Restorations: Do They Need to Be Redone?

I have distinct memories of hearing lectures on the rationale for redoing restorations that included marginal leakage and stain as an indication to redo a veneer or crown. That often included brown stain at the cervical margins of veneers and that “microleakage” would end up in recurrent decay and disaster. That would mean the veneers in the photo should be redone because of the marginal stain. The restorations in the photo need to be redone for other reasons, but let’s just look at the stain.

Do Stained Restorations Indicate a Redo?

The margins in this case are supragingival and the stain is not sticky, nor can an explorer catch the margins or go under a margin. There is no radiographic evidence of decay and there is no evidence that the leakage has spread under the veneer, meaning there is no discoloration. So, should these restorations be replaced on the basis of leakage? One might argue that they should be replaced for esthetic reasons; that the discoloration at the cervical is enough to redo them. That could be true if the patient was really upset or if there is no other way. The truth is that often this stain can be polished away with a routine prophy and if that doesn’t result in complete removal of the stain, there is another way to get rid of it. The simplest – and often least invasive and most effective – method to remove the stain at the margins is simply to fabricate an at-home bleaching tray and give the patient a tube of bleaching gel. They can use it for two weeks and usually that is enough to get rid of the stain. Sometimes the easiest way is the best for the long-term benefit of the patient.