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CSA > Failure of restorations > Flashcards

Failure of restorations Flashcards

1
Q

Why do we restore teeth?

A

Restore shape, anatomy, function and occlusion
Stop lesion progression and prevent recurrences
Aesthetics
Maintain physiological integrity of teeth with adjacent hard and soft tissues
Restore patient comfort and satisfaction

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2
Q

What is success?

A

The duration that the restoration will stay in fulfilling its objective - ability of the restoration to perform as expected.

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3
Q

What is failure?

A

Inability of the restoration to meet the desired outcome

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4
Q

What is success rate?

A

Used as a measure of clinical performance - length of time a restoration survives

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5
Q

What are the causes of amalgam failure?

A 
Microleakage, creep, ditching
Tarnishing
Bad contacts
Incorrect case selection
Inadequate retention
Poor matrix
Amalgam manipulation
Failure to condense
Improper finishing and polishing
Post op pain
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6
Q

What are the causes of composite failure?

A 
Incorrect case selection
Difficulty in adhesion to dentine
Failure to light cure in increments
Contamination
Moisture control
Shrinkage - marginal defects, secondary caries, fracture
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7
Q

What are the causes of GIC failure?

A

Poor handling
Excessive occlusal loads - makes excellent dentine replacement as lining but lacks physical properties needed to be used alone for posterior restorations.

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8
Q

Why is it bad that restorations fail?

A

Every time you replace a filling you remove more healthy tooth structure.

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9
Q

What are patient factors that influence treatment?

A

Caries risk - OHI, fluoride, diet, regular brushing
Bruxism/occlusal forces
Tooth to be restored
Cavity size and location - moisture control
Pulpal health
Periodontal health
Allergies - lichenoid reactions, amalgam, gold alloys or sensitivity to HEMA in resin/fissure sealants

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10
Q

How can sensitivity to amalgam be noticed?

A

In close proximity, can have a reticular, erosive, atrophic (erythmatous) or plaque like patch

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11
Q

What do you do if you have a patient sensitive to amalgam?

A

Remove amalgam and use different material and observe, lesion should disappear after two weeks, if no response refer to oral medicine.

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12
Q

What are operative factors that influence treatment?

A

Correct choice of material
Cavity design, retention, removal of unsupported enamel and weakened cusps
Optimal handling
Placement and finishing techniques

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13
Q

What are material factors that influence treatment?

A 
Compressive strength
Rigidity
Surface hardness
Wear characteristics
Flexural strength
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14
Q

What do stronger materials resist more?

A

Deformation and fracture
Provide more equitable stress distribution
Stability

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15
Q

What does microleakage cause?

A

Secondary caries, minimum of 10um exists between restorations, not clinically perceivable but large enough to allow bacterial ingress.

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16
Q

What is creep?

A

A result of slow deformation placed under constant load, when load is less than necessary to cause fracture it causes marginal breakdown - mostly in gamma 2

17
Q

What is ditching?

A

Breakage of a thin edge creating an irregular V shaped crevice

18
Q

What do corrosion products do?

A

Leak and fill the gap between the tooth and restoration. Advantage - seals margins but is due to stress so can lead to failure

19
Q

What does ditching cause?

A

Food packing and plaque which can increase risk of secondary caries

20
Q

How do we assess restorations?

A

Aesthetics: surface lustre, staining, surface margin, colour, translucency, aesthetic form
Function: fracture, retention, marginal adaptation, wear, anatomical form, patients view, post operative sensitivity and vitality.
Biology: recurrence of caries, erosion, abfraction, tooth integrity, periodontal response, adjacent mucosa, oral and general health

21
Q

How do restorations fail?

A 
Marginal breakdown
Fractures
Trauma
Caries
Tooth wear
Periodontal disease
Pulpal problems
Retention failure
Defective contours 
Tooth fracture
22
Q

How do we detect a failed restoration?

A 
Patient symptoms
Visual and tactile
Transillumination
Radiographs
Occlusal examination
23
Q

What is the main reason for replacing restorations?

A

Secondary caries

24
Q

When do we repair?

A

No obvious spreading of caries into tooth that would undermine tooth structure
Sufficient volume of retained restoration remaining
Strong enough to resist masticatory forces
Possibility to bond old and new restoration to the tooth
No aesthetic mismatches

CSA (18 decks)

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