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LEVINE DENTISTRY, INC. 2 Osborn Street, Suite 120 Irvine, CA 92604 949.727-9600 COMPARISONS of INDIRECT RESTORATIVE DENTAL MATERIALS

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LEVINE DENTISTRY, INC. 2 Osborn Street, Suite 120 Irvine, CA 92604 949.727-9600 COMPARISONS of INDIRECT RESTORATIVE DENTAL MATERIALS LEVINE DENTISTRY, INC. 2 Osborn Street, Suite 120 Irvine, CA 92604 949.727-9600 COMPARISONS OF INDIRECT RESTORATIVE DENTAL MATERIALS COMPARATIVE PORCELAIN PORCELAIN NICKEL OR COBALT-CHROME FACTORS (CERAMIC) (FUSED TO METAL) GOLD ALLOYS (NOBLE) (BASE METAL) ALLOYS The following document is the Denial Board or California's Denial Materials Fact Sheet The Depanmenl or Consumer Affairs has no position with respect to the language of this Dental Materials Fact Sheet: and Its linkage to the DCA Web GENERAL Glass.llke' material r°'med into Glass·llke material that is Mixtures of gold, copper and Mixtures or nlckel. ch'omlum. OESCRIPTION fillings and aowns using -enameled " onto metal shells. other metals use<1 mainly f()( site does not constitute an endorsement of the content or this document models of lhe prepared teeth. Used rot t1owns and fixed- crowns and fued bridges. bridges. ' PRINCIPAL Inlays, veneers. crowns ond Crowns and fixed-bridges: Cast crowns and fixed bridges: Crowns and rP:ed bridges; most The Dental Board of California materials used lo restore the teeth. All materials com· USES fixed·bfidges. some partiat denture frame- partial denture framewofks. · works. monly used (and listed in this fact sheet) have been DENTAL MATERIALS FACT SHEET shown - through laboratory and clinical research, as Adopled by lhe Board on Oc1ober 17, 2001 RESISTANCE Good, If the 1estorotion fits Good, if the restoration fits Good, If the restoration fits Good, if the restoration fits well as through extensive clinical use - lo be safe and TO FURTHER well. well. weU. well. DECAY effective for the general population. The presence of As required by Chapter 801. Statutes of 19g2, the these materials in the teeth does not cause adverse ESTIMATED MO<ierate; Brittle material that Very good. Less MCeptible to Ucellent. Does not fractUfe Excellent. Does not fracture DURABILITY may fracture under high biting fracture due to the metal under stress; does not corrode under stress: does not corrode Dental Board of California has prepared this fact health problems for the majority of the population. (Permanent forces. Not recommended for substructure. In the mouth. In the mouth. sheet lo summarize information on the most frequent­ There exist a diversity of various scientific opinions teeth) posterior (molal') teeth. ly used restorative dental materials. Information on regarding the safely of mercury denial amalgams. RELATIVE Good . Moderate. Little Moderate-High. More tooth Good. A sttong material that Good. A suong material that this fact she·et is intended 10 encourage discussion The research literature in peer-reviewed scientific jour­ AMOUNT removal of natural toolh Is must be removed 10 permit requires removal of a thin requires remoYal of a thin between the patient and dentist regarding the selec· nals suggests that otherwise healthy women, children OF TOOTH necessary ror veneers: more '°' the metal to accompany the outside layer or the tooth. outside layer or the tooth. tion of dental materials best suited for the patient's PRESERVED crowns since sttength is related porcelain. and diabetics are not al increased risk for exposure to ·· to its bulk. dental needs. It is not inlended to be a complete mercury from dental amalgams. Although there are guide to dental materials science. various opinions with regard lo mercury risk in preg­ RESISTANCE Reststant to SUl'fate wear: but Resistant to surf ace wear; Similar hardness to naturaf Harder than natural enamel TO SURFACE abrasive to opposing teeth. permits either metal Of porcelain enamel: does not abrade but minimally abrasive to nancy, diabe1es. and children, these opinions are not WEAR on the biting surrace of crowns opposing teeth. opposing natural teeth. Does The most frequently used materials in restoralive den­ sclenliflcally conclusive and therefore the dentist may and btldges. noc fracture lo bulk. tistry are amalgam, composite resin, glass ionomer want 10 discuss these opinions with their patients. RESISTANCE Poor resistance to fracture. Poree.lain may fracture. Does not fracture In butk.. Does not fracture In bulk. cement, resin-ionomer cement, porcelain (ceramic), There is no research evidence that suggests pregnant TO porcelain (ft1sed-to-metal), gol.d alloys (noble) and women, diabetics and children are al increased FRACTURE nickel or cobalt-chrome (base-metal) alloys. Each health risk from dental amalgam· fillings in their RESISTANCE Very good. Can be rabricatcd Good - Very good depending Very good - EJ1Cellent. Can be Good-Very good - Stirrer thin material has its own advantages and disadvanlages, mouth. A recent