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What are Fillings & Bonding

The Term “Bonding” Actually Has Two Meanings

First, bonding is the method of attaching artificial tooth material to natural tooth structure at the molecular level. Second, the common term “bonding” outside of dental jargon usually refers to cosmetic modern dentistry using tooth-colored filling materials. The fact of the matter is that bonding, whether for cosmetic or functional purposes, has revolutionized dentistry during since the 1960’s, and the application of material engineering and the science of color and light perception by the human eye continue to enhance what modern dentistry can offer in the form of artificial tooth materials.

The History of Bonding

Prior to the 1950’s, it was not possible to actually attach restorative dental materials to natural tooth structure. All fillings and crowns had to utilize mechanical retention components like stainless steel and titanium pins screwed into dentin, slots drilled in teeth, and “pot holes” drilled in teeth to wedge filling materials into. It is easy to understand that these mechanical retentive features caused tooth injury and fracture, but they allow teeth that had decay to be saved for a period of time. In 1955, a follow by the name of Dr. Michael Buonocore introduced the concept of adhesive dentistry by presenting a scientific paper about using acid to etch enamel so that resin could attach to it. Since then, dental bonding agents have been continually improved to the point where it is now possible to reasonably bond to even dentin, which is the fluid-laden inner layer of a tooth.

Bonding adhesives are now used virtually in every aspect of restorative dentistry. These are just some of the uses for adhesive dentistry today:

  • Ceramic crowns, onlays, and veneers are often bonded to the tooth.
  • Sensitive areas on exposed roots of teeth can be sealed with dental adhesive.
  • Deep grooves on the chewing surfaces of teeth are sealed with dental adhesive material to prevent decay (sealants).
  • Metal fillings can be bonded to tooth structure.
  • Tooth-colored fillings can greatly enhance ethetics with predictable outcomes.

Dental composite resin, the material used for “tooth colored fillings,” is simply dental bonding adhesive resin that has particles of glass, silica, and porcelain embedded into it for color and three-dimensional effect.

Dental composites, often referred to as bonding, come in many shades that correspond to natural tooth structure. Placing aesthetic bonding requires the clinician to have advanced skills like:

  • Understanding tooth anatomy, not only in exterior form but also in 3-D architecture
  • Understanding the science of adhesive dentistry
  • Understanding color science so that the right hue, chroma, and value are created to mimic tooth structure
  • Having the hand skills to put all of the above knowledge together to deliver a beautiful, natural restoration that cannot be discerned from natural tooth structure by the naked eye.

Cosmetic bonding is one way of creating a beautiful smile by artificial means.

Since the dental composite resins are softer than dental ceramics and because they are directly placed in the mouth by freehand, they are commonly used as a transitional restoration until a more definitive solution becomes possible. For example, cosmetic bonding may be used as a diagnostic tool to develop a prototype for future ceramic veneers. While dental composite resin restorations can be beautiful, they typical do not have the optical characteristics of ceramic restorations fabricated by a master ceramist in a dental laboratory under the skilled direction of a dentist, and they tend to have a shorter duration of service.

Bonding-before
Bonding-Before

This patient desired to restore her worn front teeth.

bonding-after
Bonding-After

“Bonding” was done to create a prototype of future ceramic veneers.

Bonding-Before
Bonding-Before
Bonding-After
Bonding-After

Cosmetic bonding with direct composite resin was done in one visit to replace the unsightly older resin restorations.


VIDEO: Composite Filling Anterior

VIDEO: Composite VS. Amalgam Fillings

In rare circumstances an alternative to bonding could be dental amalgam