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RGUHS Nat. J. Pub. Heal. Sci Vol No: 16 Issue No: 1 eISSN:  pISSN: 

Review Article

Failure and Management of Direct Restorations

Dr. Divyashree D Dandavati1 , Dr. Madhu Pujar2 , Dr. Pallavi Gopeshetti3 , Dr. Veerendra Uppin4 , Dr. Seema B Hanjagi5 , Dr. Athulchandra6

Postgraduate Student1, Professor and Head2, Associate Professor3, Professor4, Postgraduate Student5, Postgraduate Student6
Department of Conservative & Endodontics, Maratha Mandal’s NGH Institute of Dental Sciences, Belgaum, Karnataka.

*Corresponding author:

Divyashree D Dandavati, Department of Conservative & Endodontics, Maratha Mandal’s NGH Institute of Dental Sciences, Belgaum, Karnataka. Affiliated to RGUHS.

Received date: October 28, 2020; Accepted date: November 6, 2020; Published date: March 31, 2021

Year: 2021, Volume: 13, Issue: 2, Page no. 37-38, DOI: 10.26715/rjds.13_2_2
Views: 2456, Downloads: 187
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CC BY NC 4.0 ICON
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0.
Abstract

The clinical assessment of a failing restoration plays an imperative role in recognising the cause of failure and helps in decision making for replacement or repair of the restoration. This paper describes about how to appropriately diagnose a failing restoration and either replace or repair the restoration as soon as possible without causing more damage to the natural tooth.

<p>The clinical assessment of a failing restoration plays an imperative role in recognising the cause of failure and helps in decision making for replacement or repair of the restoration. This paper describes about how to appropriately diagnose a failing restoration and either replace or repair the restoration as soon as possible without causing more damage to the natural tooth.</p>
Keywords
Amalgam, Composite, DFG, Failure, GIC, Repair
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Introduction

A failing restoration can be described as one that has suffered biomechanical defect or damage, resulting in immediate detrimental clinical consequences to the patient.1

The repair of such restorations is a viable alternative to the replacement of the defective restoration. However, to repair a restoration, understanding of the material aspect, the steps involved, and the probable causes of failure are mandatory.1,12 The aim of the present paper was to unravel the various aspects of failure of different direct restorations and to comprehend the repair of these materials.

Failure of specific restorations

Composite

As per the saying, “Everything has beauty, but not everyone sees it”, only dentists can give justice to the defects and this is possible with composites.

Failures can be caused due to improper caries removal, faulty preparation, faulty handling, manipulation of material, improper isolation, contamination, improper finishing and polishing.1,3,4,13,14

Glass Ionomer Cement (GIC)

Failure occurs due to alterations in powder liquid ratio, improper dispensing, altered mixing/working time, and improper finishing.1,3,4,14

Amalgam

Failure occurs due to faulty cavity preparation, poor matrix adaptation, faulty manipulation, improper condensation, contamination, improper finishing, and polishing procedures.1,3,4

Direct Filling Gold (DFG)

Failure is attributed to improper caries removal, large cavities, improper condensation, contamination, improper annealing, and plaque accumulation.1,3,4

Management of specific restorations

Composite

Review: If the composite restoration has no advantage in operative intervention, the restoration can be reviewed.

Refurbishment: Composite restorations can be refurbished such as polishing the restoration.

Resealing: Flowable composites can be used along with the adhesive to improve sealing.

Repair: Conditioning of existing restoration is mandatory. The procedures include surface roughening, air-abrasion, bioactive glass particles, silica oxide, etching with 37% phosphoric acid.

Replacement: If the above measures cannot resolve the existing problem, the entire restoration can be replaced.1,4

Glass Ionomer Cements (GIC)

Review: If minimal defects are present, it can be reviewed.

Refurbishment: Surface conditioning can be done with phosphoric acid for 20 seconds/maleic acid.

Repair: A new layer of GIC can be placed over the old restoration.

Replacement: If the old restoration is not acceptable, it can be replaced.1,4

Amalgam

Review: If minor deficiencies are present such as tarnish, it can be reviewed.

Refurbishment: Refurbishment/re-finishing existing amalgam restorations is a useful treatment for anatomical form defects.

Reseal: Flowable resin-based material can be used to seal a non-carious marginal gap defect.

Repair: Can be repaired with amalgam, resin composite or as a temporary/provisional measure with glass ionomer or resin-modified glass ionomer cements.

Replacement: If the restoration cannot be repaired, the old restoration can be replaced.1,4,15

Direct Filling Gold (DFG)

The efficiency of methods used for repairing gold restorations are insufficiently analyzed. Resins and glassionomer cements are suitable materials for repairing gold restorations.1,4,14,15

Conclusion

Failure and success are not accidents as we suppose, but strict justice of nature. Repair is a viable alternative to replacement, and it can significantly increase the lifetime of restorations.1,3,9

Conflict of Interest

None

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References
  1. Green D, Mackenzie L, Banerjee A. Minimally invasive long-term management of direct restorations: the ‘5 Rs’. Dent Update. 2015;42(5):413-26.
  2. Mount GJ, Tyas MJ, Ferracane JI, Nicholson JW, Berg JH, Simonsen RJ, Ngo HC. A revised classification for direct tooth-colored restorativ materials. Quintessence International. 2009 Sep 1;40 (8).
  3. Elderton RJ. The causes of failure of restorations: a literature review. J Dent. 1976;4(6):257-62.
  4. Blum IR, Jagger DC, Wilson NH. Defective dental restorations: to repair or not to repair? Part 1: direct composite restorations. Dent Update. 2011;38(2): 78-84.
  5. Wilson NH, Dunne SM, Gainsford ID. Current materials and techniques for direct restorations in posterior teeth: Part 2: resin composite systems International Dental Journal. 1997 Aug;47(4):185- 93.
  6. Manhart J, Garc a-Godoy F, Hickel R. Direct posterior restorations: clinical results and new developments. Dental Clinics. 2002 Apr 1;46(2):303-39.
  7. Opdam NJ, Frankenberger R, Magne P. From ‗Direct Versus Indirect’Toward an Integrated Restorative Concept in the Posterior Dentition. Operative dentistry. 2016 Sep;41(S7):S27-34.
  8. American Dental Association Council on Scientific Affairs. Direct and indirect restorative materials. J. Am. Dent. Assoc. 2003;134:463-72.
  9. Hickel R, Dasch W, Janda R, Tyas M, Anusavice K. New direct restorative materials. FDI Commission Project. Int Dent J. 1998;48(1):3-16.
  10. Shivakumar AT, Kalgeri SH, Dhir S. Clinical considerations in restorative dentistry-A narrative review. Journal of the International Clinical Dental Research Organization. 2015 Jul 1;7(2):122.
  11. Elderton RJ. The prevalence of failure of restorations: a literature review. Journal of Dentistry. 1976 Sep 1;4(5):207-10.
  12. Kim KL, Namgung C, Cho BH. The effect of clinical performance on the survival estimates of direct restorations. Restor Dent Endod. 2013;38(1):11-20.
  13. Roulet JF, Wilson NH, Fuzzi M. Advances in operative dentistry. Quintessence Publishing (IL); 2001 Oct 1.
  14. Roberson T, Heymann HO, Swift Jr EJ. Sturdevant’s art and science of operative dentistry. Elsevier Health Sciences; 2006 Apr 13.
  15. Anusavice KJ, Shen C, Rawls HR, editors. Phillips’ science of dental materials. Elsevier Health Sciences; 2012 Sep 27.  
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