Identification of a defect in a restoration, and the subsequent decision-making, tends to be limited to visual and
tactile examinations; however, the management plan for the restored tooth should be based on risk assessment, including assessment of further caries, structural deterioration, catastrophic failure, and loss of pulp vitality. The recognition of one or more limited defects in a restoration does not necessarily mean that the restoration has suffered irreversible damage and requires immediate replacement. Most defects in restorations, other than those caused by sudden impact fracture, develop gradually over extended periods of time,13 providing the clinician with an opportunity to address the cause of the problem and undertake some form of minimal intervention to correct the defect or defects, thereby extending the life expectancy of the restoration. Minimal intervention treatment may include repair of the defects, especially if the defects are localized and accessible, or simple refurbishment of the restoration if the defects are superficial.14,15 The main advantage of such approaches to the management of limited defects in restorations is the avoidance of unnecessary removal of intact tooth tissue, leaving restored teeth more able to withstand loading in function and, as a consequence, an improved prognosis. Furthermore, a replacement restoration is always larger than the one replaced, and larger restorations perform less well in clinical service than smaller restorations. Notwithstanding the benefits of restoration repair, restoration replacement may be inevitable when a restoration is undermined by extensive caries or in the presence of cracked cusps adjacent to the existing restoration. Such cracks are not detectable on radiographs and often asymptomatic, even when the crack is quite advanced. In such cases, removing the entire restoration facilitates detection of cracked cusps where the crack typically propagates from the internal line angles of existing restorations.
รหัสของข้อบกพร่องในการคืน ภายหลังตัดสินใจ มีแนวโน้มที่จะจำกัดการมองเห็น และtactile examinations; however, the management plan for the restored tooth should be based on risk assessment, including assessment of further caries, structural deterioration, catastrophic failure, and loss of pulp vitality. The recognition of one or more limited defects in a restoration does not necessarily mean that the restoration has suffered irreversible damage and requires immediate replacement. Most defects in restorations, other than those caused by sudden impact fracture, develop gradually over extended periods of time,13 providing the clinician with an opportunity to address the cause of the problem and undertake some form of minimal intervention to correct the defect or defects, thereby extending the life expectancy of the restoration. Minimal intervention treatment may include repair of the defects, especially if the defects are localized and accessible, or simple refurbishment of the restoration if the defects are superficial.14,15 The main advantage of such approaches to the management of limited defects in restorations is the avoidance of unnecessary removal of intact tooth tissue, leaving restored teeth more able to withstand loading in function and, as a consequence, an improved prognosis. Furthermore, a replacement restoration is always larger than the one replaced, and larger restorations perform less well in clinical service than smaller restorations. Notwithstanding the benefits of restoration repair, restoration replacement may be inevitable when a restoration is undermined by extensive caries or in the presence of cracked cusps adjacent to the existing restoration. Such cracks are not detectable on radiographs and often asymptomatic, even when the crack is quite advanced. In such cases, removing the entire restoration facilitates detection of cracked cusps where the crack typically propagates from the internal line angles of existing restorations.
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