In addition to permanent fillings, temporary are often used in dentistry. They are necessary to close the cavity only for the duration of the diagnosis or treatment. Temporary filling material for today is presented in several categories. We will present their characteristics in the article. We also indicate the requirements for such materials, indications for their use.
About the procedure
The name of the procedure “filling” came from the Latin plumbum - “lead”. This is the replacement of certain defects in the dental tissues with artificial material. The goal is the restoration of the anatomical shape of the tooth, the restoration of its functionality. Today, for this, both permanent and temporary filling materials are used.
A filling can compensate not only hard dental tissues, but also protect against pulp and apical periodontium from a number of adverse external factors.
The success of previous medical interventions in this case is assessed by the usefulness and duration of the preservation of the filling. For the procedure today, a whole mass of materials is used, differing in structure, purpose and properties.
Varieties
Temporary filling materials in dentistry is only one of the categories. For convenience, a whole classification has been introduced that combines them:
- Permanent. They are used to restore the anatomical shape of the tooth and its direct, indirect functions.
- Temporary filling materials. Accordingly, they are needed for temporary closure of the dental cavity.
- Therapeutic. The group includes the so-called therapeutic pads: zinc-eugenol containing calcium hydroxide or combined.
- Materials for filling the root canals.
- Sealants.
- Adhesive materials.
There is a slightly different classification drawn up from the standpoint of materials science:
- Metallic materials for filling.
- Polymer and plastic filling materials.
- Cement.
- Dental sealants and adhesives.
- The set of composite materials.
Major clinical requirements
And for temporary filling materials, and for all of the above listed, uniform clinical requirements are presented:
- Materials should not have toxic effects on hard tooth tissues, pulp, and mucous membranes of the oral cavity.
- Filling substances should be harmless in general to the body.
- Materials must have antiseptic and anti-inflammatory effects.
- These substances directly prevent the penetration of both pathogenic microflora and toxins into the pulp.
- Materials have anticariogenic effects.
- They are characterized by low thermal conductivity, which prevents the dissolution of materials in saliva.
- Filling materials are chemically inert. In other words, they are resistant to aggressive agents such as alkalis and acids.
- Such substances are quite hard, mechanically strong, wear-resistant, and also have good aesthetic properties.
- Materials do not change the shade of the tooth and do not lose their original color over time.
- Substances for filling do not cause the appearance of galvanic currents in the oral cavity.
- Materials do not change the volume and shape during their solidification. At the same time, they quickly set, have high adhesion to tooth tissues.
- By their nature, these substances are radiopaque.
Material study
Filling materials for temporary fillings, like all others, are comprehensively studied before their direct use in dental clinics. The ongoing research can be divided into three vectors:
- Physical and mechanical tests.
- The study of the biological properties of substances.
- Clinical trials.
The physico-mechanical characteristic of filling materials for temporary fillings consists of the results of a number of laboratory tests:
- Determination of the consistency of the material.
- Rising material temperature during hardening.
- Volumetric changes in the substance during solidification.
- Color fastness.
- Water absorption.
- Determination of the working time of solidification of the mass.
- Solubility in water and other media.
- Hardness.
- Opacity.
- Adhesion.
- Resistance to abrasion and other characteristics.
Biological tests of temporary filling materials (including for root canals) make it possible to reveal their indifference both to the body as a whole and to the tissues of the tooth. Conducted types of biological tests are aimed at determining the following:
- The general toxicity of the substance when administered orally.
- Chronic toxicity of the material.
- Local toxicity.
- Specific sensitization.
Biological tests in this case are conducted on experimental animals. This allows you to obtain the most reliable data on the biological properties of temporary filling material (for root canals, hard tissues of the tooth, etc.), substantiate recommendations for further clinical trials.
For the latter, specific facts from individual observations in dental practice are important. This allows you to judge the advantages and disadvantages of each material in terms of its actual use, operation.
Assessment of the condition of the seal
And the filling material for temporary teeth, and its other varieties are evaluated primarily by the already delivered filling. The following characteristics are important here:
- Marginal fit.
