Failure of Restorations Flashcards
What type of amalgams tend to have the best longevity?
High Copper alloys tend to last longer
In composite with dentine bonding when does failure in cervical cavities typically begin?
10-12 months
How is the longevity of composite with dentine bonding normally improved?
Improved survival with acidic primer
When is a restoration considered failed? (5)
- Secondary disease occurs
- Loss of function of tooth
- “Inevitable” progression to caries
- Microleakage causing sensitivity or pain
- Appearance unacceptable to patient
What could be a potential symptom of secondary disease in a failed restoration? (2)
- Discolouration
- Symptoms of pulpits
How could you detect secondary disease signs at restoration margins? (3)
- Visually
- Radiography
- Tactile (scrape around tooth)
How could you detect secondary disease signs in deep tissue? (2)
- Visually
- Radiography
What are some signs of loss of function of a tooth after a failed restoration? (2)
- Restoration can be loose or lost
- Fractured tooth/cusp causing loss of occluding surface
What are some signs of inevitable progress of caries in a failed restoration? (2)
(Permitting microleakage)
- Fractured restoration permitting microleakage
- Loss of marginal integrity permitting microleakage
List some ways patients may be unhappy with the appearance of a restoration (5)
- Marginal staining
- Discolouration of anterior material
- Contrast with “normal” darkening of tooth
- Gingival recession (darker roots)
- Desire for white fillings
Why do restorations fail? (4)
- Patient factors
- Operator factors (iatrogenic)
- Materials factors
- Chance e.g. trauma
Name some patient factors leading to a failed restoration (5)
- Diet
- Plaque
- Saliva
- Poor oral hygiene
- Para-functional habits
How can we minimise the patient factors in a failed restoration?
When you are giving diet and hygiene advice, customise your advice to your patient lifestyle
What are some examples of errors in planning leading to a failed restoration? (5)
(Operator factors)
- Failure to promote prevention
- Failure to check occlusion before management of tooth
- Failure to take account of whole patient
- Inappropriate restoration for tooth or situation
- Inappropriate restorative material
What are some examples of errors in execution leading to a failed restoration? (8)
(Operator factors)
- Damage to pulp-dentine complex
- Leaving infected carious tissue
- Unsatisfactory cavity design for restorative material
- Failure to cover vital dentine surfaces causing hypersensitive dentine
- Failure to reduce height of tall thin cusps in occlusion
- Failure to use matrix properly causing over/under contoured restorations
- Incorrect use of material
- Using composite resin when the pulpal margin is in dentine
