Restoration Materials Failure PDF

RESTORATION MATERIALS FAILURE I FAILURE OF RESTORATION MATERIALS Today, in order to increase the clinical performance of restorations Studies on the development of the qualities of materials and restoration construction techniques are gaining importance. Restorations Prolonging th...

RESTORATION MATERIALS FAILURE I FAILURE OF RESTORATION MATERIALS Today, in order to increase the clinical performance of restorations Studies on the development of the qualities of materials and restoration construction techniques are gaining importance. Restorations Prolonging the duration of stay in the oral environment Maintaining their clinical performance for a long time Keeping the loss of dental tissue to a minimum It is among the main goals of Adhesive Dentistry. FAILURE OF RESTORATION MATERIALS Extending the clinical life of restorations, It is of great importance in terms of preserving the remaining dental tissues. Complete removal of a defective restoration from the tooth Carrying out a new restoration It causes material losses from the tooth tissues every time. Minimizing the loss of substance in the tooth tissues as a result of restorative procedures As a "Minimally Invasive Treatment Concept" (Ultraconservative Dentistry) Defined.  Failure can be defined as falling short to meet the desired result in the dictionary sense. Restoration materials, The causes of failures in clinical use can be examined under three main headings: 1. Technical Errors in Clinical Practices (Physician-Related Failure) 2. Properties of Restorative Material (The properties, clinical use and long-term studies of the materials should be well known by the physician) 3. Patient Factor (Patient Motivation and Clinical Follow-up) FAILURE OF RESTORATION MATERIALS 1. Physician's ; Erroneous / Missing Indication - To be careful about Treatment Planning, To have sufficient knowledge and equipment about the restoration material to be used, Clinical skills and experience are up-to-date and sufficient, To work with technical precision and in accordance with ethics, Finishing - It is necessary to apply the polishing processes sufficiently. FAILURE OF RESTORATION MATERIALS 2. Materialin ; To be reliable (company) and not to have a clinical shelf life, Appropriate storage conditions, compliance with clinical use/storage recommendations, The use of the material in clinical practice in accordance with the technical sensitivities specific to the material, Use of the material in accordance with clinical restrictions and indications Must. FAILURE OF RESTORATION MATERIALS 3. The patient ; The ability to understand and coordinate what is stated should be carefully reviewed, What to do/not to do after treatment should be told to him, Sufficient motivation to act in accordance with oral hygiene protocols should be provided, Parafunctional habits should be reviewed, attention should be paid to determining indication/material, Clinical follow-up should be performed to determine the long-term factors that are not aware of and overlooked.  Considering all these factors, the clinical success of the restorations; Indication / Planning Selection of Suitable / Proven Materials Clinical Storage Conditions of the Material Application / Technical Precision Finishing / Polishing Controls Patient Motivation It depends on the Clinical Follow-up / Evaluation steps. All these steps will directly or indirectly determine the success / failure rate of the physician. FAILURE OF RESTORATION MATERIALS After the application of restoration materials, The main factor causing the failure has been reported as microleakage. Microleakage ; Bacteria and bacterial products, liquids, molecules or passage of ions through the gap between the cavity restoration boundary FAILURE OF RESTORATION MATERIALS The main causes of microleakage are; Improper cavity design and insufficient condensation of the material Incomplete and careless finishing and polishing processes Rates of polymerization shrinkage of restoration materials Thermal expansion differences between dental tissues and restoration materials The quality of the adhesion mechanism created between the tooth / restoration can be listed under the headings. FAILURE OF RESTORATION MATERIALS Today, manufacturers have succeeded in minimizing the thermal expansion coefficient differences between dental tissues and restoration materials. Polymerization shrinkage rates in restoration materials, It has been reduced to lower values compared to the materials used in the past, However, although the polymerization shrinkage of monomers has been reduced due to the chemistry of the conversion mechanisms of monomers to polymer structure, it has not been completely eliminated.  The duty of the physician; Cavity preparation Condensation of the material Placement technique of the material To have skills in finishing / polishing processes and technical precision. is to pay attention. Clinical knowledge, skills, equipment and The better the adaptation of the Restoration Material, The risk / amount of microleakage will be reduced at the same rate.  Restoration materials, Failure criteria in clinical follow-up ; Marginal Unconformity (Distortion of Edge Alignment) Long-Term Ongoing Sensitivity Secondary Bruises Formation of Cracks and Fractures in Restoration Material Formation of Cracks and Fractures in Dental Tissues Anatomical Form Disorders It can be listed as Aesthetic Form Disorders.  