Dental bonding - Applications for front teeth.
Dental composite, the material used with tooth-bonding technique, is unique in two ways:
- It mimics the color and appearance of tooth enamel well.
- It's able to adhere directly to a tooth's surface (even a smooth flat one).
And due to these characteristics, it's useful in a wide range of applications for front teeth. They include:
This page explains these uses, and provides information about issues such as:
- How long can bonded restorations last?
- How they compare to other types of restorations placed on front teeth, like porcelain veneers.
A) White fillings.
Dental composite is the standard restorative used to make white fillings for front teeth. It has been since the 1960's.
For teeth where a simple, conservative, natural-looking repair is needed, there is no alternative.
This page outlines the steps a dentist follows when placing bonding. This exact same process is used with each of the various applications listed on this page.
B) Minor cosmetic improvements.
The fact that dental composite adheres well to even smooth tooth surfaces makes it ideal for correcting most any type of small imperfection (such as isolated areas of staining, surface pitting, small chips or minor shape deformatives).
The smaller the problem area, the more likely the only reasonable solution is dental bonding.
In some cases, the needed repair can be astoundingly easy. Possibly as simple as bonding a layer of composite directly over the offending area, without even having to trim the tooth first.
With this and the remainder of applications listed on this page, the use of a dental anesthetic may not be needed when the bonding is placed.
C) Filling in gaps between teeth.
Dentists use the term "diastema" to refer to a space between two front teeth.
From a standpoint of function and dental health, these gaps pose no problem. But in regard to cosmetic appearance, some people find them unappealing. For those who do, bonding can provide a solution.
The idea is that dental composite is placed on the sides of the teeth that lie to each side. By making each tooth just a little bit wider, the space is "closed" (filled in).
Porcelain veneer placement would be the most common alternative to closing a gap with bonding. We compare the advantages and disadvantages of each below.
The smaller the width of the diastema, the more likely that closing it using dental composite makes the best choice.
Since the underlying goal is increasing the size of the tooth, it's likely that no tooth trimming will be required. If so, no other way of closing a gap is as minimally-invasive as this.
Notes - 1.
Unlike with other techniques, if for some reason the results of closing a gap are unpleasing or problematic, returning the teeth to their original condition is possible and relatively easy. (Dental composite can be buffed off a tooth with no resulting damage to it.)
Notes - 2.
Porcelain veneers are made by a technician in a dental laboratory, as opposed to right on the tooth like with dental bonding.
D) Dental composite veneers.
Similar to porcelain veneers, a dentist can use dental composite to create a covering for the entire front surface of a tooth. In fact, the technique of placing composite veneers predates the porcelain procedure by several decades.
The goal of this procedure is to resurface the tooth without significantly increasing its thickness. That means the dentist may need to trim back the tooth's front side somewhat before placing the bonding. If so, anesthetic may be required.
What's so unique about dental composite veneers is the amount of artistry that's needed on the part of the dentist.
When a porcelain one is made, the dentist takes an impression of the prepared tooth. A dental laboratory technician then creates a plaster cast from this impression and makes the veneer on it.
In comparison, when bonding is used it's the dentist who is the artisan. And unlike a dental technician who is working in a laboratory environment at their leisure, a dentist has to achieve their results right there during the dental appointment, within the amount of time that has been allotted.
How long will bonded restorations on front teeth last?
All dental composite restoration have the potential to stain (see below). And for larger restorations, wear or fracture can become an issue.
We found two studies that evaluated the longevity of relatively larger restorations (those used to close tooth gaps and/or resurface and reshape teeth).
1) Frese (2013) reported that at the 5-year mark roughtly 15% of the 175 restorations followed required some type of repair (none were completely lost, all could be repaired). Of the restorations that didn't experience some type of failure, 90% were rated as clinically good or excellent at 5 years.
2) Wolff (2010) followed 327 composite restorations. This paper determined a 80% 5-year survival rate. Most of the repairs needed were related to minor fractures of the bonding. One restoration was lost totally. Like above, of the restorations that didn't experience some type of failure, 90% were rated as clinically good or excellent at 5 years.
Advantages and disadvantages of composite restorations over porcelain ones.
Some of the applications for dental bonding for front teeth could instead be treated via the placement of porcelain veneers. When trying to decide between the two, here's a list of general advantages and disadvantages to consider.
A) Bonding is usually less expensive.
Dental composite restorations usually cost less than porcelain ones.
They're placed in just one visit whereas porcelain ones require two appointments (and therefore more of the dentist's time). And unlike with porcelain veneers, there's no bill from a dental laboratory for fabricating it.
B) Bonded restorations can be repaired if they break.
If a veneer created from dental composite does chip or break, a dentist can almost certainly repair it. And in most cases they can probably make the repair by just patching the damaged part. In comparison, if a porcelain veneer breaks it will likely need to be replaced.
C) Composite restorations will show wear.
Dental composite is a plastic. And although manufactures add components to enhance wear resistance, it still occurs.
A person may notice that over time the outline shape of their bonding has changed (especially on its biting edge). In comparison, porcelain is harder, and therefore will hold its original form better over the long term.
D) Bonding can be expected to stain.
It's the nature of dental composite to stain over time. For the most part, porcelain (an impervious ceramic) won't.
The entire restoration may become discolored, or else just portions of it, or even just its edges. Stain is more likely to form in cases where the person has a high level of consumption of coffee, tea, cola, or tobacco products.
As a fix, it might be possible that just polishing the surface of the bonding will restore it to its original appearance. In other cases, the dentist may feel they need to trim off the entire front side of the restoration and resurface it with a new layer.
D) Porcelain restorations tend to look more natural.
Porcelain has a glass-like translucency that closely mimics the light handling characteristics of tooth enamel.
In comparison, dental composite is more opaque and therefore typically doesn't mimic the luster of tooth enamel as well.
What creates luster?
With natural teeth and porcelain veneers, the outer surface of the tooth is translucent.
And the way light is able to enter into this layer and then reflect back out is what creates the glass-like luster that we typically associate with tooth enamel. (This page gives a more detailed explanation.)
How dental bonding handles light.
In comparison, dental composite is more opaque. And as a result, the way it reflects light is different.
Much of the light that strikes a bonded tooth is reflected off its outer surface (there isn't as much light penetration into the tooth). And this difference (due to the lack of translucency) means that less natural-looking luster is created.