Mistakes in the treatment of caries can occur at every stage starting from the stage of diagnosis and can cause complications (pulpitis, periodontitis), or an esthetic defect (the wrong choice of color fillings, poor shaping of the veneer, poor polishing).
DIAGNOSTIC MISTAKES
The first large group of mistakes are diagnostic errors. Diagnostic mistakes can cause serious complications developing quite rapidly. Diagnosis of caries in cases of chronic periodontitis results in the doctor's only placing a filling in the tooth cavity, although it is necessary to perform root canal treatment. This mistake in diagnosis will lead to a complication - exacerbation of chronic peri-odontitis. To avoid this error, the dentist needs to administer a radiograph. If the doctor diagnosed caries instead of chronic pulpitis, after filling of the tooth there will be a complication - pain syndrome because of pulpitis exacerbation. To avoid this mistake, it is necessary to take into account the findings of past history, to assess electric pulp test and reaction to temperature stimuli.
MISTAKES AND COMPLICATIONS DURING PREPARATION AND FILLING
Mistakes and complications arising during preparation and filling of carious cavity are as follows:
► insufficient preparation of carious cavity;
► perforation of pulp chamber;
► damage of adjacent tooth;
► damaging the gingival margin with a bur, poor contact point;
► placing a single filling in adjacent carious cavities;
► overhanging margin of restoration.
Another large group of mistakes occurs at the stage of preparation and filling.
1. Damage of adjacent teeth may occur during preparation of carious cavities located on the contact surfaces of the teeth, in case when the rules of removing carious cavity on the occlusual surface are disregarded. The degree of damage to the hard tissues of the tooth adjacent to the cavity may vary from a minor defect of the surface layer of the enamel to its complete absence. Slight defects of enamel are treated with fluoride varnish or other fluoride (remineralization) medications. In the presence of enamel defect with disrupted dentinoenamel junction close to the corresponding filling material (preparation of the defect or when composites are used without significant preparation of the hard tissues of the affected neighboring tooth).