Dentists use a large number of dental restoration materials for an impaired tooth. Before choosing the most suitable restoration material for the procedure, the dentist and the patient must consider many factors, and the longevity of the restoration material is usually one of the most vital.
The success of a restoration is the proven ability of the restoration to meet performance expectations, while the longevity of the restoration (otherwise called its survival rate) is typically used to determine its clinical performance. Repairing or replacing failed restorations make up 60 percent of all restorative treatments performed by dentists, and it is estimated to cost around five billion dollars in America alone.
Restoration materials have a limited lifespan, and immediately after the restoration procedure, the restoration count begins, in which case, it will probably be repaired or replaced several times during the patient’s lifetime.
What determines the longevity of restoration materials?
Certain factors caused by the patient or the dentist can affect the lifespan of a dental restoration. They include:
Recurrent dental cavities — high frequency of dental decay or cavity can affect the longevity of the restoration material.
Restoration size — larger restorations have more potentials of failing. The large surface area exposes them to the threat of recurrent cavities, breakage and restoration failures.
Tooth position — restoration materials used on the molars usually have a lower lifespan than the front row teeth. Their lower longevity is because they take more restoration materials and have to ensure constant chewing forces.
The dentist — experienced dentists typically have higher success or survival rates on restorations.
Types of restoration materials
This is currently one of the most regularly used restorative materials, especially for posterior teeth. Its usage has recently been controversial because patients now want more visually appealing materials and there are health concerns on mercury poisoning. The average survival rate of amalgam is around 22 years, with some studies revealing an average failure rate of 3 percent annually.
Composite resin materials used to have a high failure rate of about 50 percent after the first 10 years. Its lifetime has, however, improved with the development of new forms of the material. They can be categorized into micro-filled, nano-filled or micro/nanohybrid material, with the material percentage varying from 42-55 percent.
Of the types of composite resin, hybrid composites have the best performance with an annual failure rate of 1.5 to 2 percent, usually due to fracture. The success rate has also improved significantly with the addition of glass ionomers.
Glass ionomer cements
Glass ionomers perform better when used as a lining or base for other restoration materials. They do not have the physical resilience to be applied independently to posterior restorations. When used alone as a restorative material, they have an annual failure rate of about 7%.
Porcelain fused to metal
This restoration material has a survival rate of 97 percent over 10 years. The most significant percentage of failures stem from the anterior region caused by excessive chewing pressure, accidents or iatrogenic factors.
There are different forms of ceramic materials for restorations, and the selection is based on the need for either aesthetic values or strength. Of all the types, heat-pressed, reinforced ceramics have the highest survival rate.
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