- Anatomical shape.
- Color fastness.
- Change the shade of the seal on the periphery.
- The incidence of reduced caries.
Temporary materials
When diagnosing caries of temporary teeth, filling material is selected according to their condition and a number of other important factors. Compositions for temporary fillings are further divided into subcategories. However, the same requirements apply to all. The properties of temporary filling materials are as follows:
- Harmless to the pulp.
- Plasticity: substances should be easily introduced and removed from the pulp.
- The material should not inactivate drugs.
- The substance is not soluble in the oral cavity.
- The material provides tightness for up to two weeks.
- The substance is strong enough. But at the same time it is possible to remove it from the tooth cavity using an excavator probe or drilling.
Indications for the use of temporary filling materials: closure of the carious cavity, treatment of both complicated and uncomplicated caries. Often, such materials are used as medical or insulating linings already under a permanent seal.
Purpose of application
Temporary filling in dentistry is carried out with the following objectives:
- Dressings in the treatment of caries and a number of its complications.
- Control fillings in the diagnosis of pulpitis and caries.
- Insulating linings.
- Filling of temporary teeth.
- Temporary fixation of orthopedic elements.
- Temporary root canal filling for therapeutic purposes.
Accordingly, for each task its own variety of material is shown. But in dentistry, universal formulations for temporary fillings are also popular. We will get to know all of them further.
Varieties
The most common types of temporary filling materials:
- Zinc sulfate cement. Also known as artificial dentin. It stands out "Dentin-paste", "Dentin for dressings", "Vinoxol" and so on.
- Zinc-eugenol cement.
- Zinc phosphate cement.
- Polycarboxylate cement.
We will present each group of funds in more detail below.
There is another classification. According to it, temporary filling compositions are divided according to their chemical composition into three groups:
- Zinc-eugenolic cements.
- Eugenol-free cements.
- Light curing materials.
Used tools
We list the tools for making temporary filling materials that the dentist uses in his work here:
- The powder itself for the preparation of a solution for a future temporary filling, distilled water, paste material, liquid solution, depending on the selected material.
- Chrome spatula.
- Special dental glass.
- Smoothers.
- Tweezers.
- Cotton balls.
Zinc Sulphate Cement
We continue to get acquainted with temporary and permanent filling materials. Artificial dentin is a white powder. The composition of the temporary filling material is as follows:
- Zinc oxide - 70%.
- Zinc sulfate - 25%.
- Dextrin or kaolin - 5%.
As for zinc oxide, it provides good adhesion of temporary fillings to dental tissues. The remaining components are responsible for the strength and ductility of the material. To prepare such a temporary insulating filling, artificial dentin powder is diluted with distilled water.
The dentist acts here according to standard instructions:
- Powder of artificial dentin is applied to the rough surface of the dental glass. It is diluted with 5-10 drops of distilled water.
- Then, with a spatula, gently mix the powder with water for 30 seconds.
- Before filling, the tooth cavity must be freed from saliva and dried.
- Next, the dentist in one portion takes the mass to the trowel and places it in the tooth cavity. The material is compacted with a cotton ball, and its excess is removed with a swab.
- After this procedure, the specialist begins to perform other clinical work.
It is important to note that the most suitable consistency for artificial dentin fillings is “thick sour cream”. 1-2 minutes after being placed in the tooth cavity, the mass freezes. The doctor must remove excess dentin - the material is only in the tooth cavity, and not on the mucous membrane of the gums or in the interdental space.
All zinc-sulfate cements are removed from the tooth cavity by the lever-like movement of the probe or excavator. If such actions are undesirable or impossible, the dentist uses a drill to remove mass.
"Dentin paste"
This temporary filling material is used as a substance to close the dental cavity for a certain period. "Dentin-paste" is a patented one-component product. It is a mass of white. May have a pale pinkish or grayish-yellow tint. It has a slight smell of clove oil.
It includes the following:
- Zinc oxide
- White clay.
- Zinc sulfate.
