The Relationship Between Malocclusion and Failure of Dental Restorations

This review article investigates the correlation between malocclusion and the failure of dental restorations, providing a critical synthesis of current evidence to elucidate the underlying biomechanical mechanisms and clinical implications of this association. Scientific data indicate that malocclusion, by disrupting the equilibrium of occlusal forces and generating non-axial and concentrated stress patterns, accelerates restorative material fatigue, marginal microleakage, and the formation of microcracks. These biomechanical alterations not only compromise the longevity and structural integrity of restorations but also influence the supporting periodontal structures, masticatory muscle dynamics, and the temporomandibular joint (TMJ). Different malocclusion patterns—such as crossbite, deep bite, and open bite—modify the trajectory and intensity of occlusal load transmission, thereby altering the mode and location of restorative failure. The mechanical resilience and failure threshold of restorative materials—including amalgam, composite resin, ceramic, and zirconia-based systems—depend largely on occlusal loading conditions and the structural design of the restoration. Thus, clinical success in restorative dentistry relies on the synergistic interaction of three fundamental parameters: appropriate material selection, precise operative technique, and comprehensive occlusal management. In addition, pre- and post-operative occlusal evaluation and adjustment, the use of digital occlusal force analysis systems (such as T-Scan), selection of restorative materials with higher fatigue and fracture resistance in high-stress zones, biomechanically optimized cavity design, and patient education with periodic follow-up are critical strategies for minimizing restoration failure. Despite significant advances in diagnostic technologies and material sciences, notable knowledge gaps persist regarding the precise role of malocclusion in restorative failure. This highlights the necessity for longitudinal investigations and randomized controlled clinical trials aimed at developing evidence-based clinical guidelines for managing restorations in patients with occlusal discrepancies.

کلیدواژه ها:

Malocclusion ، Dental restoration failure ، Restorative materials