ABSTRACT
The clinical diagnosis of secondary caries is by far the most common reason for replacement of restorations, but the scientific basis for the diagnosis is meager. The purpose of this article is to review the literature on secondary (recurrent) caries and present case reports to document the problems encountered in the clinical diagnosis of secondary caries. The literature on secondary caries was critically reviewed and subdivided into clinical diagnosis, location of secondary lesions, histopathology, microleakage, and microbiology. The case reports included restorations that were scheduled to be replaced because of secondary caries or stained margins of composite restorations. The lesions were photographed preoperatively and postoperatively. Based on the limited literature available, secondary caries appears to be a localized lesion similar or identical to primary caries. It is most often localized gingivally on restorations. Narrow gaps, crevices, ditches, and "microleakage" do not lead to secondary caries, but wide voids may. Secondary caries is difficult to diagnose clinically. Consistency or hardness and discoloration of dentin and enamel are the best parameters. Secondary caries is the same as primary caries located at the margin of a restoration.
Subject(s)
Dental Caries/diagnosis , Dental Caries/etiology , Dental Restoration, Permanent/adverse effects , Dental Caries/microbiology , Dental Caries/pathology , Dental Caries Activity Tests , Dental Leakage/complications , Dental Restoration Failure , Hardness , Humans , Recurrence , Retreatment , Tooth Discoloration/diagnosisABSTRACT
Gingival recessions and noncarious cervical lesions are frequent and closely related defects which can be successfully treated by mucogingival surgery and restorative therapy techniques either used alone or in combination depending on the defect characteristics. Proper treatment planning is guided by careful clinical diagnosis. A selection of treatment modalities are presented and useful hints proposed: the long term success is always strictly bound to the identification and elimination of the etiologic factors, to a correct treatment and a meticulous maintenance program.
Subject(s)
Gingival Recession , Tooth Abrasion , Tooth Cervix , Tooth Erosion , Gingival Recession/etiology , Gingival Recession/therapy , Humans , Tooth Abrasion/etiology , Tooth Abrasion/therapy , Tooth Erosion/etiology , Tooth Erosion/therapyABSTRACT
This paper reviews secondary caries which is the major reason for failure of restorations and therefore worthy of attention if operative dentistry is to be cost effective. The basic premise of the review is that the secondary caries process is difficult to diagnose and cannot be permanently treated away by operative management. Preventive therapy, dependent on the patients' self-care, is essential. However, the quality of the restorative material and the skill with which it is handled are also relevant to the prevention of further failure.
Subject(s)
Dental Caries/etiology , Dental Restoration, Permanent , Dental Caries/diagnosis , Dental Caries/therapy , Dental Restoration, Permanent/adverse effects , Humans , RecurrenceABSTRACT
The use of resin-based composite restorations, the reasons for failure, and the longevity of these restorations have been surveyed in 62 Italian private practices. Almost two-thirds of the 1025 restorations inserted were class 3 and 5 restorations, while 18% were class 1 and 2 restorations. Secondary caries was the most common reason reported for replacement of resin-based composite restorations (44%), followed by discoloration (21%), and bulk and margin fracture (14%). The age of restorations needing replacement was reported for 53% of the sample. The median longevity in this sample was calculated to be 3.3 years.
Subject(s)
Composite Resins , Dental Restoration, Permanent/statistics & numerical data , Dental Caries/etiology , Dental Restoration, Permanent/adverse effects , Humans , Italy , Prosthesis Failure , Reoperation , Treatment FailureABSTRACT
The reasons for placement and replacement and the longevity of amalgam restorations were recorded by 62 Italian private practitioners. The survey compiled 1935 amalgam restorations inserted due to primary caries (59%) and failed restorations (41%). The clinical diagnosis of secondary caries constituted 59% of failures of amalgam restorations. The age of 46% of the restorations needing replacement was noted. The median longevity was 4.7 years.
Subject(s)
Dental Amalgam , Dental Restoration, Permanent/statistics & numerical data , Dental Caries/etiology , Dental Restoration, Permanent/adverse effects , Humans , Italy , Prosthesis Failure , ReoperationABSTRACT
A survey, in order to ascertain the reasons for placement and replacement of amalgam and composite restorations was made with the consent of the Italian Academy of Conservative Dentistry. 62 dentists answered the questionnaire, analysing their daily restorative work for two weeks: a total of 2,960 restorations were scored. The results show a prevalence of the primary caries over the replacements, and a prevalence of the secondary caries over the remaining reasons for replacement. Both data possibly mean the need for a more preventive approach to dental caries in Italy, even if the results fit fairly well into the values of the international research.
Subject(s)
Composite Resins , Dental Amalgam , Dental Restoration, Permanent , Child , Child, Preschool , Dental Caries , Humans , RecurrenceABSTRACT
The amalgam continues to be the most widely used material for durable restoration of decayed bicuspids and molars. After a discussion of this material's relative drawbacks, the author describes the restoration possibilities now offered by the advanced high-copper alloys available today. The latest developments involve both "conservative" preparations and extensive pre-prosthetic occlusal restorations.
