Restorative dentistry

Not every carious change in a tooth needs to be "drilled" straight away.

We try to stop caries in its early stages by improving oral hygiene and using special fluoride products. In addition, caries "between the teeth" (approximal caries) can be sealed with a special low-viscosity polymer (microinvasive treatment of caries infiltration) as long as the enamel surface has not yet collapsed.

If the tooth already has a break in the enamel surface due to caries, this defect should be cleaned and filled with a composite, for example.

Direct adhesive composite restorations are the most modern and substance-preserving way to restore tooth defects. If tooth decay, an accident, increased tooth wear (abrasion) or direct exposure to acid (erosion) has resulted in tooth substance defects, we can preserve the tooth structure and maintain the vitality of the dental pulp (tooth nerve) using a minimally invasive and defect-oriented procedure.

Composite restorations are not only gentle on the tooth structure, they are also tooth-coloured and durable. They allow for high-quality restorations that are small, defect-related and highly aesthetic.

Composites are materials made of tiny inorganic ceramic filler particles and a light-curing resin matrix. They are tightly bonded to the tooth using an adhesive system so that the restoration (filling) and tooth form a single unit. This is usually possible without having to remove a lot of tooth structure. Only in the case of caries do we carefully remove severely damaged parts of the tooth.

Sometimes a tooth defect is too large or too unfavourably located to be treated with a direct composite filling. In this case, depending on the size of the defect, an inlay, a partial crown or a crown may be used.

We often use the latest CAD/CAM technologies (e.g. the CEREC system) to create durable, highly aesthetic ceramic restorations that are bonded to the tooth. We will be happy to advise you on the various options available to find the best solution for your individual needs.

Inlay: An inlay is an filling made of ceramic or precious metal (gold). In contrast to a crown, our work here is more defect-oriented. This means that we only cover the affected areas of the tooth with an inlay.

Onlay / partial crown: With an onlay / partial crown made of metal (gold) or ceramic, we restore the chewing surface of a tooth that has extensive defects. We often replace one or more cusps. Healthy structures are largely preserved.

Crown: In the case of very large substance defects that cover more than 2/3 of the natural tooth crown, the function of the tooth can be restored with a crown. The crown encloses the entire visible tooth. Dental crowns on an implant can also replace missing teeth and fully restore chewing function and phonetics.

When caries has spread deep into the tooth, the vitality of the dental pulp and the stability of the tooth are threatened. However, even these teeth can usually be treated successfully and for a long time using special procedures.

Fluorescence-assisted caries excavation

In the case of deep caries, the affected hard tooth tissue is softened and heavily infected with bacteria. We use fluorescence-assisted caries excavation to visualise bacterially infected tooth areas and then remove them in a targeted and substance-preserving manner. If these infected areas are very close to the dental pulp, it may make sense to leave these areas selectively (selective caries excavation). We can then specifically cover them with an antibacterial and neutralising medication (indirect capping) before restoring the tooth with an adhesive restoration, such as a composite filling.

Tooth preservation without root canal treatment

Our extensive experience has shown that teeth with deep caries can almost always be preserved with this method, retain their vitality and do not require root canal treatment.

Sometimes one or more teeth deviate from their natural shape or colour, either congenitally or acquired. Sometimes individual teeth are too narrow or not aligned at all, leaving small gaps between the neighbouring teeth. Such malformations can often be corrected in an aesthetically pleasing way by correcting the shape or colour of the teeth.

• Tooth reshaping (odontoplasty): Gaps in the anterior region or congenital and acquired substance defects, as well as fractured teeth, can in many cases be treated directly with highly aesthetic composite restorations. As a rule, we use modern additive techniques so that we do not have to grind the affected teeth. In special cases, it may be advisable to correct the front teeth indirectly with laboratory-made ceramic veneers.
   
• Tooth reshaping can also be part of an overall orthodontic plan in conjunction with orthodontic treatment.
   
• Tooth whitening (bleaching): Tooth whitening can be useful if the tooth structure itself is discoloured. In addition to natural ageing processes, internal tooth discolouration is often caused by enamel abnormalities, tooth development problems or the death of the dental pulp due to caries or trauma. Depending on the cause of the discolouration, different treatments are available. However, the most common cause of discoloured teeth is plaque build-up. In this case, there is no point in tooth whitening. However, the plaque can be removed relatively easily and gently during a professional dental cleaning (PDC).
   
• External whitening: Vital teeth can be whitened externally with peroxide-based gels of varying concentrations, depending on the type and intensity of tooth discolouration. Performing the procedure in the dental practice or at home according to dental planning and instructions helps to eliminate potential risks of tissue damage from the bleaching agents used. We strongly advise against the use of over-the-counter products that are not precisely defined.
   
• Internal whitening: In rare cases, teeth that have become discoloured after root canal treatment can be successfully whitened from the inside. Bleaching agents (perborates) are deposited in the upper part of the root canal over several days but must be removed from there. Internal whitening is a tooth-friendly alternative to having a crown placed on a root canal tooth for purely aesthetic reasons. This treatment may only be carried out by a dentist.