Metal-free restorative dentistry

Amalgam-free Dentistry

At Dentistry on Merivale all restorative dental procedures are carried out without the use of mercury amalgam or other heavy metals.

There are many types of amalgam-free materials that can be used instead of dental amalgam in the long-term maintenance of dental health. Each amalgam-free material has its own benefits and limitations, and the decision over which to use in a given situation is based on several factors too involved to be discussed in detail here and must follow a clinical examination.  The three most frequently used materials (in our practice) and their basic characteristics are:

Composite

This is a tooth-coloured, metal-free material that can be used as a direct replacement for small to medium fillings. It is basically composed of very small ceramic particles bound into a resin or plastic matrix. One physical limitation of the material is that it is intrinsically not as strong as amalgam, so cannot be predictably used for long-term replacement of larger restorations. There are several types and manufacturers of composite, each with their own compositions of resins and ceramic fillers. One evolving concern with composite is the presence and possible release from fillings of BPA resins. While the negative health issues associated with this remain unproven, we do have a composite that is BPA free that can be used if requested.

Dental Ceramics

These form a large family of tooth coloured, physiologically inert dental restoration materials.  They are probably as close to ‘ideal’ as modern technology allows in terms of durability and appearance but tend to be more costly as the process involves a lab fabrication step that entails more that one appointment. There are single appointment (cad-cam or ‘cerec’) porcelain fabrication systems around, but we find the best long-term results are obtained using an indirect, 2 step technique. There are many different types of dental ceramic, each of which has its own characteristics and applications. Choosing the material that is ideal for a given situation is dependent on many factors, and will be discussed in detail when a treatment plan is organised.

Gold

After decades of use, gold is still an excellent dental restorative material today. As with ceramics, two steps are required. Gold can be used for nearly any size filling required from very small inlays to full crown coverage restorations. It is also physiologically inert and very reliable in terms of strength and longevity, however cosmetically it obviously has its limitations.

Other

There are several other families of dental restorative material, such as glass ionomers, indirect composites etc, however, in our opinion, these do not perform over the long term and are not used (in our practice) for anything other than temporary restorations in most cases.