Filling or restoration: who says which
Filling is the everyday word, used by patients and clinicians alike in conversation. Restoration is the clinical term and the broader one: it covers inlays, onlays and crowns, not only fillings.
The next division is how the thing is made:
- direct restoration — built in the mouth: composite filling, amalgam filling, glass ionomer filling
- indirect restoration — made outside the mouth and then cemented: inlay, onlay, overlay
Materials carry two registers too. A patient says white filling and silver filling; the chart says composite and amalgam. Tooth-coloured filling is the neutral middle option for conversation.
On duration: a temporary filling lasts days or weeks, a permanent filling does not have a planned end. Provisional is the commoner written synonym for temporary.
Black's cavity classification
Six classes working as a shorthand code — the number tells you the site.
- Class I — occlusal surface, pits and fissures of posterior teeth
- Class II — proximal surfaces of premolars and molars
- Class III — proximal surfaces of anteriors, incisal angle not involved
- Class IV — proximal surfaces of anteriors with the incisal angle involved
- Class V — cervical third, facial or lingual
- Class VI — incisal edges and cusp tips
Alongside it runs surface-letter notation: an MOD cavity is mesio-occluso-distal, with MO and DO built the same way. Black's preparation principles are four terms: outline form, resistance form, retention form and undercut.
Inlay, onlay, overlay: where each stops
Three words separated by how much tissue is replaced:
- inlay — within the cavity outline, cusps untouched
- onlay — includes one or more cusps (cusp coverage)
- overlay — covers the whole occlusal surface
Past an overlay you are into crown territory. These three are borrowed into most other languages untranslated, which makes them rare terms you do not have to learn twice.
Why restorations fail
A vocabulary of its own, and the one that appears in complaints and referral letters:
- marginal gap and open margin — a defect at the edge
- overhang — excess material, usually proximal
- marginal leakage and microleakage — seepage along the interface
- secondary caries — caries beneath or around an existing restoration
- high spot — occlusal interference, treated with occlusal adjustment
- post-operative sensitivity — sensitivity after placement
- fractured and debonded restoration — broken and detached
- shade mismatch — wrong colour
The finishing steps exist precisely to prevent these: contouring, finishing and polishing, margin finishing.
Terms that look interchangeable and are not
- Secondary caries and recurrent caries both describe decay at a restoration; secondary is the restorative term, recurrent the cariology one
- Temporary and provisional mean the same here, but provisional dominates in writing
- Cavity preparation is the act; cavity the lesion; preparation on its own means the prepared tooth
- Liner and base are both placed under a filling, but a base is thicker and load-bearing
- Incremental layering and bulk filling are opposed techniques, not stages of one
- Finishing shapes the surface, polishing makes it smooth — the pair is almost always written together
