Bonding & Composites

BONDING
Bonding is a restorative procedure performed to repair a damaged tooth that is either worn, chipped, decayed or discolored. After removing the damaged area, we “bond” or attach a tooth colored material called composite resin onto the tooth. Bonding is also an effective way to close a small space or gap between two teeth.The tooth is restored by preparing it’s surface and then “etching it” to increase it’s adhesive area.A primer is then applied which decreases sensitivity and increases adhesive potential. Next,the prepared area of the tooth is coated with a bonding liquid, which is set by shining a bright light on the tooth. Once the liquid sets, the previously color-matched composite resin is placed onto your tooth, and sculpted to the desired shape. The light is used a second time to harden the composite. After the composite has set, the restoration is sculpted and polished to a high luster. Now the aesthetic imperfections have been corrected and the bonded tooth blends beautifully into the smile.

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A fractured tooth(Before)

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Restored by bonding(After)

Bonding can work wonders for discoloured teeth not changed by bleaching, to close spaces, or to appear to change tooth position.
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Before       After

COMPOSITES – FREQUENTLY ASKED QUESTIONS
What is a composite resin (white filling)?

A composite resin is a tooth-colored plastic mixture filled with glass (silicon dioxide). Introduced in India in the late 1970s, dental composites were confined to the front teeth because they were not strong enough to withstand the pressure and wear generated by the back teeth. Since then, composites have been significantly improved and can be successfully placed in the back teeth as well. Composites are not only used for restoring decay, but are also used for cosmetic improvements of the smile by changing the color of the teeth or reshaping disfigured teeth.

How is a composite placed?

Following preparation, the dentist places the composite in layers, using a light specialized to harden each layer. When the process is finished, the dentist will shape the composite to fit the tooth. The dentist then polishes the composite to prevent staining and early wear.

How long does it take to place a composite?

It takes the dentist about 15 minutes longer to place a composite than a silver filling. Placement time depends on the size and location of the cavity. The larger the size, the longer it will take.

What are the advantages of composites?

Aesthetics are the main advantage, since dentists can blend shades to create a colour nearly identical to that of the actual tooth. Composites bond to the tooth to support the remaining tooth structure, which helps to prevent breakage and insulate the tooth from excessive temperature changes.Bonding procedures are advantageous because one or more teeth can be corrected during a single appointment and the positive results are immediately apparent.

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Silver fillings

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“Bonded” Composite fillings

DENTAL VENEERS (LAMINATES)
Ceramic laminate veneers are all white, thin ceramic shells, which fit precisely onto the faces of prepared anterior teeth. Like bonding, veneers are used to cover up discoloration, cracks and chipping, and to change the shape or size of your teeth. Veneers outperform bonding with greater resilience and a greater resistance to stains and dulling.

Most veneer procedures require two appointments to complete, the first of which is dedicated to preparing and taking an impression of the teeth. Veneers are minimally invasive restorations. Therefore,we need to remove only a small portion of the face and top edge of a tooth to achieve a proper preparation design. After the tooth or teeth are prepared, an impression is taken, which, along with accompanying photos and models, is sent to the lab. The lab fabricates porcelain shells, which, not unlike false fingernails on your fingertips, fit onto your teeth. These are your veneers.

During your second appointment,we will cement your veneers onto your teeth. Be sure to leave plenty of time for this appointment, since placing veneers is a meticulous and delicate procedure. Each veneer must be trial fitted and assessed for aesthetic and functional success before final cementation. If required, fine adjustments are made prior to or immediately after final cementation.

Ceramic laminate veneer procedures are exacting, but their results can be extremely worthwhile. Stronger and longer lasting than composite resin restorations, they are the current state-of-the-art procedure to restore and beautify your smile.

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Chipped,discoloured teeth with gaps

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The smile with veneers

This patient has tetracycline staining which occurs when a patient is exposed to the drug while the teeth are developing. The stain is all the way through the tooth (we call it Intrinsic).To hide the stain, we can remove about 0.5mm of tooth structure and replace it will porcelain or composite. The same technique is seen in the before and after pictures below.We closed the space between the two front teeth (a diastema) with the veneers and also recontoured the other teeth to make up for missing lateral incisors.

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Porcelain Veneers – Before and after pics

Porcelain ( Ceramic) veneers

What are porcelain veneers?

Porcelain veneers are ultra-thin shells of ceramic material,which are bonded to the front of teeth. This procedure requires little or no anesthesia, and can be the ideal choice for improving the appearance of the front teeth. Porcelain veneers are placed to mask discolorations,to brighten teeth, and to improve a smile. Highly resistant to permanent staining from coffee, tea, or even cigarette smoking, the wafer-thin porcelain veneers can achieve a tenacious bond to the tooth,resulting in an esthetically pleasing naturalness that is unsurpassed by other restorative options.

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Porcelain Veneer

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Veneer Prep

Why would you recommend a porcelain veneer?

Porcelain veneers are an excellent alternative to crowns in many situations. They provide a much more conservative approach to changing a tooth’s color, size, or shape. Porcelain veneers can mask undesirable defects, such as teeth stained by tetracycline, by an injury, or as a result of a root-canal procedure, and are ideal for masking discolored fillings in front teeth. Patients with gaps between their front teeth or teeth that are chipped or worn may consider porcelain veneers.

What happens during the procedure?

The patient should spend time in the decision-making and planning of the smile and understand the corrective limitations of the procedure.

To prepare the teeth for the porcelain veneers, the teeth are lightly buffed to allow for the small added thickness of the veneer. Usually, about a half a millimeter of the tooth is removed, which may required a local anesthetic. At this appointment, a mould is taken of the teeth, which is sent to the laboratory for the fabrication of the veneers. This can take about a week. Because the teeth are buffed or reduced, they will look a little different until the next appointment when the veneers will be placed. If the teeth are too unsightly you, a temporary veneer can be placed, at an additional cost.

Bonding of veneers: First, the dentist places the veneers with water or glycerine on the teeth to check their fit and get a sense of the shade or color. While the veneers are resting on the teeth, the esthetic results are viewed with particular attention to the colour. At this point, the colour of the veneers can still be adjusted with the shade of the cement to be used. The colour cannot be altered after veneers are cemented. To apply the veneer, the tooth is cleansed with specific chemicals to achieve a bond. Once a special cement is sandwiched between the veneer and tooth, a light beam initiates the release of a catalyst to harden the cement.

For about a week or two, the patient will go through a period of adjustment as he/she gets used to the “new” teeth that have been changed in size and shape. Brushing and flossing is to be carried on daily, as usual. After one or two weeks,there is a follow-up appointment.

Have realistic expectations

Porcelain veneers are reasonable facsimiles of natural teeth, not perfect replacements. It’s not uncommon to see slight variations in the colour of porcelain veneers upon close inspection, as this occurs even in natural teeth. Nevertheless, this procedure can greatly enhance the smile, and can heighten inner satisfaction and self-esteem.