RGUHS Nat. J. Pub. Heal. Sci Vol No: 16 Issue No: 3 pISSN:
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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
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.
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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
Supporting File
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