The dental laboratory is of great importance as a part of the dental health care system: dental technicians create dental prostheses that are both functionally and aesthetically appealing to the wearer. In order to suit these requirements, our laboratory is equipped with state-of-the-art technology, staffed with highly skilled technicians who each are experts on a specific field. The finished restorations' quality is being supervised by our master technicians.

A tooth restoration is any artificial substance or structure that replaces missing teeth or part of a tooth in order to protect the mouth's ability to eat, chew, and speak. Dental restorations include fillings, inlays, crowns, bridges, partial and complete dentures, and dental implants. Restorations have somewhat different purposes depending on their extensiveness. Fillings, inlays, and crowns are intended to repair damage to individual teeth. They replace tooth structure lost by decay or injury, protect the part of the tooth that remains, and restore the tooth's shape and function. Bridges, dentures, and implants are intended to protect the shape and function of the mouth as a whole. Hungary Dentist »

I. Types of Dental Restorations

1. Fixed restorations

2. Removable restorations

3. Combined restorations

4. Restorations to dental implants

5. Restorations made by using CAD/CAM technology

II. Materials Used in Dental Restorations

1. Metals and metallic alloys

2. Porcelain (ceramics)

3. Dental composites

Part I.: Types of Dental Restorations

Method: the dental technician fabricates the restoration, your dentist tries it in your mouth to ensure proper fit and bite. After that, he/she bonds the restoration to the prepared tooth.

• in-lays
• veneers
• crowns
• bridges

A partial denture is a removable appliance that replaces missing teeth. It is held in place by your existing teeth. It is important that these teeth be healthy in order to support your partial that is why they may need treatment (crown and bridgework) prior to making the partial.

• partial plastic denture
• partial metal denture

Full dentures are used to replace teeth when there are no teeth remaining. They are processed into a custom made acrylic base which is made to intimately and comfortably fit the gum tissue in your mouth.

• full plastic denture
• full metal denture

The case when fixed and removable restorations are used jointly is referred to as ''combined restorations''. In this case crowns will be placed onto the remaining teeth and onto these the removable part will be fixed with invisible metal clips. The removable part is being attached at a discrete but completely stable position. It has to be taken out of the mouth every day to be cleaned. The ground plate can be made either of metal or plastics, while the teeth are made of plastics or ceramic.

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Implants have become an important tool for patients and doctors alike in the quest for total oral health care. After decades of research implant techniques have been refined to the point where they are as predictable as many other dental procedures. A dental implant is an artifical tooth root replacement made of pure titanium, which anchors into the jawbone and supports an implant crown. The bone grows around the implant screw's roughened surface - titanium could be succesfully incorporated into bone, it is biocompatible and stable - as if it was a natural tooth root but even stronger. A variation on the implant procedure is the implant-supported bridge or implant-supported denture. Dental implants can be for one tooth, several teeth or, in some special cases, for your entire mouth. Not only the appearance, but also the safe feeling of natural teeth is restored.

Implant placement is a relatively mild surgical procedure that usually consists of two phases. Phase I: the surgeon places the titanium implant in the bone with a delicate procedure. Over the next three to six months the implant will bond to the bone through a process known as osseointegration. Phase II: once integrated and healed, the dental technician fabricates the crown, bridge, or denture attachment using techniques similar to traditional crown and bridge. Techniques are improving all the time whereby the procedures are becoming more systematic, predictable, easy to perform, and in a more timely fashion.

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The CEREC® method (this is the world's first and only chairside CAD/CAM restorative procedure): first of all, the dentist examines the tooth and determines the appropriate treatment. It could be a simple filling, an in-lay or a full crown, depending on how much healthy tooth structure is remaining. Then he/she takes an optical impression of the prepared tooth by using a camera. Next, the specific software takes the digital picture and converts it into a 3D virtual model on the computer screen. After that, the restoration design data is sent to a separate milling machine in the office. A ceramic block that matches your tooth shade is placed in the milling machine. About 10-20 minutes later, your all-ceramic, tooth-colored restoration is finished and ready to bond in place.

The Procera® method uses patented CAD/CAM technology to improve coping production. Traditionally, once a tooth is prepared for a crown, a cast is made and sent to a laboratory, where a coping is produced by manual techniques. With Procera, the cast is scanned in the lab, and the image is then sent electronically to a Procera Sandvik production facility, where a coping is made by computer-directed machines to exacting specifications of the original scanned casting.

