This seminar lists the causes of common problems associated with some composite restorations and potential solutions to those problems.

1. CommonProblemswith
CompositeRestorations
(Causes & Potential Solutions)

2. Presinter
MuhammedM.
Nasser

3. Common
Problems
▪ Poor Isolation of the Operating Area
▪ White Line or Halo Adjacent to the
Enamel Margin
▪ Voids
▪ Weak or Missing Proximal Contacts
(Class II, III, and IV)
▪ Inaccurate Shade
▪ Poor Retention
▪ Contouring and Finishing Problems

4. PoorIsolationof
theOperating
Area
❖ Causes:
▪No rubber dam or leaking rubber
dam.
▪Inadequate cotton roll isolation.
▪Careless technique.
▪Preparation so deep gingivally that
the operating area cannot be
isolated.

5. PoorIsolationof
theOperating
Area
❖ Potential solutions:
▪Use of better technique.
▪Use of a matrix to help isolation.
▪Use of a restorative material other
than composite that does not
require bonding.
▪Repeating bonding procedures (if
the area is contaminated).

6. WhiteLineorHalo
Adjacenttothe
EnamelMargin
❖ The following factors cause micro-
fracture of marginal enamel:
▪ Traumatic contouring or finishing
techniques.
▪ Inadequate etching and bonding of
that area.
▪ High-intensity light-curing,resulting in
excessive polymerization stresses.

7. WhiteLineorHalo
Adjacenttothe
EnamelMargin
❖ Potential solutions:
▪ Re-etching, priming, and bonding the
area.
▪ Conservatively removing the defect and
re-restoring.
▪ Using atraumatic finishing techniques
(e.g., light intermittent pressure).
▪ Using soft-start polymerization
techniques.
▪ Leaving as is and monitoring for leakage

8. Voids
❖ Causes:
▪Mixing of self-cured composites
(however, self-cured materials are
rarely used today).
▪Spaces left between increments
during insertion.
▪Tacky composite pulling away from
the preparation during insertion.

9. Voids
❖ Potential solutions:
▪Using a more careful technique.
▪Repairing marginal voids by
preparing the area and re-
restoring.

10. WeakorMissing
ProximalContacts
(ClassII,III,andIV)
❖ Causes:
▪ Inadequately contoured matrix band.
▪ Inadequate wedging, preoperatively and
during the composite insertion.
▪ Matrix band movement during composite
insertion or matrix band not in direct contact
with the adjacent proximal surface .
▪ A circumferential matrix being used when
restoring only one contact.
▪ Tacky composite pulling away from matrix
contact area during insertion n Matrix band
too thick.

11. WeakorMissing
ProximalContacts
(ClassII,III,andIV)
❖ Potential solutions:
▪ Properly contouring the matrix band.
▪ Having the matrix in contact with the adjacent tooth.
▪ Using a firm preoperative and insertion wedging
technique n Using a matrix system that places the
matrix only around the proximal surface to be restored.
▪ Using specially designed, triangular light-curing tips to
hold the matrix against the adjacent tooth while curing.
▪ Using a hand instrument to hold the matrix against the
adjacent tooth while curing the incremental placements
of composite.
▪ Being careful with insertion technique

12. Inaccurate
Shade
❖ Causes:
▪Inappropriate operator lighting
while selecting the shade.
▪Selection of shade after the tooth is
dried.
▪Shade tab not matching the actual
composite shade.
▪Wrong shade selected

13. Inaccurate
Shade
❖ Potential solutions:
▪ Using natural light when selecting shade, if
possible.
▪ Selecting the shade before isolating the
tooth.
▪ Pre-operatively placing some of the selected
shade on the tooth and curing (then
removing).
▪ Not shining the operating light directly on the
area during shade selection.
▪ Understanding the typical zones of different
shades for natural teeth.

14. PoorRetention
❖ Causes:
▪Inadequate preparation form.
▪Contamination of the operating
area.
▪Poor bonding technique.
▪Use of incompatible bonding
materials.

15. PoorRetention
❖ Potential solutions:
▪ Preparing the tooth with appropriate
bevels or flares and secondary
retention feature,when necessary.
▪ Keeping the area isolated while
bonding.
▪ Following the manufacturer’s
directions strictly.

16. Contouringand
Finishing
Problems
❖ Causes:
▪ Injuring adjacent unprepared tooth
structure.
▪ Over-contouringthe restoration.
▪ Under-contouring the restoration.
▪ Ditching cementum.
▪ Creating inadequateanatomic tooth
form.
▪ Dealing with difficult-to-see margins.

17. Contouringand
Finishing
Problems
❖ Potential solutions:
▪ Being careful with the use of rotary instruments to
avoid adversely affecting the structure of the
adjacent tooth or teeth.
▪ Having a proper matrix with appropriate axial and
line angle contours.
▪ Creating embrasures to match the adjacent tooth
embrasure form.
▪ Not using rotary instruments that leave roughened
surfaces.
▪ Using a properly shaped contouring instrument for
the area being contoured.
▪ Remembering the outline form of the preparation.
▪ Viewing the restoration from all angles as it is
contoured.

18. THANK YOU