This summary is based on the article published in the European Journal of Oral Sciences: Longevity of posterior dental restorations and reasons for failure (December 2012)
Context and Purpose of the Study
- Tooth-coloured restorative materials are being used increasingly more often in Class II preparations in permanent teeth.
- The authors used a practice-based study design to assess the survival time of Class II restorations and to identify factors relevant to their longevity.
Key Messages
- In this practice-based study, amalgam restorations showed significantly better longevity than resin composite.
- Secondary caries were the most common reason for replacing resin-composite restorations.
- Failure of the resin-composite restorations was significantly related to the patient’s young age, the patient’s high previous caries experience, large cavity depth, use of saucer-shaped preparation technique, and Filtek Z100 as the resorative material.
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biggest reason for failure is Occlusion…..by far!
On behalf of Dr. Jaf
I think one of the main reasons for the failure of posterior tooth coloured restorative material specially Class II filling is the use of flowable material as a first layer. The reason is because the flowable composite has a higher rate of polymerization shrinkage over time, leading to breakage of the marginal integrity and leakage, recurrent caries and pulp irritation.
Clinically, on every recall exam, bitewings show that there is a difference in the radiolocency between the surface and deep layers of the composite fillings and most decay is around the areas were flowable has been used as a first layer.