Other Dental Materials: Cements, Grafts and Root Fillings

Temporary materials protect a tooth or fill a gap while the final restoration is made; they do not replace it. How long they stay depends on the material and your treatment plan, so ask how long yours is meant to last.

• Temporary crowns and bridges. A 2022 review divides the resins used for them into two broad types¹: resins based on PMMA (polymethyl methacrylate) or a related acrylic, and bis-acrylic resins. They can be shaped in the mouth, or milled or 3D-printed¹. Some are made to stay in the mouth for longer¹. The review examined laboratory tests, so it does not show how long printed temporaries last in the mouth.
• Temporary fillings. When root canal treatment needs more than one appointment, the tooth is temporarily sealed² between visits. In its 2006 quality guidelines, the European Society of Endodontology (ESE) called an effective temporary restoration essential to prevent contamination³ of the canals between visits.
• Immediate dentures. These are fitted on the day teeth are taken out and can fill the gap while the gums heal. As the gum and bone change shape, they often need adjusting or replacing within about a year⁴.

If a temporary crown or filling comes off, see a dentist soon to protect the tooth, and do not glue it back yourself. Our page on acrylic materials for dentures and temporary restorations explains provisional resins and dentures in more detail.

A crown, inlay or veneer made outside the mouth has to be fixed to the tooth. There are two broad ways of doing this. In both, a thin layer of material fills the space between the restoration and the prepared tooth. The choice depends on the material and the tooth.

• Conventional cementing. A cement fills the space and holds the restoration in place. In 2015 a European Commission scientific committee (SCENIHR) published an opinion on filling materials. It says glass ionomer cements bind chemically to dental hard tissues⁵.
• Adhesive bonding. The tooth and the fitting surface of the restoration are first treated, so that the material bonds to both. The 2015 opinion describes bonding systems made up of etchants, primers and bonding resins⁵. Glass ceramics such as lithium disilicate can be etched with acid and treated with silane, which allows a strong adhesive bond⁶. Bonding resin to zirconia can be challenging⁶.

Either way, the design has to leave the right space for the cement. A 2014 narrative review says that with too much space, the restoration fits loosely; with none, it will not fit⁷ unless it is adjusted by hand.

Some materials can be fixed in more than one way. One manufacturer says its milled lithium disilicate restorations can be fixed adhesively, with a self-adhesive cement or with conventional cement⁸, depending on the clinical situation. This is the manufacturer's own statement.

A crown on an implant can be cemented onto the abutment (the connecting part screwed to the implant) or held by a small screw. An international consensus report says neither failure nor complication can be avoided⁹ by choosing one method. Problems can occur with both, but which problems are more common differs between them⁹. Cement left under the gum is a possible risk indicator¹⁰ for inflammation around the implant. Ask which method is planned for you, and why. Our composite resin page explains how composite is bonded to the tooth.

An impression records the shape of your teeth and gums, so that a restoration, denture or appliance can be made to fit.

• Conventional impressions. A tray of soft material is pressed over the teeth and left to set. Clinical studies of implant impressions have compared scans with impressions in polyvinyl siloxane, a type of silicone, or polyether materials¹¹.
• Digital scans. An intraoral scanner records the teeth and gums as a 3D model on a computer. With a scan, no plaster model is needed¹².
• Models. In the conventional route, a laboratory pours a model from the impression. A 2014 review describes recording an impression, pouring a stone model and constructing a wax pattern⁷. Models can also be 3D-printed from a scan. A 2021 review describes the use of 3D printing to make working models for diagnosis and surgery¹³. It adds that the accuracy of printed models is somewhat reduced¹³ compared with that of the digital files.

Neither method suits every case. A 2017 narrative review found that scans did not appear to have the same accuracy as conventional impressions¹² for long bridges and full arches. Our digital scanning page explains when each method is used, including later studies of full arches on implants.

Graft materials help the body rebuild bone or gum. Bone grafts are used where there is too little bone for an implant, for example in a sinus lift.

