Restorative challenges and how to overcome them

Abstract

Restoration of deep carious lesions may be challenging in clinical practice. Many generations of dentists have been trained to remove all weakened carious dentin. This may, however, easily lead to pulp exposure and subsequent endodontic treatment. Especially this type of treatment may weaken a tooth, and it has been documented that endodontically treated teeth are more prone to fracture. New insights in the pathology of caries and the importance of a well-sealing restoration have led to changing treatment concepts. Selective carious tissue removal allows to avoid pulp exposure, but may also compromise the longevity of the restoration, mainly because of mechanical and adhesive reasons. Moreover, residual carious dentin is challenging with regard to radiographic diagnosis. In this chapter, these restorative challenges and possible solutions are discussed.