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10.Longevity and Causes of Failure of Amalgam and Composite Restoration

Muhammad Amer Khan1, Mohammad Adnan Khan2, Mamoona Shah3, Shawana3, Junaid Ahmed4 and Shehzad Fahad3


Objective: The objective of this was to determine the longevity and causes of failure of amalgam in patients reporting to tertiary care center.

Study Design: Cross-Sectional Study

Place and Duration of Study: This study was conducted at the Khyber College of Dentistry Peshawar, Bacha Khan Medical College Mardan and Kohat Institute of Dental Sciences on 100 patients for a period of ten months from January 2019 to October 2019.

Materials and Methods: Patients with faulty amalgam or composite restorations, placed at least 6 months before the time of examination, and needing replacement their tooth restorations on esthetic or functional ground were included in this study. Patients with limited mouth opening, below 10 year of age, mental and psychiatric disorder were excluded. Teeth were examined under mirrors and explorers. Proximal restorations were evaluated with dental flosses. Evaluation was also done using periapical and bite-wing radiographs when required. We ask for reasons for replacement which are; endodontic treatment/pain, caries, fracture of tooth, fracture of restoration, extraction of adjacent tooth, and insufficient approximal contact. The operator experience and duration of restoration were also recorded. Data analysis was done in SPSS 20. Data stratification was done by using Chi-Square test. A P-value of less than or equal to 0.05 was considered significant.

Results: The mean age of the participants was 29.98±8.84 years. The males were 62(62%) and females were 38(38%). The most common location of restorations was mandibular molars (n=49, 49%) followed by mandibular anterior teeth (n=18, 18%). The frequency of failed restoration was found in 28(28%) cases. The most common cause of amalgam and composite failure was combined endodontic failure and fracture of the restored teeth (n=9, 9%) followed by fracture of restoration itself (n=8, 8%) and need for root canal treatment (n=6, 6%). The most common longevity of restoration was of 2-5 years duration (n=49, 49%) followed by 6-8 years (n=17, 17%) and 1-2 years (n=16, 16%).  Most commonly failed restorations were those placed by technicians (n=8, 53.30%), student in institute (n=3, 37.50%) and general dental practitioners (n=14, 25.5%). The failure for specialist (2-year degree) was 14.3% (n=1) and specialist (4-year degree) was 13.30% (n=2) and they were statistically significant (P=0.109).

Conclusion: The amalgam and composite restorations needed to be replaced due to endodontic failure, fracture of tooth, fracture of restoration itself, secondary caries, and insufficient proximal contact. The clinicians need to be vigilant to combat these issues in their practices.

Key Words: Amalgam, composite, restoration, causes of failure, reason for replacement

Citation of article: Khan MA, Khan MA, Shah M, Shawana, Ahmed J, Fahad S. Longevity and Causes of Failure of Amalgam and Composite Restoration. Med Forum 2021;32(8):42-46.