Should my composite restorations last forever? Why are they failing?

Abstract

Composites resins have become the first choice for direct anterior and posterior restorations. The great popularity is related to their esthetic appearance and reduced need of sound tissue removal as compared with former treatments. Several studies have demonstrated that composite restorations may last long in clinical service. In this review we discuss the factors playing a role on the long-term longevity. Composite restorations have demonstrated a good clinical performance with annual failure rates varying from 1% to 3% in posterior teeth and 1% to 5% in anterior teeth. Factors related to the patients such as caries risk and occlusal stress risk, in addition to socioeconomic factors, may affect the survival significantly. Characteristics of the clinical operators, particularly their decision making when it comes to observing or approaching an existing restoration, are decisive for longevity. Cavity features such as the number of restored walls, composite volume, and presence of endodontic treatment are of major importance and may dictate the service time of the restorative approach. The choice of restorative composite seems to have a minor effect on longevity provided that appropriate technical procedures are used. The main reasons for failure in posterior teeth are secondary caries and fracture (restoration or tooth/restoration), while in anterior teeth esthetic concerns are the main reasons leading to restoration failures. Composite resin restorations can be considered a reliable treatment as long as both the professional and the patient are aware of the factors involved in restoration failures.

The impact of crown fracture in the permanent dentition on children’s quality of life

“…29,33 Some positive features of the present study should be highlighted such as the sample calculation that was obtained through a two-stage conglomerate sampling stratified according to the ages, thus ensuring proportionality among the participants. 29,33 Some positive features of the present study should be highlighted such as the sample calculation that was obtained through a two-stage conglomerate sampling stratified according to the ages, thus ensuring proportionality among the participants.…”

“…28 Whereas just an enamel fracture had no impact on the children's quality of life, the clinical importance of the present study demonstrates that in these types of trauma, and according to the individual assessment of each patient, the restorative treatment of anterior teeth may not be the best option, as this procedure may present long-term defects, such as blemish and replacement by new restorations causing dental wear. [29][30][31] Considering the age range of the participants of the present study, they would need to undergo other procedures throughout their life to overcome these problems, a fact that can be delayed with less invasive treatments such as smoothing the fractured enamel edge. 32 The enamel-dentin fractures negatively impact children's quality of life and therefore require dental intervention that addresses the aesthetic and functional issues.…”

“…It is important to understand the needs that the patient reports and to adapt the best behaviour to each case, clarifying possible doubts as to the measures to be taken in post-trauma situations, to report on the severity of the trauma, the need for treatment, both regarding aesthetics and discomfort, as well as the long-term damage to the child's quality of life. 29,33 Some positive features of the present study should be highlighted such as the sample calculation that was obtained through a two-stage conglomerate sampling stratified according to the ages, thus ensuring proportionality among the participants. The methodology was previously tested in the pilot project with the objective of verifying the feasibility of its execution.…”

Cerium Dioxide Particles to Tune Radiopacity of Dental Adhesives: Microstructural and Physico-Chemical Evaluation

“…The presence of a radiopacifying agent is essential to enable the identification of restorative materials and dissimilarity from pathological processes in the adjacent areas [21]. Recurrent caries and marginal gaps are very often the reasons for the replacement of composite restorations [22]. The misdiagnosis and treatment decision for unnecessary replacement of restorations lead to additional loss of sound tooth tissue, with an increased cost and discomfort for the patient [23].…”

Protocolo de acabamento, texturização e polimento para restaurações diretas em resina composta

“…Em função dos princípios de máxima conservação e mínima intervenção que norteiam o exercício da odontologia atual, as restaurações diretas em resina composta são consideradas estratégias de primeira eleição dentre as alternativas restauradoras para reestabelecimento ou otimização da estética em dentes anteriores. 1,2 No entanto, a perda e/ou diminuição da percepção estética vem sendo relatada como principal razão para a substituição desse tipo de intervenção nos dentes anteriores. 3,4 As etapas de acabamento e polimento das restaurações, muitas vezes negligenciadas pelos profissionais, são manobras clínicas essenciais e desafiadoras, capazes de otimizar a mimetização dos dente s nat u ra is.…”