Clinical failure criteria in restoration materials; Amalgam Secondary caries Overflow in the cervic Corrosion and Blackening Edge mismatches Fractures in restoration Tubercule abrasions and fractures Dimensional changes (flow-creep) FAILURE OF RESTORATION MATERIALS Causes of clinical failure in Amalgam Restorations; The reasons for failure in amalgam restorations in the studies carried out; ~ 56% deficiencies in cavity preparation, ~ 42% attributed to inadequate material manipulation.  Causes of clinical failure in Amalgam Restorations; Basic Principles of Cavity Preparation: All fragile and weak enamel should be included in the cavity and the cavity should be prepared. All defects/defects found on the surface should be included in the cavity. Cavity boundaries are the restoration of the cavity at a proper angle with the cavity It should be prepared in such a way that it provides a smooth fit. The Cavo-Surface angle should be prepared in the range of 90-110 degrees. a sharper angle leads to fractures in the structures of the teeth, A wider angle will cause fractures in the restoration.  Causes of clinical failure in Amalgam Restorations; Basic Principles of Cavity Preparation: In the occlusal of amalgam cavities, Pits and fissures that are not included in the cavity will cause the formation of secondary caries. Restoration limits at interfaces, If left on the interface inside the embrace, it will form areas that cannot be cleaned. At least 2 mm of restoration of tubercles that have entered the function, The tubercles that do not enter must be at least 1.5 mm thick.  Causes of clinical failure in Amalgam Restorations; Basic Principles of Material Manipulation: poor matrix adaptation; The matrix cavity should be located 0.5 - 1 mm below the gingival border. It should be strong enough not to interfere with the condensation of the material, when removed, it should be placed in such a way that it does not damage the restoration, it must be supported by a wedge, A wedge should be selected that is suitable for the restoration form, the gap with the adjacent tooth should not be created.  Causes of clinical failure in Amalgam Restorations; Basic Principles of Material Manipulation: Condensation is one of the most important factors for the success of amalgam restorations. Insufficient condensation causes cavities in the material, decrease in the resistance of amalgam material, Restoration and It will cause ruptures and fractures in dental tissues. The presence of contamination during the condensation phase will reduce the mechanical properties of the restoration.  Causes of clinical failure in Amalgam Restorations; Basic Principles of Material Manipulation: Finishing and polishing processes of amalgam restorations; Excessive carving (manipulation/pit-fissure processing) process, It causes thinning of the restoration material, increasing the risk of fractures. Under-performing carving (manipulation/pit-fissure processing) process, early contacts of restoration material in occlusion, Therefore, it causes post-operative pain, pulp irritations and indirectly fractures in restoration.  Causes of clinical failure in Amalgam Restorations; Basic Principles of Material Manipulation: Finishing and polishing processes of amalgam restorations; Polishing should not be done before 24 hours have elapsed If the polishing is not done well enough, Rough areas remaining on the surface will become favorable in terms of corrosion and plaque retention. If overheating occurs during the polishing process, The mercury in its content will evaporate and the mechanical properties of the material will decrease.  Clinical failure criteria in restoration materials; Pin Restorations Secondary caries Wear and fracture in restoration Rupture and separation in restoration Discolorations on the polished surface of the restoration Reduction in dentin pin mechanical connection, mobility  https://youtu.be/KeDZqRudZCc https://youtu.be/hwHT4Pb5P8U  Causes of clinical failure in Pin Restorations; The reasons for failure in pin restorations in the studies carried out; 1. In restoration 2. Restoration Material in the Pin link 3. Pin material content 4. Between Pin - Dentin connection 5. It is detected on the surface of the dentin tissue.  Causes of clinical failure in Pin Restorations; Failure in restoration ; Improper matrix selection and incorrect placement Moving the matrix Insufficient condensation Early removal of the matrix tape Missing the height of the contact points in the occline  Causes of clinical failure in Pin Restorations; Failure in the Restoration Pin connection; Selection of unsuitable materials Corrosion of the pin material Decrease/damage to the joint due to corrosion The restoration needs to be repeated again  Causes of clinical failure in Pin Restorations; Failure in pin connection / placement; Excessive force when activating the pin material Placing the pin material in dentin more than necessary or in the enamel Locating It is necessary to reposition the pin material at a distance of 2 mm from the inserted gap The restoration needs to be repeated again  Causes of clinical failure in Pin Restorations; Pin Dentin connection / Failure in dentin tissue; The preparation made before the pin is placed is wider than the pin gap Fracture of dentin as a result of excessive force while activating the pin material Loss of mechanical properties of dentin in teeth that have undergone root canal treatment Ignoring the pulp or dentin canals close to the pulp in vital teeth