General and Restorative Dentistry

Restorative Dentistry and General Dentistry

Fixing holes in teeth is similar to fixing holes in other structures.  However, what is different is the environment in which teeth reside.  The environment is warm, moist, dark, acidic, and has the hardest substances colliding in the body under compressive, tensile, and shearing forces.  Did I mention we doubled the life expectancy in the last 120 years so your teeth have to last you longer than ever?

silverbefore

We do not place "silver" or mercury-containing fillings.  Dr. Heimbach has not installed a silver filling in his private practice career.  We remove many for a variety of reasons outside of the high mercury content in your body.  The expansion of these materials differs completely from natural teeth.  When you drink Hot fluids, you are essentially causing yourself the equivalent of "frost heaves."  What I mean is the expansion and contraction of the material, because it differs from that of your teeth, is a recipe for disaster.  We see cracks or "creep" in long-standing mercury fillings.  Either they crack the host tooth from expansion or they walk their way out of the hole opening up a gap between the tooth and the filling.  The gap gets colonized by cavity-causing bacteria, a black line forms as the bacteria oxidize the surface, and a cavity under your existing filling is born. 

Restorative success does not revolve around installation.  Restorative success is determined by longevity and durability without destroying the surrounding tooth structure when it fails in 30-50+ years.  We all learned from China products.  We all learned to about "economic engineering" when our Home Depot products did not last the test of time.  Composite resin is not the answer to replace silver fillings.  These are the modern day equivalent to "new refrigerators" that last roughly 5 years.   

We prefer to use the Cerec as a tool to deliver porcelain and ceramic products.  These provide better esthetics than silver fillings, and better durability for restoring our molars and posterior teeth than BPA-containing or non-BPA containing composite resin.  These teeth receive more forces because they are closer to the joint.  The closer food gets to your joint, the more force you can apply to it.  Therefore, the restoration material must be able to resist the increased forces.  Resin on average, will wear out every 6 years. 

 OnlayBefore

Onlayaftercerec restorations completed by Dr. Matthew Heimbach

Restorations with porcelain and ceramics increase the overall tooth strength, seal out bacteria, and provide durability in the areas of the mouth where chewing forces are greatest.  Why weren't you told this before is a common question when I describe this to patients? 

 I can speculate on why these materials, offered and delivered with Cerec technology, are only offered by 10% of US dentists (and growing quickly).  I have been using this method for 10 years so my success lives and breathes by the success of these restorations.  The technology made sense and offering the best fits my criteria of excellence, my primary motivation as a dentist.  No-brainer for me.   Others are motivated differently and have not researched the success of these materials or witnessed it.  Some don't want to commit to a large technological purchase (my Cerec wasn't cheap).  The Cerec system does not fit into some large practice models because it takes more time. Sorry, even my dog is getting bored.

ollie

Now CAD/CAM dentistry is exploding with different manufacturers offering different systems.  We debate which is best but really the patient is the true winner independent on which CAD/CAM system is best.  They get a superior restoration in esthetics and durability.