• Where bone graft material comes from. A hospital in Cambridge wrote a leaflet for its own patients. It says graft material can come from yourself, another person, an animal or a synthetic source¹⁴. The graft material acts as a scaffold into which your own bone can grow¹⁴. Covering membranes can also be of animal origin.
• Does the source change the result? A review looked at sinus lifts done through a window in the side of the sinus, with at least five years of follow-up. In its studies, 6 mm of bone or less was left below the sinus¹⁵. The review found no significant difference¹⁵ in implant loss between your own bone and bone substitutes. That does not show that every material works equally well.
• Gum grafts. For receding gums, a collagen material of animal origin can be used instead of tissue taken from your palate. In a 2025 review, there was less pain after surgery with it in three of four trials¹⁶. But in trials of several receded teeth, complete root coverage was more frequent with your own tissue¹⁷.
• Regeneration in gum surgery. A hospital in London explains gum surgery to its own patients. It says a material may be applied to try to rebuild bone and the tissue attaching the tooth to it¹⁸, a process called regeneration.

If animal-derived products matter to you for religious or personal reasons, say so before you consent. The Cambridge leaflet asks anyone with concerns about the use of animal-based products¹⁴ to discuss them with the clinician carrying out the operation. The leaflet also lists problems after a sinus lift, among them infection, exposure of the graft and too little new bone for an implant¹⁴. Our bone grafting and sinus lift page explains when a graft is proposed and its risks.

Root canal (endodontic) treatment removes infected or inflamed tissue from inside a tooth, then cleans and fills the canals. A hospital in Leeds describes the materials used in a leaflet for its own patients. According to the leaflet:

• a rubber sheet placed around the tooth, called a rubber dam, keeps the tooth dry and prevents infection from saliva²;
• the root canals are washed with a disinfectant liquid²;
• between appointments, the tooth is temporarily sealed;
• the canals are filled to prevent re-infection².

In 2006 the ESE said root filling materials should be compatible with body tissues, dimensionally stable and able to seal the canal³. They should also show up on X-rays and be removable if the tooth needs treating again. It said a solid or semi-solid filling material should be combined with a sealer, which fills the gaps between it and the canal wall³. The ESE's 2023 guideline, summarised by its authors in 2025, says filling the canals with gutta-percha and a sealer¹⁹ may be considered. The sealer can be based on epoxy resin, zinc oxide-eugenol or calcium silicate; the guideline does not rank them.

A different treatment aims to keep the nerve alive when deep decay has exposed it (vital pulp therapy). For this, the guideline recommends a protocol that includes a hydraulic calcium silicate cement¹⁹. This protocol is one of the guideline's recommendations on deep decay. Its summary says these recommendations were made because studies were lacking¹⁹, and rest on the views of the guideline's authors rather than on research evidence.

After root canal treatment the tooth usually needs a new filling, onlay or crown. The Leeds leaflet says the success of treatment depends on this final restoration sealing the tooth². Among the risks, it lists the liquid used to wash the canals or filling material passing out through the root end. This may cause pain, burning, swelling, bruising, numbness or tingling of the face, and may need further treatment². Our root canal treatment page explains the treatment and its risks.

If pain keeps increasing, or you have facial swelling or a fever, see a dentist without waiting for the clinic's reply.

Emergencies. With a suspected dental abscess, the following need urgent medical help²⁰. Do not wait for a dental appointment; go to the nearest emergency department or call 112.

• Difficulty breathing, speaking, swallowing or opening your mouth
• A swollen or painful eye, or sudden problems with your eyesight
• A lot of swelling inside your mouth

Your dentist proposes a material at an examination, tooth by tooth. The questions that usually matter are:

• The job. Is it for temporary protection or longer use? Will it be made in the mouth or in a laboratory?
• The site and the forces. Is it for a front or back tooth? What is your bite like? Do you clench or grind your teeth?
• How it will be fixed. Will it be bonded, cemented or, on an implant, screwed? See "Cements and bonding materials".
• The product's instructions. Each product has its own limits. See "Traceability and product instructions".
• Your health. In 2015 SCENIHR advised basing the choice of filling material on patient characteristics. It named whether the tooth is a baby tooth or an adult tooth, pregnancy, allergies to components of dental materials and reduced kidney function⁵.
• The evidence. Studies show what tends to happen in groups of patients and restorations. They cannot predict exactly how your own restoration will do.

Ask which material and product are proposed for you, why, and what the alternatives are.

Biocompatibility describes how a material and the tissues of the body respond to each other. Reactions to dental materials are uncommon. In its 2015 opinion, SCENIHR put local reactions in the mouth to dental materials in general, including allergy, at an incidence below 0.3 per cent⁵. It said they are usually readily managed. It also named substances that cause allergy in patients and dental staff. Among them were two resin ingredients, TEGDMA and HEMA, and the metals nickel, cobalt and palladium from alloys⁵.