study reported in the JADA factors in TO for very accurate nt or the upon design or the margins or ramed with gut predsJon 9l1d ro;ld: less adapt>ble, but can be LEAKAGE margins of the crowns. the crowns. can be tightly adapted lo the omied will> great p<l!CisJOll. benefits and risks. These and other relevant factors a reduced tolerance (1/50th of the WHO safe limit) tooth. are compared in the attached matrix lilied for exposure in calculating the amounl of mercury "Comparisons of Restoralive Dental Materials. " "A RESISTANCE Moderate: brittle mate<lal Very good. Metal substructure Excellent E11ce1lent that might be taken in from dental fillings. This level TO susceptible to fracture under gives high resistance to frzicture. Glossary or Terms· is also attached to assist the read­ falls below the established safe limits for exposure to OCCLUSAL biting forces. · er in understanding the terms used. STRESS a low concentration of mercury or any other relea.sed component from a dental restorative material. Thus, TOXICITY Excellent. No know~ adverse. Vory Good to Excellent. Ucellent. Rare ollergi to some Good. Nickel allergies ore The statements made are supported by relevant, cred­ while these sub-populations may be perceived to be effects. Occasional/rare .allergy to metal alloys. common among woman, ible dental research published mainly between 1993 • alloys used. tllthougtl rarely manitested In at increased health risk from exposure to dental dental restoratiom. 2001. In some cases, where contemporary research restorative materials, the scientific evidence does not is sparse, we have indicated our best perceptions support that claim. However, there are individuals ALLERGIC None Rafe. Occasional allergy to Rare. Occasional allergic Occasional; infrequent reactions OR ADVERSE metal substructure. reacatlons seen In susceptible to nickel. based upon information that predates 1993. who may be susceptible lo sensitivity. allergic or REACTIONS li:"dlviduals. adverse reactions lo selected matenals. As with all The reader should be aware that the outcome of den­ SUSCEPTI- · Not material dependent; docs Not material dependent; does CondUcts heat 9l1d cold: may Conducts heat and cold: dental materials, the risks and benefits should be dis­ BIUTY TO not conduct heat ond cold well . not conduct heat and cokf well. irritate sensitive teeth. may irritate sensillYe teeth. tal treatment or durability or a restoration is not solely cussed with the ·patient, especially with those in sus­ POST- a function or the material from which the restoration ceptible populations. OPERATIVE SENSITIVITY was made. There are differences between dental materials and ESTHETICS Ucenent Good to Excellent P00<- yellow metal Poor- dark silver metal The durability of any restoration is influenced by the the individual elem"ents or components that compose (Appearance) dentist's technique when placing the restoration, the these malerials. For example, dental amalgam filling FREQUENCY Varies; depends upon biting Infrequent; porcelain fracture Infrequent repacement Is Infrequent; replacement is ancillary materials used in ·the procedure, and the material is composed mainly of mercury (43-54%) OF REPAIR forces; fractures of molaf' teeth can ol\en be repaired with usuaNy due to recurert decay usually due to recurrent decay patient's cooperation during the procedure. Following and varying percentages of silver, tin, and copper OR are more Ukely t~ anterior composite resin. a.round margins around margins REPLACEMENT teeth; porcelain rrac.ture may restoration or the teeth, the longevity or the restora­ (46-57%). It should be noled that elemental mercury often be repaired wl1h tion will be strongly Influenced by the pallent's com­ is listed on the Proposition 65 list of known toxins and co~iteresln. pliance with dental hygiene and home care, their diet carcinogens. like all materials In our environment, RELATIVE H+gh; requires at least two High; requires at ~ two omce High: requires at least two office High; requires at least two ortke and chewing habits. each of these elements by themselves is toxic at some COSTS TO office visits and laboratory visits and latx>ratory services. visits and labo<atory setVices. visits 9l1d laboratory seMces. PATIENT services. level of concentration if they are taken into the body. Both the public and the dental profession are con­ When they are mixed together, they react chemically NUMBER OF Two - minimum: matching Two - minimum: matching Two· mlnirrK.Jm Two·minimum cerned about the safety or dental treatment and any lo form a crystalline metal alloy. Small amounts of VISITS esthetlcs of teeth may require esthetics or teeth mziy require polenlial health risks that mighl be associated with the REQUIRED more visits. more visits. free mercury may be released from amalgam fillings COMPARISONS OF DIRECT RESTORATIVE DENTAL MATERIALS over rime and can be detected in bodily fluids and Composite reSins
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