Replacing Silver Fillings

Posterior composites are tooth-colored plastic-based materials reinforced with glass particles used for fillings in back teeth (molars and premolars). These materials have long been used in the restoration of defects in front teeth, and have been increasingly applied in the restoration of posterior defects as well. Posterior composites represent an esthetic alternative to "silver fillings" (dental amalgam) for back teeth.

Posterior composites are indicated for the restoration of small to moderate defects in back teeth (e.g., tooth decay, tooth fracture, developmental defects, etc.) and also for the replacement of broken or lost fillings. More fluid versions of this material are used as sealants, to prevent tooth decay in pit and groove areas on the top of the back teeth.

The advantages of posterior composites are that they:

• are highly esthetic, tooth-colored fillings,
• adhesively bond to the tooth,
• require less removal of tooth structure, and
• can strengthen the tooth.

The disadvantages are that they:

• are more difficult for dentists to place,
• are more expensive than silver fillings, and
• in large fillings, are less durable than silver fillings.

Posterior composites are tooth-colored fillings for use in back teeth when a high degree of esthetics is desired. When placed as small-to-moderate sized fillings, they can provide many years of excellent service. In the illustrated clinical example, a defective silver filling was replaced by a posterior composite restoration.