04 October 2023

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Longevity of dental materials – what is it really about and what can we do about it?

Lorenzo Breschi

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Resin composite materials are the material of choice for restoring posterior and anterior cavities due to their proven good mechanical and esthetical characteristics. Thanks to the great advance in adhesive systems and resin composite materials, a clinical can be minimally invasive in restoring small defects but can also restore large defects with direct composite restorations with a predictable clinical outcome. Recent studies showed that, if these materials are handled properly, resin composite restorations can last even more than 30 years, with relatively low annual failure rate (about 2%). Nevertheless, there are certain risk factors that are responsible for failure of restorations, and they can be divided into: patient-level factors, dentist-level factors, and tooth/restoration-related factors. The most common failures seen in anterior teeth are due to esthetic reasons and fracture, while posterior restorations fail due to secondary caries and fractures. Non-carious cervical lesions fail due to loss of retention and marginal discoloration. So, what can we do to prolong the life-span of the restorations we place?

Firstly, we should know that gender and the type of resin do not seem to influence the clinical longevity of composite restorations. On the other hand, high caries risk, parafunctional habits and socio-economic status do seem to play an important role on the survival of the restorations we place. Similarly, endodontic treatment (increases the risk for failure more than 2 times) and number of restored surfaces are important for tooth prognosis. Lastly, it is of great importance to underline the “dentist-factor”: different operators and operator’s experience can significantly influence the longevity of restorations. Therefore, it is essential to strictly follow manufacturers instructions when carrying out restorative procedures, as well as to treat their patients comprehensively and individually, promoting a healthy lifestyle which includes excellent oral hygiene level and regular check-ups.