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CSA > the failure of directly placed restorations > Flashcards

the failure of directly placed restorations Flashcards

1
Q

why do we restore teeth

A

to stop lesion progression and prevent its recurrences
restore occlusion and function
restore aesthetics
maintain physical integrity
restore comfort and satisfaction of the patient

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2
Q

what is the median survival rate of amalgam

A

15 years in one study upto 22.5 years in another

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3
Q

what is the annual failure rate of amalgam

A

3%

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4
Q

what are some causes of amalgam failure

A 
Incorrect case selection
Cavity preparation: inadequate retention
Poor matrix preparation
Amalgam manipulation
Contamination
Failure to condense
Improper finishing and polishing procedures
Post-operative pain : inappropriate lining material
Microleakage, ditching and creep
Tarnish and corrosion
Faulty contacts
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5
Q

what is the median survival of composite

A

8 years

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6
Q

what is the annual failure rate of composite

A

2%

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7
Q

what are the causes of composite failure

A

Incorrect case selection
The difficulty to obtain long term adhesion between the composite resin and the dentine, failure at the gingival margin is not uncommon
Failure to light cure composite in increments
Contamination of the material: moisture control
Polymerization shrinkage causing caries, fracture, sensitivity, marginal deficiency

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8
Q

what is the survival of glass ionomer in permanent teeth

A

30-43 months

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9
Q

what is the annual failure rate of GIC

A

7%

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10
Q

what are the implication of restorative failure

A 
time
cost 
material choice
technique 
remaining tooth structure
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11
Q

why might gic fail

A

DUE to case selection

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12
Q

what might affect the success or failure of restorations

A

Patient factors
Operative factors
Material factors

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13
Q

what are patient factor of why restorations might fail

A 
Caries risk: Oral hygiene, diet regular dental check up
Heavy occlusal forces: bruxism 
Tooth to be restored
Cavity size and location
Pulpal health
Periodontal health
Allergies
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14
Q

what happens when patients are allergic to amalgam or gold alloys

A

oral lichenoid reaction of the oral mucosa

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15
Q

what are operative factors of why restorations might fail

A

The correct choice of restorative dental material for the situation
Cavity design ,retention, removal of unsupported enamel and weakened cusps
The optimal handling of that material
The use of exemplary clinical techniques in placement & finishing

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16
Q

why might restorations fail due to materials

A

compressive strength
regdity
surface hardness
flexural strength

17
Q

what is ditching and creep

A

slow deformation of amalgam placed under constant load, When the load is less than necessary to produce fracture ,causing marginal breakdown. Mostly seen when using amalgam with gamma 2 phase products.

18
Q

what shape does ditching or crevicing make

A

irregular V shape crevice

19
Q

when does creep happen

A

the corrosive products leak and fill the gap between the tooth and the restoration

20
Q

which diseases cause restorations to fail

A 
Caries
 Tooth wear
 Periodontal disease
 Pulpal problems
 Trauma
21
Q

how do you detect a failed restoration clinically

A

patient symptoms: pain aesthetic concerns discolouration and fracture
visual + tactile: caries marginal breakdown
transillumination
radiographic examination
occlusal exam

22
Q

what do we consider in the radiographic examination

A

caries apical and perio status and overhangs

23
Q

what is the risk of secondary caries in composite

A

3.5 x

24
Q

what are the causes of colour changes

A

loss of marginal integregity microleakage
marginal staining
loss of surface lustre and polish

25
Q

when do we repair the restoration

A

No obvious spreading of gross caries that would structurally undermine the restoration or remaining tooth structure

Sufficient volume of retained restoration remaining and it is strong enough to resist masticatory forces

The possibility to bond or mechanically interlock the new restoration into the ‘old’ restoration and tooth

No potential aesthetic mismatches between the ‘new’ and ‘old’ materials

26
Q

what materials might produce an oral lichenoid reaction

A

amalgam or gold alloys or sensitivity to HEMA in resin

27
Q

why does amalgam have reduced microleakage

A

due to the formation of corrosive products

28
Q

which ways would restorations fail

A

disease or technical failure

29
Q

give examples of technical failure

A 
Fractured restoration
 Marginal breakdown
 Tooth fracture 
 Defective contours
 Failure of retention
30
Q

where does secondary or recurrent caries occur

A

at the margin or underneath a restoration

CSA (51 decks)

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