- Clove and peach oils.
In the oral cavity, this material finally hardens in 1.5-2 hours. "Dentin-paste" is plastic, has good adhesion and water-repellent properties.
The dentist applies this material for temporary fillings as follows:
- A paste is applied to the rough surface of the dental glass. Using a spatula, stir it.
- The patient's dental cavity is cleaned of accumulated saliva and dried.
- The material is placed in the tooth cavity with a smoothing device. Then the paste is sealed with a cotton ball. Excess material is removed with a cotton swab.
This tool for temporary filling is appreciated for its ductility. The paste completely fills the cavity with itself, does not allow pathogenic microflora, chewed food, and saliva into it. Why, with its help, a medicinal pad is often sealed.
It is important that the dentist does not leave excess dentin paste on the gingival papillae or in the interdental spaces. Since the material hardens only after 1.5-2 hours, the patient is released, without waiting for the complete hardening of the paste. The dentist warns the patient that within two hours should abandon the use of drinks and food.
"Dentin paste" hardens when exposed to saliva. The latter accelerates the setting process of the material.
Vinoxolum
Vinoxolum is a two-component remedy. Accordingly, a powder based on zinc oxide and a liquid (a solution of polystyrene in guaiacol is supplied). This material for temporary filling is appreciated for its high strength, good adhesion, antiseptic effect.
The components of the agent (40 g of powder and 10 g of liquid agent) are stirred for 30 seconds, after which the composition is placed in the tooth cavity. Its complete hardening occurs in 3-4 hours. At this time, the patient should give up drinks and snacks.
Dentists do not use Vinoxolum as a lining before applying composite materials.
Zinc Eugenol Cements
The basis of temporary filling materials from this category is eugenol and zinc oxide. Additional subcategories are distinguished inside:
- Actually zinc oxide-eugenol.
- Based on orthoethoxybenzoic acid.
- Hardened zinc oxide-eugenol (filler is added to their composition).
Zinc-oxide-eugenolic filling materials are two-component. They consist of zinc oxide powder and purified eugenol (or clove oil, where 85% of the mass is eugenol). To accelerate the solidification of the mass, distilled water or acetic acid is added to the liquid component.
When mixing the mass, resinous evangalate of zinc leaves. It binds the elements of zinc oxide into a pasty mass, which hardens over time. When exposed to moisture (in this case, the patient’s saliva), this composition hardens quite quickly, after 10 minutes it becomes strong.
A filling mass is prepared and applied according to the above instructions for artificial dentin.
Hardened zinc oxide-eugenol materials-cements, respectively, are distinguished by slightly improved mechanical properties. To zinc oxide powder, 10-40% finely ground artificial or natural resins are added. Rosin, polystyrene, polymethyl methacrylate, polycarbonate catalysts are used for this.
The liquid component of hardened zinc oxide-eugenol materials is the same eugenol, clove oil. A certain number of the above resins, a catalyst (in most cases acetic acid) and antibacterial components can be dissolved in it. The hardening reaction here is similar.
To improve the properties of the above cements, 50-66% EVA (orthoethoxybenzoic acid) is introduced into the liquid component of the product. This addition allows you to significantly increase the strength of this filling material. Therefore, often zinc oxide-eugenol cements with EVA are also indicated for fixing orthodontic structures.
They are used in dental practice similarly to artificial dentin: dry and liquid components are mixed, placed in a tooth cavity cleaned from saliva, compacted, and excess material is removed.
Zinc phosphate fillings
As a temporary filling material, almost all varieties of these dental cements are used. Specialists apply them in cases where a temporary seal must be put on a long term. Zinc-phosphate masses protect the tooth cavity for 2-3 weeks.
Polycarboxylate materials
As for these cements, they are used both as temporary fillings and as gaskets when filling with other materials. The method of manufacturing the mass here repeats the above for artificial dentin.
There are a lot of materials for temporary fillings. But the same requirements are imposed on their quality. The composition should not only protect the open dental cavity for a certain time, but also be safe for the patient.