Pain after filling

[Kingsley2019]

Hi,

Please give your thoughts on what may be causing pain.

Case:
UL7 shallow occlusal composite filling, first done 6 years ago.

Since having the filling done, patient has pain only on biting something hard on the filling or when directly pushing against the filling with her finger, though no pain on touching the tooth itself with the finger. The pain is very acute, sharp and shooting type pain, but short lived, with no dull ache or throbbing. There is no discomfort with cold, hot or sweet things. It has been like this for the last 6 years.

The filling has been redone by 3 different dentists approximately 4 times, there is no obvious fracture line in the tooth , and this has been checked with a microscope once the filling is removed. The filling is also not high, and has been adjusted out of the occlusion.

The composite filling was replaced with a temporary zinc oxide eugenol filling and the pain went completely. After 4 months, a permanent composite was again placed, and the pain symptoms returned. The tooth is not tender to percussion and responds perfectly normally to cold test. There is no pocketing around it.

Aside from a possible fractured tooth (which seems unlikely given the very small size of the filling), I cannot think what may be causing the pain.

Any thoughts on possible reasons for the pain?

I have attached a copy of a recent bitewing I took.

Thank you,

Kingsley

 

[honestdoc]

Unfortunately all composite materials shrink about 1 to 1.5% during light curing. This can cause micro stresses between the bonding and tooth structure. Have your dentist use Fuji Equia final glass ionomer restorative material or better yet (more expensive to the dentist) Activa bioactive restorative material from Pulpdent.

 

[MattKW]

Sometimes the smaller composites can be more troublesome than incrementally filled larger composites. The fact that you got relief using a temp ZnO is a good sign. Also consider a amalgam with a Dycal or GIC lining.

 

[Butterfly5]

Dear Kingsley

Were you able to solve your problem? If so, how?

Thank you very much