S et al. Int J Oral Sci 2023; 15(1): 21.

Development and maintenance of surface gloss of dental composites after polishing and brushing: Review of the literature.
Amaya-Pajares SP et al. J Esthetic Restorative Dentistry 2022; 34(1): 15-41.

Consideration of Dental Tissues and Composite Mechanical Properties in Secondary Caries Development: A Critical Review.
Gauthier R et al. J Adhesive Dentistry 2021; 23(4): 297-308.

Trends in Restorative Dentistry: Composites, Curing Lights, and Matrix. Bands
Lawson NC. Contin Educ Dent 2021; 42(2): 93-94.

A Review of Dental Composites: Methods of Characterizations.
Aminoroaya A et al. S Biomater Sci Eng 2020; 6(7): 3713-3744.

Probing the hierarchy of evidence to identify the best strategy for placing class II dental composite restorations using current materials.
Ferracane JL et al. 2021; 33(1): 39-50.

Emerging nanomaterials for dental treatments.
Mok ZH et al. Emerg Top Life Sci 2020; 4(6): 613-625.

Treatment options for large posterior restorations: a systematic review and network meta-analysis.
Vetromilla BM. J Am Dent Assoc 2020; 151(8): 614-624.

Resin based restorative dental materials: characteristics and future perspectives
Pratap B et al. Jpn Dental Sci Rev 2019; 55(1): 126-138.

Dental restorative composite materials: A review
Yadav R et al. J Oral Bioscience 2019; 61(2): 78-83.