Dental Case Analysis: Multiple Damaged Fillings with Active Decay

Case Overview

The image shows posterior molars with old metallic (amalgam) restorations. The fillings appear fractured and poorly adapted, with visible secondary decay and food impaction between teeth. This indicates structural weakening and progressive deterioration.

Zoom 100% Visual Examination

Observed Findings

• Multiple molars with old amalgam (silver) fillings

• Marginal breakdown around restorations

• Visible brown decay between teeth

• Possible enamel fracture near filling edges

• Food debris accumulation

• Gum tissue mildly inflamed

• Narrow interproximal contact areas

Diagnosis

Primary Diagnosis

• Failing multiple amalgam restorations

Secondary Diagnosis

• Secondary (recurrent) caries

• Interproximal decay

• Structural compromise of tooth walls

Clinical Interpretation

Old amalgam restorations may:

• Expand and cause microfractures

• Allow bacterial leakage

• Trap food in open margins

• Weaken surrounding enamel

If untreated, decay may extend into dentin and pulp.

Treatment Objective

• Remove failing restorations

• Eliminate all infected tooth structure

• Reinforce tooth integrity

• Prevent nerve infection

• Restore proper bite alignment

Treatment Process to Execute

Step-by-Step Plan

1. Comprehensive clinical examination

2. Bite analysis

3. Dental X-rays to assess depth of decay

4. Removal of old fillings

5. Caries excavation

6. Treatment options:

   • Composite restoration for moderate damage

   • Onlay for cusp reinforcement

   • Crown for severely weakened teeth

   • Root canal treatment if pulp involvement exists

7. Occlusal adjustment and polishing

Healing and Recovery Timeline

First 14 Days

• Mild sensitivity to temperature

• Bite adjustment adaptation

• Gum inflammation begins improving

After 14 Days

• Stable chewing comfort

• Reduced bacterial load

• Structural stability restored

Healing depends on whether root canal or crown is required.

If Treatment Is Delayed

Issues That May Scale Up

• Deep pulp infection

• Severe toothache

• Tooth fracture

• Dental abscess

• Bone involvement

• Tooth loss requiring implant or bridge

Multiple failing fillings increase risk significantly.

Professional Comments

• Restoration margins appear compromised

• Secondary decay likely active

• Multiple teeth require evaluation

• Early intervention prevents complex procedures

Recommendation

Schedule a comprehensive restorative evaluation immediately.

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