Secondary caries around amalgam restorations

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Secondary caries is one of the greatest causes for replacement of amalgram restorations. This study verified whether marginal defects in class I restorations could be a determining factor in the development of secondary caries. Fifty-five extracted premolars and molars whose occlusal surfaces were already restored with amalgam were selected. A macroscopic examination of these teeth was carried out to see whether there was a difference in the prevalence of caries beneath ditched and nonditched margins. To assess the presence of caries, a section was ground in each tooth so that the cut passed through a ditched margin and a better margin. This permitted assessment of the two types of margins that had been exposed to the same oral environment. Macroscopic examination revealed caries in 3.6% of the nonditched margins and caries in 20% of the ditched margins. Microscopic examination revealed caries in 47.06% of the nonditched margins and caries in 58.82% of the ditched margins. Statistical analysis supports the conclusion that the marginal defect itself is insufficient to determine the presence of secondary caries that surround the amalgam restoration on the occlusal surface.

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Cited by (38)

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    However, we did not estimate the former attachment level of the teeth and the respective distance from restoration margin to the gingiva in this study. It appears thus, that defective proximal amalgam restoration margins, as established for occlusal restorations before are not per se indicative for the presence of secondary caries.29,30 It was shown in a clinical trial that only 14% of the teeth with clinically defective margins also presented caries in the radiograph.31

  • Alternative treatments to replacement of defective amalgam restorations: Results of a seven-year clinical study

    2011, Journal of the American Dental Association
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    Despite the fact that some investigators have associated microleakage with secondary caries formation,28,29 the majority of evidence16,17,30 suggests that no relationship exists between the development of secondary caries and the size of the leakage, except in cases in which the occlusal crevice exceeds 250 micrometers29 or 400 μm.31 Therefore, researchers have presented substantial evidence that in amalgam restorations with defective margins and crevices smaller than 400 μm, no secondary caries will develop.15,16,17 Because we observed most of the downgraded and failed restorations during the first two years of clinical service, we elected to carry forward the change-in-level scores for restorations not seen at the seven-year evaluation for analytical purposes.

  • A clinical evaluation of a self-etching primer and a giomer restorative material: Results at eight years

    2007, Journal of the American Dental Association
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    Marginal breakdown has been reported to be one feature of resin-based composite restorations that can lead to secondary caries.35 Several studies,36–38 however, have challenged the notion that marginal breakdown leads to secondary caries. No relationship exists between the development of secondary caries and the size of the crevice at the tooth-restoration interface,36–38 except in cases of macroleakage in which the crevice exceeds 250 nanometers36 or 400 nm.37

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    2005, Journal of the American Dental Association
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    However, they rarely develop carious lesions, because recurrent carious lesions seldom are diagnosed on the occlusal surface. In fact, a study of ditched and nonditched margins of amalgam restorations has shown that there is no difference in the presence of carious lesions in the two situations.47 It is important in this situation to keep in mind that an explorer will stick in any crevice, regardless of whether it is carious.

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