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Part II.: Materials Used in Dental Restorations

These metals are mostly used for making crowns, bridges and dentures. Pure titanium could be succesfully incorporated into bone, it is biocompatible and stable.

• titanium

• gold (high purity: 99,7%)
• gold alloys (with high gold content)
• gold-platina alloy
• silver-palladium alloy

• cobalt-chrome alloy
• nickel-chrome alloy

Full-porcelain (ceramic) dental materials include porcelain, ceramic or glasslike fillings and crowns (a.k.a jacket crown, as a metal free option). They are used as in-lays, on-lays, crowns and aesthetic veneers. A veneer is a very thin shell of porcelain that can replace or cover part of the enamel of the tooth. Full-porcelain (ceramic) restorations are particularly desirable because their color and translucency mimic natural tooth enamel.

Another type is known as porcelain-fused-to-metal, which is used to provide strength to a crown or bridge. These restorations are very strong, durable and resistant to wear, because the combination of porcelain and metal creates a stronger restoration than porcelain used alone.

One of the blessings of computerized dentistry (CAD/CAM technologies) is that it enabled the application of zirconium-oxide (ZrO₂). The introduction of this material in restorative and prosthetic dentistry is most likely the decisive step towards the use of full ceramics without limitation. With the exception of zirconium-oxide, existing ceramics systems lack reliable potential for the various indications for bridges without size limitations. Zirconium-oxide with its high strength and comparatively higher fracture toughness seems to buck this trend. With a three-point bending strength exceeding nine hundred mega-Pascals, zirconium-oxide can be used in virtually every full ceramic prosthetic solution, including bridges, implant supra structures and root dowel pins.

Previous attempts to extend its application to dentistry were thwarted by the fact that this material could not be processed using traditional methods used in dentistry. The arrival of computerized dentistry enables the economically prudent use of zirconium-oxide in such elements as base structures such as copings and bridges and implant supra structures. Special requirements apply to dental materials implanted for longer than a period of thirty days. Several technical requirements include high strength, corrosion resistance and defect-free producability at a reasonable price.

Ever more stringent requirements are being placed on the aesthetics of teeth. Metals and porcelain are currently the materials of choice for crowns and bridges. The demand for full ceramic solutions, however, continues to grow. Consequently, industry and science are increasingly compelled to develop full ceramic systems. In introducing full ceramic restorations, such as base structures made of sintered ceramics, computerized dentistry plays a key role.

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Crowns and in-lays can be made in the laboratory from dental composites. These materials are similar to those used in direct fillings and are tooth coloured. Their strength and durability is not as high as porcelain or metal restorations and they are more prone to wear and discolouration.

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Different types of dental restorations are designed to do specific jobs; here is a breakdown of the most common:

In-lays are used in similar situations as fillings except a pre-made piece of ceramic material is bonded into the tooth. This results in superior physical properties, possibly providing a lifespan of 2 to 3 times longer than a composite filling. Inlays are a top-quality alternative to the composite filling. Traditionally gold alloy has been used for inlays, but now ceramics are excellent.

On-lays – used in situations where the tooth is fractured or has been severely weakened, the onlay is similar to the inlay described above except that the ceramic covers the entire or most of the biting surface. Unlike a crown, it does not cover the entire visible tooth structure, so there is no need to grind away all sides of the tooth unless there is a specific reason (like decay.)

Crowns ("Caps") – a crown, the largest tooth restoration, sometimes cannot be avoided. It covers all sides of the tooth as well as the end. It is used when there is limited tooth structure left, when an existing crown must be replaced, or when the tooth is an "anchor" tooth for a fixed bridge.

Veneers – thin porcelain facings that cover the front side of teeth. Used cosmetically to change the length, color and shape of teeth.

Bridges are used to replace missing teeth when sufficient "anchor" teeth are available on each side of the gap. Numerous systems are available, including fiber-reinforced ceramics, Zirconium-based ceramics and porcelain fused to metal bridges.

Implants – titanium posts surgically placed into the jawbone. Implants are used to support a dental prosthesis (from single crowns to full denture) once the bone grows around the post (usually six months after placement).

Removable Partial Dentures – used to replace missing teeth when insufficient teeth remain to support fixed bridges or a patient does not test well for bridge materials. Partial dentures can be metal or acrylic-based. Acrylic-based partials are bulkier and do not stay in place as well as metal partials. Metal partials can be made with precision attachments that eliminate the use of unsightly metal clasps.

Removable Full Denture is used when no teeth remain.

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