When considering a core build up for a tooth, the selection of an appropriate material is crucial for ensuring the restoration’s long-term success and stability. The ideal material should possess a combination of strength, biocompatibility, and ease of handling. A core build up is necessary when a significant portion of the natural tooth structure is missing due to decay, fracture, or previous restorations, and it acts as a foundation upon which the final restoration, such as a crown, can be placed. The ultimate goal of the core build up is to provide adequate support and retention for the crown, preventing future complications. Which material is ultimately chosen will be dependent on the dentist’s assessment of the clinical situation.
Understanding Core Build Up Materials
Several materials are commonly employed for core build ups in dentistry. Each material has its own advantages and disadvantages, which dentists must carefully weigh when making their selection. Here are some of the most frequently used options:
- Amalgam: A traditional material known for its strength and durability, amalgam has been used for core build ups for many years. However, its aesthetic limitations and the presence of mercury have led to a decline in its use.
- Composite Resin: Composite resin is a tooth-colored material that offers excellent aesthetics and bonds well to the tooth structure. It’s a popular choice for core build ups, especially in cases where aesthetics are a concern.
- Glass Ionomer Cement: Glass ionomer cement releases fluoride, which can help to prevent secondary caries. It also chemically bonds to tooth structure. However, its strength is generally lower than that of amalgam or composite resin.
- Resin-Modified Glass Ionomer (RMGI): RMGI combines the benefits of glass ionomer with the improved strength and aesthetics of resin. It’s a versatile option for core build ups.
Factors Influencing Material Selection
The choice of material for a core build up depends on several factors, including:
- Remaining Tooth Structure: The amount of remaining tooth structure will influence the type of material that can be used. For example, if there is very little tooth structure left, a stronger material like amalgam might be preferred.
- Location of the Tooth: The location of the tooth in the mouth can also affect the material selection. For example, a composite resin might be chosen for a front tooth where aesthetics are important, while amalgam might be used for a molar where strength is more critical.
- Occlusal Forces: The amount of force that the tooth will be subjected to during chewing can also influence the material selection. Teeth that are subjected to high occlusal forces may require a stronger material.
- Patient Allergies: Patient allergies should always be considered when selecting a material. For example, patients with a mercury allergy should not be treated with amalgam.
- Cost: The cost of the material can also be a factor in the decision-making process.
A Comparison of Common Core Build Up Materials
Here’s a comparative table summarizing the key properties of different core build up materials:
| Material | Strength | Aesthetics | Bonding | Fluoride Release | Cost |
|---|---|---|---|---|---|
| Amalgam | High | Poor | None | None | Low |
| Composite Resin | Moderate to High | Excellent | Excellent | None | Moderate |
| Glass Ionomer Cement | Low | Fair | Good (Chemical) | High | Low |
| Resin-Modified Glass Ionomer (RMGI) | Moderate | Good | Good (Chemical & Mechanical) | Moderate | Moderate |
Ultimately, selecting the most suitable material for a core build up involves careful consideration of all the factors mentioned above. The dentist will assess the specific clinical situation and weigh the advantages and disadvantages of each material to determine the best course of treatment. Which material is best is dependent on the specific situation.
