During treatment of lateral teeth from upper and lower jaw, premolars and molars, we often have a problem to choose the best kind of filling that we use after removal of caries and tissues preparation.

There are two groups of reconstructive materials. The first group contains materials that we use to make fillings directly in patient’s mouth (intraoral method). Amalgams, the oldest and still used as filling materials, glasionomers and composites are in this group.

Amalgams are durable, damp-proof and resistant to attrition. Currently used silver amalgams have accurately chosen components ratio, thus the mercury (Hg) content is not harmful for patients.
Disadvantages of amalgams are unattractively, silver-grey colour and thermal expansion. Changes of temperature during eating, ranging from below zero to even 80oC, cause metal shrinking and expansion. As a result cracks in enamel and dentine occur. It leads to filling leakiness, filling loss or break of tooth wall.

Glasionomers are less resistant to mechanical damages and attrition. As a rule glasionomers are used as temporary fillings in permanent teeth or fillings in milk-teeth.

The advantage of glasionomer is the fluorine content that has a positive influence on teeth tissues remineralization.

Nowadays composites are the most often used reconstructive materials.
Composites are characterized by good plasticity, that makes the work easier, and cosmetics that guarantee the proper colour of filling, matching natural tooth colour. They are also durable, but the attrition of their surface is greater in comparison to natural teeth tissues. That is why their durability is about 5-6 years.

Disadvantage of composite is contractility while polymerizing. The size of shrinkage depends on material kind and thickness of filling. The bigger filling is the greater shrinkage occurs. As a result of this phenomenon microcracks of enamel and dentine occur during unskillfully filling. We minimize the shrinkage by applying the material laminary, but it requires a great deal of work and is time-consuming.

Second group of reconstructive fillings contains those modeled out of patient’s mouth.
They can be made from metals, the most often gold, composites or porcelain. Advantage of these fillings is great precision in modeling all of surfaces, especially masticatory and adjacent surfaces. Proper preparation of teeth tissues gives the possibility to obtain exact adherence of the filling to tissues. A crack between filling and tooth has only a few microns. Filling the crack with sealing composite material prevents from microcracking of enamel and dentine as it happens using direct method of composite filling (intraoral).

So far a big inconvenience of this method has been its time and work consumption. Fillings have been made for a few days by dental technician. It has required impression and two visits at the clinic at a few days interval.

At present fillings can be made in a few hours with great precision. Usage of the special device with laser scanner (‘LAVA’) for designing prepared porcelain block enables to proceed the treatment precisely and without requirement of technician and impressions. With the help of scanning camera we obtain three-dimensional image of tissue defects in one or more teeth. At the same time the image is sent to the computer so we have virtual image. We can correct the image depending on individual patient’s conditions. The filling prepared by laser has to be made up in order to get the filling indistinguishable from natural teeth. At the end the filling is cemented using composite materials.

The new method mentioned above is precise, fast, almost it doesn’t require patient’s participation and it gives possibility to reconstruct missing teeth tissues in the most similar to the natural conditions way. Fillings are characterized by hardness and attrition resistance comparable to natural teeth features. The way of cementation eliminates the possibility of leakiness occurrence as the result of microcracks. These two advantages indicate that this method of cavities restoration characterizes of a long-time durability.