Restorative material and other tooth-specific variables associated with the decision to repair or replace defective restorations: Findings from The Dental PBRN

Abstract

Objectives Using data from dentists participating in The Dental Practice-Based Research Network (DPBRN), the study had 2 main objectives: (1) to identify and quantify the types of restorative materials in the existing failed restorations; and (2) to identify and quantify the materials used to repair or replace those failed restorations. Methods This cross-sectional study used a consecutive patient/restoration recruitment design. Practitioner-investigators recorded data on consecutive restorations in permanent teeth that needed repair or replacement. Data included the primary reason for repair or replacement, tooth surface(s) involved, restorative materials used, and patient demographics. Results Data for 9,875 restorations were collected from 7,502 patients in 197 practices for which 75% of restorations were replaced and 25% repaired. Most of the restorations that were either repaired or replaced were amalgam (56%) for which most (56%) of the material used was direct tooth-colored. The restorative material was 5 times more likely to be changed when the original restoration was amalgam (OR=5.2, p<.001). The likelihood of changing an amalgam restoration differed as a function of the tooth type (OR=3.0, p<.001), arch (OR=6.6, p<.001); and number of surfaces in the original restoration (OR=12.2, p<.001). Conclusion The probability of changing from amalgam to another restorative material differed with several characteristics of the original restoration. The change was most likely to take place when (1) the treatment was a replacement; (2) the tooth was not a molar; (3) the tooth was in the maxillary arch; and (4) the original restoration involved a single surface.

Survival time of direct dental restorations in adults

“…Dental amalgam and composite resin were the most frequently used materials in this study 22,23 and the fact that most of the restorations were placed with composite resin confirms the worldwide trend of using composites as a universal restorative material (for anterior and posterior teeth). The growing desire of individuals for aesthetic materials also contributes to the increase in the use of composites 7,[24][25][26][27] .…”

The Management of Defective Resin Composite Restorations: Current Trends in Dental School Teaching in Japan

“…The challenge for clinicians becomes that of deciding when intervention is required and what form this intervention should take. 23 The traditional approach to the management of restorations exhibiting signs of marginal deterioration (defective margins) or secondary caries as diagnosed clinically has been total restoration removal and replacement. This approach is based on the long-held premise that restorations with defective margins suffer damaging leakage and that lesions of caries formed at the margins of restorations adversely affect the tooth restoration interface down to and including the base of the cavity.…”

Do socioeconomic determinants affect the quality of posterior dental restorations? A multilevel approach

“…26 Following this trend, recent data from this cohort and from other studies have shown in the last decade an increase of both use and teaching of composite in comparison with amalgam. [27][28][29][30] In the present study, the overall failure rates for composite and amalgam were 9.36 and 12.20, respectively, and these differences were significant only in the bivariate analysis, losing the significance when multilevel analysis was performed.…”