Operative dentistry aje qualtrough, jd satterthwaite la morrow, pa brunton

Recognition of failure
Failure of a restoration may take many forms and may be due to major
defects (such as fracture and loss of a portion of the supporting tooth
or restoration) or may be due to minor defects such as marginal
deficiencies, staining or microleakage. When a restoration has failed,
but does not involve loss of restoration or tooth bulk, it is unlikely that
the failure will be noticed by the patient unless there are symptoms or
there is a visible aesthetic problem. This is apparent for both direct
and indirect restorations
9
. A delay in treatment of a failed restoration
may result in further damage to the tooth or render repair impossible
and as such it is important that an appropriate maintenance pro-
gramme for a patient with a restored dentition includes frequent
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Maintenance of the restored dentition


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recall appointments, at which deterioration or failure can be recog-
nised at an early stage by a clinician.
Most marginal defects are directly observable. In addition to 
clinical examination, radiographs are a useful adjunct to identify
interproximal marginal defects/deficiencies or caries that may other-
wise go unnoticed
10
. Also given the incidence of loss of vitality of
teeth with indirect restorations, especially long-term
11
, periapical
radiographs may be useful to detect peri-radicular pathology.
It is easy to replace a failed restoration without considering the
implications of failure, which are often underestimated. Situations
such as sub-standard treatment, incorrect diagnosis (initially or of
failure) or provision of restorations with a short life expectancy will
all result in more frequent intervention. Quite simply, the implica-
tions of failure relate to cost, both in terms of economic implications as
well as harm to the tooth.