Problems After Composite Restorations or Fillings
Most commonly used filling material is the composite filling material as it is tooth colored associated with and adhere well to the tooth. In this minimum tooth material is lost as the filling ahs mechanical bonding with the tooth. It is an esthetic filling and have good strength. They come in different shades so the shade matching can be done easily. There are certain complication which can be there because of the improper technique and wrong diagnosis. These are-
1) Discoloration, Specially At Margins -If proper finishing and polishing is not done then the Discoloration can occur especially at the margins
2) Marginal Fracture-f the filling is too thin at the margins then the fracture of the filling can occur especially at the margin.
3) Recurrent Caries-If proper adaption of the filling is not there and there is gap between the tooth and the filling it can cause the food impaction which later can cause the caries known as recurrent caries or the secondary caries.
4) Post Operative Sensitivity - This is the common complication after the composite filling. The tooth becomes sensitive to hot and cold sensation. It is normally because of improper filling technique. In such cases the fling s removed as s refilled.
5) Gross Fracture of Restoration- If gross fracture occurs then the filling s done again. The advantage with composite is that if the filling has fractured then one does not have to remove the whole filling. The filling can be easily repaired.
6) Lack of Maintaining Contact- If during filling the proper contact is not made with the adjacent tooth then the problem of food impaction is there which can cause the gum problem and it can also cause the caries in the adjacent tooth.
7) Accumulation of Plaque around the Restoration- If the filling is not done properly and is not polished then the plaque accumulation can be there around the filing . So after doing the filling proper finishing and polishing of the filling is the must.
Following are the problems which can be there if the filling is not done properly that are the proper procedure is not adopted. The filling materials give good result but they are very technique sensitive ad if any negligence is there then it can cause the failure of the filling.
a) Incomplete Excavation of Caries- If the caries are not removed completely it can cause the failure of the filling. The patient may have pain afterwards as the secondary caries can be there.
b) Improper Etching and Bonding Technique- Before using the composite the tooth surface is etched with 37% phosphoric acid and then bond is applied. If the etching or the bond application is not proper as recommended by the manufacturer the failure of the restoration can occur. In such cases refilling is done.
c) Lack of Moisture Control –With composite filling and the amalgam filling the moisture control during filing is very important. In case of amalgam filling , if it comes in contact with moisture during the placement of filling, The expansion occurs which can cause pain and in case of composite if it comes in contact with moisture then the filling does not adhere well to the tooth surface causing the f
d) Improper Condensation- In case of amalgam filling the condensation has to be proper. If proper condensation is not there then the voids will be there causing the weak filling
Anterior Teeth Composite Restorations Problems
1). Improper esthetics: The shade of the filling should be properly matched for good esthetics.
- To prevent this natural light should be used for shade selection.
- Selection should be done before isolation.
2) Discoloration of margins- It occurs due to microleakage
- After bleaching the discoloration of the normal teeth is decreased but not of the composite restoration.
- So, the treatment of a discolored composite restoration is replacement of the restoration only.
3) Fracture of the Restoration:
- Care should be taken in case of restorations at the edges of the teeth as excessive pressure may lead to chipping off of the restoration.
- The thickness of the restoration must be checked properly when the patient occludes teeth as a restoration which interferes in occlusion may chip off.
Posterior Teeth Composite Restorations Problems
Post Operative Sensitivity- it occurs because of the shrinkage of the composite restoration during setting which leads to micro leakage and thus sensitivity.It can be prevented by:
a) doing the filling in increments.
b) use of self etch bonding agents
c) in deep cavities, give adequate protection with liners or bases.
Weak Contacts- Occur mainly because of inadequately contoured matrix band or movement of the band during filling. It may also occur due to use of too thick matrix band.
Proper placement of the matrix band is necessary to avoid this. Also adequate thickness of the band should be taken.
Gross Fracture of the Restoration- it occurs due to inadequate technique, Inadequate tooth preparation, Contamination of the site while filling the cavity, Poor bonding technique.
- It can be prevented by keeping the site clean and dry while restoring the tooth.
- Placing retentive features during cavity preparation.
- Placing the filling in increments to allow complete curing of the restoration.
Accumulation of Plaque- rough surface of the composite filling encourages the accumulation of plaque. So, proper finishing of the composite restoration is must.