Conservative is the branch of dentistry dealing with reconstructing the teeth, when destroyed by trauma or carious processes, and trying to “preserve” the most part of the natural structures.
It is divided into two major sectors: a direct conservative (consisting in fillings and restorations) and an indirect one (consisting in inlays). The direct conservative is dedicated to rebuild, in one sitting, the lost portions of the tooth by removing all the diseased tissue and immediately, through the use of composite resins with high aesthetic and mechanic value, to restore shapes, sizes, colours and functions of the tooth under treatment. However, for physical and mechanical reasons, the damage to the tooth must be of modest entity, meaning that the tooth should not have its morphology substantially altered or the damage should not be excessively extended. The indirect conservative deals, on the contrary, with those elements that have suffered greater damages, devitalized teeth, fractured teeth with large caries affecting more than two-thirds of the biting surface. In these cases, a normal reconstruction is no longer sufficient because it does not ensure a proper physical and mechanical strength over time. The inlays are nothing else than large reconstructions that are performed by the technician in the laboratory on a model of the dental arches.
For their execution, two appointments are required.
During the first one, we remove all the damaged tissue and / or not suitable to accommodate the inlay, we give a proper shape to the cavity that is formed and, finally, we take a precise dental print. At this point the technician reconstructs the missing part of the tooth with composite resins that have a high aesthetic value.
At the second appointment, we are going to glue the inlay that will perfectly fit to the tooth and this will ensure stability and durability. Particular mention must be made for sealing, small fillings of high preventive value, which are produced by closing and then sealing the grooves of the chewing surfaces. These recesses are areas where new carious lesions often start.
For these procedures it is extremely important to work in a dry environment using a rubber dam to allow the perfect adhesion of the material to the enamel and the dentin of the tooth. An imperfect adhesion of the material is a guarantee for caries recurrence . The use of the microscope allows also the control of the closure at 20 magnifications since, to the naked eye, the verification of the compliance of the product to the tooth is totally insufficient.
This post is also available in: Italian