Dental Library- Restorative Dentistry

Restorative dentistry encompasses a wide variety of clinical treatments to restore broken down diseased teeth back to their proper form, function and esthetic qualities, replace missing teeth and restore proper occlusion (bite). Restorative dentistry can range from restoring a single tooth to full mouth reconstruction and rehabilitation involving most or all of the patient's teeth, opening the patient's bite and reestablishing the patient's entire chewing motion to proper function. Restorative dentistry can achieve this through simple tooth recontouring or small direct restorations (fillings) to using a variety of indirect restorations such as inlays, onlays, crowns, fixed bridges, implant crowns, implant bridges and porcelain laminate veneers. Restorative dentistry can also utilize full dentures and removable partial dentures to replace missing teeth and restore proper form, function, esthetics and bite for patients.

In the case of less severe problems restorative dentistry can often employ direct restorations or fillings. The patient is anesthetized and the tooth in need of treatment is isolated under a rubber dam, which minimizes contamination of the treatment field from blood or saliva and protects the patient's gums, cheeks and tongue from being inadvertently cut from the drilling and from being exposed to the chemicals used in the restorative treatment. Rubber dam isolation also optimizes the final quality or the restoration being placed again through minimizing contamination of the treatment field.

In more advanced cases restorative dentistry can employ indirect restorations that are fabricated in a dental laboratory. These restorations include inlays, onlays, crowns, fixed bridges, implant crowns and fixed bridges and porcelain laminate veneers. Because a laboratory fabricates these restorations they require multiple visits before they are completed and temporization between visits. These restorations are cemented or bonded into place and the final bite adjustments are done directly in the patient's mouth to ensure the maximum comfort possible.

In the most severely debilitated cases restorative dentistry employs a multifaceted interdisciplinary approach to accomplish full mouth reconstruction and rehabilitation. The restorative dentistry needed for these patients is complex and extensive in scope, time and cost, but can achieve miraculous life changing outcomes. Final restorations are first represented in wax models that are used as a blue print or road map to guide the doctor and laboratory to the final restorative product. Intermediate provisional restorations are a must in these cases and often times several sets of provisional restorations will be needed especially when opening a patient's bite. This ensures the patient is able to accommodate to the new bite relationship before the final restorations are placed.

When finances are limited restorative dentistry can use full dentures or removable partial dentures to replace missing teeth when the patient does not desire implants and or fixed bridges. These restorations are less expensive and therefore allow for more patients to receive care. The unfortunate consequence especially with full dentures is that the patient's jawbone is irreversibly lost forever. This can lead to complications ranging from ill-fitting dentures, loss of vertical dimension (when the tip or the nose is to close to the tip of the chin) to jawbone fractures. It is therefore advisable to avoid full dentures whenever possible.

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