Treatment Modalities Classification

Materials can also be classified according to treatment use (Table 3). For example, inlays replace intracoronal tooth structure, whereas onlays replace intracoronal tooth structure including at least one cusp.3 Veneers replace the facial surfaces of anterior teeth, and crowns replace extracoronal tooth structure and is cemented to tooth structure or an implant. An implant(s) replaces the missing tooth or teeth. Fixed partial dentures (bridge) replace a missing tooth or teeth and are cemented to adjacent teeth, known as abutments. Removable partial dentures replace missing teeth and are often retained with the aid of clasps. Complete dentures replace a fully edentulous arch. Overdentures replace an arch and are stabilized most frequently with implants or remaining canine teeth or retained roots. Securing the overdenture to implants or remaining teeth help with the fit and works well for patients with alveolar bone loss and may help prevent further alveolar bone loss for the patient.3,4

Table 3. Treatment Modalities Classification.1

Classifications of Use
Direct Restoratives Images Description
Inlays Diagram of Inlays Restoration fabricated outside of the mouth and replaces occlusal and sometimes interproximal tooth structure(s).
Onlays Diagram of Onlays Restoration fabricated outside of the mouth and replaces tooth structure, including cusp(s).
Crowns Diagram of Crowns Restoration fabricated outside of the mouth and replaces an entire tooth.
Veneers Diagram of Veneers Restoration fabricated outside of the mouth and replaces facial surfaces of anterior teeth. Generally provided for cosmetic/esthetic purposes.
Bridges Diagram of Bridges Restoration fabricated outside of the mouth and replaces two or more teeth. Generally, includes two “abutment” teeth, except in the case of the Maryland bridge which includes one “abutment” tooth and a “pontic” tooth or teeth that replace a missing tooth or teeth. Restoration is placed with cement and is fixed (permanent).
Partial Dentures Diagram of Partial Dentures Restoration fabricated outside of the mouth and replaces two or more teeth and should be removed daily. May or may not contain metal alloys “clasps” as mechanisms for stability.
Complete Dentures Diagram of Complete Dentures Restoration fabricated outside of the mouth and replaces an entire dentition. In order to prevent subsequent alveolar bone loss and improve fit, implants may be placed or canine teeth not removed to be used as an “overdenture.”
Implants Diagram of Implants Restoration fabricated outside of the mouth and replaces an entire tooth or teeth. Titanium implant, or screw, is placed in the alveolar bone and subsequent crowns or bridges placed.

Dental materials may also be classified by their longevity profile (Table 4). Longevity indicates the time the material is intended to function within the oral cavity.

Table 4. Longevity Classification.3-4

Longevity Standards Definition
Permanent Lasting for years, possibly a lifetime, such as an amalgam occlusal restoration.
Temporary Should be a temporary fix, such as a temporary crown, until the permanent crown is created. Intended to last approximately a week or up to one month, sometimes referred to as provisional.
Interim Restoration to be used before a permanent restoration can be placed. May last up to several years. An example would be a space maintainer or incisal restoration (in an anterior incisor) until the permanent incisor has fully erupted.

Another common way to classify dental materials is by the materials themselves. Table 5 explains various materials that are used in dental restorations. Specific home care and professional care instructions are listed for each material.

Table 5. Common Dental Materials.

Material Uses Home care Instructions Professional Care
Composite Direct Restorations, veneers, inlays and onlays Routine home care and specific instructions to prevent recurrent decay, possibly interproximal cleaning and fluoride Composite (diamond) polishing paste to prevent abrasion, Sodium fluoride to decrease the breakdown of filler particles caused by acidulate phosphate fluoride
Amalgam Direct Restorations Routine home care and specific instructions to prevent recurrent decay, interproximal cleaning and fluoride Regular prophylaxis, amalgam polishing as needed, any fluoride acceptable
Porcelain Crowns, bridges, veneers, inlays and onlays Routine home care with specific instructions on interproximal cleaning Diamond polishing paste with sodium fluoride to decrease the etching of margins
Acrylic Dentures, partial dentures Denture cleansers and denture brush, acceptable to use other denture cleaning products, recommend sleeping without dentures & keeping them moist when outside the mouth Clean in ultrasonic with denture cleaner, use instruments as need for calculus removal
Gutta Percha Root canals Routine home care No changes in cleaning endodontically treated tooth
Thermoplastics Bleaching trays, orthodontic appliances Daily rinsing and brushing with a soft-bristled, wet toothbrush, professional cleansers also available and acceptable, no cleaning with hot water No cleaning in office with hot water, could lead to distortion
Metal Alloys Partial denture clasps Regular brushing (with denture brush) and rinsing to remove plaque daily Clean in ultrasonic with denture cleaner
Stainless Steel Crowns Regular brushing and interproximal cleanings Routine scaling and polishing
Titanium Implants Regular cleaning recommended Special instruments available for scaling

Materials Used in Endodontic Procedures

Another common type of dental procedure, which utilizes different dental materials, is a root canal. This treatment involves removal of infected pulp tissue and replacement with gutta percha, a rubber-like material, in combination with an endodontic sealer. Endodontically treated teeth can be restored with a filling, a crown or a post/core crown. Restoration is dependent on individual patient need and the location of the tooth. The post is usually comprised of stainless steel, titanium, fiber reinforced resin or dental casting alloy that is cemented into a canal. Core buildups are made of amalgam or composite and replace large amounts of tooth structure.3