composite got loose after 1 week, is it normal?

[iamhotok]

since i asked last question about amalgam, i want to ask another one.

the first dentist who filled in one of my lateral teeth with the composite. after about a week or so, the entire piece became loose.

so i had to go to another dentist to fill it in again. and he used amalgam, and told me that he can guarantee it for about two years.

so i am just wondering if it is normal that the composite got loose so quickly? or is it because the first denist was not too good at it? she looked young.

also, what is the proximate % dentists in the country that still use amalgam to fill teeth?

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[c132]

There is too many variables to tell why exactly your composite came loose. Composite is held on by bonding, whereas amalgam is held in by cutting and undercut into the tooth. There is little to no bonding in the silver tooth. One good reason composites fail is because poor isolation. Did they put a rubber dam on? The tooth has to be perfectly dry in order for the composite to gain 100% of its strengh. Also the dentists needs to acid etch the tooth, apply primer and bonding agent before applying the composite.

I have had a composite of mine come off and I was tuned into every detail. It was on a central tooth and the pt bit too hard into something and popped it off. Point being it happens to the best of us!!!

On another note, I am still a fan of amalgam in places that you can't see it. Its a really good material, and it is constantly corroding the margins which leads to less recurrent caries. Posterior composites if they are not done with really good hands, tend to fail a whole lot faster, although they are beautiful. I personally go for a porcelin inlay or an indirect composite anytime I can do one, for they are the superior restoration to direct composite.

 

[3rdMolarRoller]

No matter how good the material is: composite or amalgam, the life of the material and function is dependent on the how good the dentist technigue is. Sounds to me like lack of moisture control. We covered some studies here at school that showed with proper technique, composite can last as long as amalgam (if you do not mind the discoloration of the composite, etc)

And an amalgam for only 2 years...hmm must be a weird prep bec amalgams can last 15+ years.

 

[DcS]

It's hard to say, there could be some extenuating circumstances around the preparation. Overall, composites are much more user sensitive as far as their retention rates. It should obviously last more than a week but amalgams overall will last longer.

As far as amalgam goes, there actually are some instances where bonding systems are used w/ amalgam in addition to proper preparation design for R&R.

 

[iamhotok]

cool. thanks for answering my question.

one last question, is it possible to cover those amalgam with the composite? so the teeth would look natural?

 

[c132]

You seem like you are unsatisfied with the restoration. Maybe you should ask for a porcelin inlay or an indirect composite. What they do is make the restoration outside the mouth (in the lab) to match your individual pred and then the dentist will cement it in. A really good prosthodontist can make the restoration look just like a tooth, you hardly can tell the difference!!!!

As far as covering the amalgam with composite. I have seen it done. They can etch it and the composite will bond semi ok to it. I wouldn't recommend it because it weakens the tooth. Also you need 1 to 1.5 mm of amalgam to be strong, so if you drill away more amalgam than that, the restoration is more likely to fail. Instead of doing all that, ask your dentist what can be done, if he says nothing, go to another dentist etc.....