Amalgam (We do not use amalgam in our office)

• Composition: mercury mixed with silver, tin, zinc and copper.
  
• Types: traditional (non-bonded) versus bonded
  
• Indication: posterior restorations (premolars and molars)
  
• Longevity: at least 7 years
  
• Costs: lease expensive restorative material
  

Advantages:

1. Amalgam fillings are strong compressive strength
2. They are inexpensive, convenient and most forgiving
3. Single dental visit required.
   

Disadvantages:

1. Poor esthetics
2. Requires the removal of healthy tooth structure for increased retention
3. Corrode over time, leading to further discoloration of the surrounding tooth structure
4. Does not bond to the tooth structure, mechanical lock only (non-bonded amalgam)
5. Increase patient exposure to mercury which has been shown to be toxic.

Composite Resin (We do not use resins that contain bisphosphonates)

• Composition: As with other composite materials, a dental composite typically consists of a resin matrix, such as a bisphenol A-glycidyl methacrylate (BISMA) or urethane dimethacrylate (UDMA), and an inorganic filler such as silicon dioxide (silica). A coupling agent such as silane is used to enhance the bond between these two components. An initiator (such as: Camphorquinone (CQ), Phenylpropanedion (PPD) or Lucirin (TPO)) begins the polymerization reaction of the resins when external energy (light/heat, etc.) is applied. A catalyst package can control its speed.
  
• Types: Direct or Indirect
  
• Indications: small to medium restorations in the posterior and anterior, especially where esthetics is of concern; anterior veneers
  
• Longevity: at least five years
  
• Costs: 20-50% more than an amalgam restoration but a fraction of the cost of a gold or porcelain restoration

Advantages:

1. Matches tooth color
   
2. Single visit restoration
   
3. Direct bonding to tooth structure
   
4. Healthy tooth structure is preserved
   
5. Easily repaired

Disadvantages

1. Questionable longevity as compared to amalgam, gold or porcelain
   
2. More technique sensitive than amalgam
   
3. Indirect composites take at least two visits to complete
   
4. Large restorations may not last as long as amalgam restorations
   
5. Greater thermal expansion

Glass Ionomers

• Composition: These materials are based on the reaction of silicate glass powder and polyalkenoic acid.
  Indication: A dental restorative material used in dentistry for filling teeth and luting cements.
  
• Longevity: varies dramatically based on size and location of restoration; overall, the shortest longevity than any other restorative material
  
• Cost: Less expensive than composites, approximately the same as amalgam
  

Advantages

1. Chemical bond to the tooth surface
   
2. Less technique sensitive than composites
   
3. Fluoride release increases its anti-caries effect
   
4. More forgiving when moisture control is more difficult

Disadvantages

1. Lower compressive strength, therefore, increased wear
   
2. Worse color stability

Cast Gold

• Composition: Gold alloy (mixture of gold and other metals)
  
• Indication: Inlays or onlays
  
• Longevity: at least 10 years
  
• Costs: 6-10 times more than amalgam, usually less than porcelain
  

Advantages:

1. Does not corrode like amalgam
   
2. May be more esthetic to some as compared to amalgam
   
3. Similar thermal expansion as natural tooth structure
   
4. Extremely durable
   

Disadvantages

1. At least two visits are required
   
2. High cost due to the material used and amount of work required
   
3. Can cause an electric current if opposing an amalgam restoration which can lead to pain

Ceramic

• Composition: porcelain
  
• Indications: Inlays, Onlays or Veneers
  
• Longevity: At least 7 years
  
• Costs: most expensive restorative material
  

Ceramic Restoration

1. Inlays
   
2. Onlays
   
3. Veneers
   
4. Crowns
   
5. Porcelain or Porcelain fused to metal
   

Advantages

1. Tooth colored
   
2. More resistant to staining or abrasion than composites
   
3. Can be a single visit procedure if using the Cerec
   
4. Lumineers porcelain veneers can be used without any tooth reduction (only recommended for certain situations)
   

Disadvantages

1. High cost
   
2. Over time can wear the opposing natural tooth surface
   
3. Requires more tooth reduction than a gold restoration