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Medical Forum / General / Dentistry / March 2007

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gums and fillings

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Eigenvector - 14 Mar 2007 02:12 GMT
Why don't the gums react well to the filling material?  To me it seems weird
that the gums would be repelled or reject filling material - do the gums
simply lay on the tooth or do they grow into it to some extent?
Amatus Cremona - 14 Mar 2007 12:42 GMT
??????

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Amatus

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> Why don't the gums react well to the filling material?  To me it seems
> weird that the gums would be repelled or reject filling material - do the
> gums simply lay on the tooth or do they grow into it to some extent?
Steven Bornfeld - 14 Mar 2007 14:00 GMT
> Why don't the gums react well to the filling material?  To me it seems
> weird that the gums would be repelled or reject filling material - do
> the gums simply lay on the tooth or do they grow into it to some extent?

    Actually that's a complicated set of questions.  There is normally a
shallow crevice between the tooth and gum (the periodontal sulcus).
When this becomes inflamed and/or deepened we call it a periodontal pocket.
    Generally you don't want any restorative material within about 3 mm or
so from the bone.  This means for most people you don't want to extend
any restoration more than maybe 1 mm at most under the gumline.  If the
restoration is further under the gumline than this, anyone will show
some inflammation as a result.
    Having said that, some materials will tend to provoke less inflammation
than others under the gumline.  There are probably papers you could
google about this; my (sometimes faulty) memory is that on average
highly-polished gold is the most biocompatible in this regard, followed
roughly by glazed porcelain, amalgam, and resin.  These may be
distinctions without a real difference though, since any can cause
inflammation.  It also goes without saying (though I will) that a
smoother surface (whatever the material) will be less of a plaque-trap
and will cause less inflammation.  Also, some individuals may be
sensitive to one or another component of a restorative material.  For
example, in the early days of non-precious casting alloys, nickel was
often used, which is commonly sensitizing.  For that reason, it is
rarely used anymore to my knowledge.

Steve
Eigenvector - 15 Mar 2007 01:43 GMT
>> Why don't the gums react well to the filling material?  To me it seems
>> weird that the gums would be repelled or reject filling material - do the
[quoted text clipped - 23 lines]
>
> Steve

Why can't dentistry use a material similar to the ones present in the
enamel?  Would it be the fact that the enamel would have to be cured similar
to a sink or washing machine enamel coating?
Amatus Cremona - 15 Mar 2007 11:58 GMT
Which characteristics of enamel would you wish to duplicate?

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Amatus

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>
> Why can't dentistry use a material similar to the ones present in the
> enamel?  Would it be the fact that the enamel would have to be cured
> similar to a sink or washing machine enamel coating?
Mark & Steven Bornfeld - 15 Mar 2007 14:51 GMT
>>> Why don't the gums react well to the filling material?  To me it
>>> seems weird that the gums would be repelled or reject filling
[quoted text clipped - 29 lines]
> enamel?  Would it be the fact that the enamel would have to be cured
> similar to a sink or washing machine enamel coating?

    I'm not sure that it hasn't been tried.  Enamel is mineralogically
hydroxyapatite, but it is not an amorphous mass; it has a very
particular structure.  It sounds like an interesting idea to use some
form of it as a restorative, but I'm not sure at all that it could be
formed like conventional ceramics.  Also, assuming there were a way to
form it accurately into a restorative, it would still have to be bonded
into position.  I have no reason to think that amorphous hydroxyapatite
would bond to enamel--a lot of the bonding ability of enamel is due to
its prismatic structure.  Furthermore, bonding under the gumline is
fraught with all kinds of problems due to moisture control, so there are
some pretty serious technical problems that would need to be overcome.
(and we're not even talking about cost of an indirect restoration).

Steve

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Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001

Eigenvector - 16 Mar 2007 02:13 GMT
>>>> Why don't the gums react well to the filling material?  To me it seems
>>>> weird that the gums would be repelled or reject filling material - do
[quoted text clipped - 43 lines]
>
> Steve

Hmm, interesting conversation.
Newbie - 15 Mar 2007 21:25 GMT
>Why can't dentistry use a material similar to the ones present in the
>enamel?  Would it be the fact that the enamel would have to be cured similar
>to a sink or washing machine enamel coating?

You invent it, and we'll use it !

Enamel is grown by specialized cells called ameloblasts..

Good luck with your research, dude.
Emily - 15 Mar 2007 22:28 GMT
>> Why can't dentistry use a material similar to the ones present in the
>> enamel?  Would it be the fact that the enamel would have to be cured similar
[quoted text clipped - 5 lines]
>
> Good luck with your research, dude.
Didn't they grow a tooth on a mouse? Or was that just an ear?

Emily
 
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