Direct vs. Indirect Restorations: What’s the Difference?

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Do you know the difference between a direct and indirect restoration? While knowing the difference between direct and indirect restorations may not seem like something you should need to know, it is certainly helpful when deciding which dental restoration to choose. You see, direct and indirect restorations are two different categories of dental restorations used to restore damaged or decayed teeth. While both types of restorations will restore damaged or decayed teeth, they each use different methods to accomplish this. With that being said, here is a closer look at these two types of restorations: 

Direct Restorations: 

composite filling

Direct restorations refer to any restoration that can be entirely fabricated directly inside the mouth during a single dental appointment. The reason for this is because direct restorations are made using a dental material known as composite resin, which can be applied, shaped, and hardened inside the mouth without the use of a dental laboratory. Not only that, but composite resin is able to create a strong bond with the tooth enamel, which eliminates the need for dental adhesives. The one main downside of direct restorations is that they only last about 5-7 years before needing replacement. 

The most popular direct restorations are composite fillings, which restore small to medium areas of tooth decay. However composite bonding is another technique that uses composite resin to repair small to medium chips and cracks, as well as to fill in gaps between the teeth. Both restorations work by applying softened composite resin to the tooth structure or cavity, then hardening the composite resin in place with a curing light. The final layer is shaped and polished so that it blends in with the rest of the tooth. Once the last layer has been hardened in place, direct restorations are complete, meaning that patients have no restrictions after their appointment. 

Indirect Restorations: 

Indirect restorations, on the other hand, are restorations that can not be entirely fabricated inside the mouth. Instead, indirect restorations are fabricated outside of the mouth in a dental laboratory or using an in-office milling machine. Only when the restoration has been completed will it be placed inside the mouth. Due to the fact that indirect restorations are fabricated outside of the mouth, they can require multiple dental appointments to place. Indirect restorations include crowns, bridges, dental implants, inlays, onlays, and veneers. 

variety of indirect restorations

Another main difference between direct and indirect restorations is that indirect restorations require more modifications to your natural tooth structure. While the composite resin used in direct restorations will bond with your tooth enamel, the dental materials used for indirect restorations require the use of dental cement in order to remain in place. As a result, some of the natural tooth structure must be removed or reshaped so that the dental restoration can be placed without changing your natural bite. Different restorations require different degrees of modification, for example a dental crown requires more modifications than a veneer. Although these dental materials require enamel modifications, they are much stronger than composite resin and last around 10-15 years. They are also more aesthetically pleasing and can be used for cosmetic dental treatments. 

After having your tooth modified to fit the desired indirect restoration, your dentist will need to take an oral scan or dental impression to obtain the information necessary to fabricate the restoration. This will then be sent to the lab or in-office milling machine to begin the fabrication process. Since it can 1-2 weeks for a dental lab to fabricate your permanent restoration, your dentist will fit you with a temporary restoration to wear until your permanent restoration is finished. Temporary restorations protect your tooth and maintain the aesthetics of your smile, however they are not very strong since they are only meant to be temporary. Because of this, you need to take special care not to break or dislodge your temporary restoration. As soon as our permanent restoration is complete, it will be checked for fit and cemented into place. 

Both types of dental restorations allow for a range of restoration options. In most cases, direct restorations are used to restore small to medium areas of damage or decay. This is because composite resin can create a bond with tooth enamel, making it an ideal dental material for smaller restorations. However, larger areas of damage or decay are generally restored using indirect restorations, since they are made from stronger dental materials that can provide more support to a tooth significantly affected by damage or decay. Indirect restorations are also used in cases where the goal is to enhance the aesthetics of the smile. 

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