Week 9 - Long term Management of Direct Restorations Flashcards
(29 cards)
What is the importance of post treatment prevention
- control of disease
- fact that every treatment will eventually fail
What do you assess during recall appointment
- General oral and dental health (review)
- Patient’s response to prior treatment/prevention.
- New or persisting etiological risk factors.
- Status and quality of existing restorations. (monitoring and maintenance)
What are the origins of restoration failure
- inherent long term weakness in restorative material (e.g. strength, wear, compressive strength)
- material used in incorrect situation
- local condition and habits (occlusal force, OH)
What are the 4 restoration failures
- Colour mismatch
- Marginal integrity loss
- Margin discoloration
- Bulk integrity loss
What causes failure in colour match
o Stained dentine or surface.
o Material aging and absorption of stains (tannins).
What causes failure in marginal integrity
o Material shrinkage
o Long term corrosion, ditching, creep,
o Margin chipping under occlusal loading due to poor restoration edge strength
o Overhangs or ledges.
o Occlusal stress.
What causes margin discolouration
Micro/macro defects at the tooth-restoration interface will permit exogenous stain (e.g. food stains) to penetrate along the outer perimeter of the restoration as well as towards the pulp.
- Due to microgaps allowing stains.
- Not always a sign of recurrent caries.
What causes loss of bulk
Restorations may be bulk fractured/partially or completely lost
* Causes:
o High occlusal load.
o Poor cavity design
o Poor bonding technique/contamination leading to adhesive bond failure and lack of retention
o Weak preparation or material voids.
* Often perceived by the patient as a “hole” trapping food.
* May affect the bite/occlusal scheme
How do you check for restoration failure
- Visually and radiographically.
- Check for pain, caries, or dysfunction.
what is the average lifespan for amalgam
10-15 yrs
What is the average lifespan of composite
5-8 years
What is the average lifespan of GIC
3-5 years
what is the recall interval for high risk patients
6-12 months
What is the recall interval for low risk patients
18-24 months
What are the 5 R’s of managing failing restorations
- Review
- Refurbish
- Reseal
- Repair
- Replace
What is review
Only minor defects are evident
Surface roughness without plaque retention.
What is refurbishment
small defects in the restoration which require intervention (reshaping and or polishing)
- can be done by air abrasion or polishing discs
What is resealing
Application of sealant into a non carious defective margin gap or surface
What is repair
Involve removal/modification defective part of the restoration and add new restorative material
What is replacement
complete removal of the existing restoration
What are characteristics of active moderate caries
- enamel whitish/yellowish opaque with loss of luster
- feels rough when probed
What are signs of inactive moderate caries
- whitish, brownish or black
- enamel is shiny and feels hard and smooth on probing
What are signs of active extensive caries
- dentine feels soft and leathery on gentle probing
What are signs of inactive extensive caries stage
dentine is shiny and hard on gentle probing