• Resins and acrylics. Acrylic sets when small molecules (monomers) join up. A 2026 narrative review says that leftover monomer in acrylic resins can trigger delayed allergic reactions²¹.
• Metals. A 2026 review found it difficult to estimate²² how common dental metal allergy is. A German clinical guideline on titanium hypersensitivity says intolerance is not adequately documented²³.
• Materials of animal origin. Some graft materials and membranes come from animals. See "Grafting and regenerative materials".

Tell your dentist about any reaction you have had to dental materials, latex (natural rubber), metals, acrylic nails or adhesives. If a reaction is suspected later, the product names in your records help a dentist find out what was used. Our pages on titanium and on metal-ceramic restorations and dental alloys explain metal sensitivity in more detail. If you notice a reaction after treatment, contact your dentist. If you have trouble breathing or swallowing, do not wait: go to the nearest emergency department or call 112.

Traceability means that you, or a dentist later on, can find out exactly what was used in your mouth.

• Custom-made items. A crown, bridge or denture made for one patient is a custom-made device. Turkey's Medical Device Regulation (Tıbbi Cihaz Yönetmeliği) was prepared as part of harmonisation with EU legislation²⁴. Under it, the manufacturer draws up a statement for each such device, and the device is accompanied by that statement²⁴. The regulation does not explicitly say that the statement is given to you; ask for a copy.
• Factory-made products. Cements, bonding agents, impression and graft materials, root filling materials and implants are made by manufacturers. Ask for each product's name, its manufacturer and its lot (batch) number where there is one.
• Product instructions. Manufacturers say how their products should be used. One, for example, gives minimum thicknesses for veneers and crowns⁸ made from its milled ceramic, and the ways they may be fixed.
• What is in a product. In 2015 SCENIHR noted that the full chemical composition of tooth-coloured filling materials is not always disclosed⁵. The product name lets a dentist look up what the manufacturer publishes.
• Your treatment record. For root canal treatment, the ESE's 2006 guidelines list the root filling material, sealer and technique³ among the details to record.

Our dental laboratory page explains the statement for custom-made devices and what it contains.

Our dental materials page compares the main families of materials and links to each detailed page.

• Ceramics: porcelain and dental ceramics, and lithium disilicate glass ceramic. Zirconia and e.max, a trade name for one manufacturer's product family, are discussed on our zirconia crowns and e.max crowns pages.
• Metals: titanium, and metal-ceramic restorations with their dental alloys.
• Resins: composite resin, and acrylic materials for dentures and temporary restorations.
• How restorations are made: the dental laboratory, CAD/CAM and digital scanning.

The bone grafting and root canal treatment pages explain those treatments; their links are in the sections above.

Before treatment, ask in writing:

• which temporary materials, cements or bonding agents, impression materials, graft materials and root filling materials are planned, with their product names and manufacturers;
• for any graft or membrane, its source: your own body, a human donor, an animal or a synthetic material;
• where any custom-made item will be made, and whether you can receive a copy of its statement;
• what will happen if a temporary restoration comes off, a crown comes loose or a root-filled tooth gives trouble, and how this is covered in your written plan.

On request, you have the right to be told the identity, role and title of the clinicians and other staff treating you²⁵.

Records. Under Turkish rules, private dental clinics record the diagnosis, the treatment and any X-rays in detail, with tooth numbers²⁶. You can examine your file and records and get a copy²⁵. Ask for a written record of the materials and products used, with lot numbers where they exist. For root canal treatment, ask for the record to include which teeth were treated, the root filling material and the sealer. Ask for copies of your X-rays too. This record helps any dentist who treats you later.

Consent. Turkey's patient rights regulation says you must be told about the other options, their benefits and risks, and the possible consequences of refusing treatment²⁵. In private dental clinics, a consent form is required for every intervention²⁶. Two copies of the form are signed, and one is given to you²⁵. Ask for your copy.

Your choice. You can say no, or ask to stop, at any stage. Once a tooth has been prepared, that step cannot be undone. Turkey's patient rights regulation gives you the right to refuse treatment or ask for it to be stopped²⁵; the possible consequences are explained to you.