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Article: Volume 44 Number 4 Page 295 - April 2017

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  Dent Update 2017; 44: 295-305

Restorative dentistry:  Complications of an Ageing Dentition Part 1: Occlusal Trauma and Cracked Teeth

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Abstract: A growing problem in dentistry is complications associated with failing amalgam restorations that have been in place for many years. At present, there is a wide variety of treatment options available in the clinician’s armamentarium when this situation arises, however, without the correct diagnosis, the prognosis for the tooth may quickly diminish, despite the clinician’s best efforts. A confusing array of symptoms and failures may confound even the most experienced dentist, which will inevitably lead to invasive and time consuming approaches in a desperate attempt to rectify the initial problem. This paper, the first part of a three-part series, discusses the possible aetiological factors responsible for restoration failure, including occlusal issues and cracks within the tooth structure. The second part of the series will focus on restorative options and root-treated teeth. The third, and final, part of the series will provide an overview of the previous papers and conclude with a case report.

Clinical relevance: Failure of amalgam restorations is a commonly encountered clinical problem in general practice and no one case presents in the same way. A competent diagnosis regarding the occlusion and tooth structure, followed with implementation of the most appropriate, minimally invasive treatment option, requires an adequate knowledge of current literature.

Author notes: Bryan Daniel Murchie, BDS, MJDF RCPS, PgCert(Implant), MSc(Rest Dent), General Dental Practitioner, Aberdeen, UK.

Objective: To understand the occlusal and cracked tooth aetiology and diagnoses associated with a failed amalgam restoration, including the associated complications.