The decision to repair or replace a defective restoration is affected by who placed the original restoration: Findings from the National Dental PBRN

Abstract

Objectives To evaluate how restoration characteristics are associated with the decision to repair or replace an existing restoration. The following hypotheses were studied: Dentists who placed the original restoration are more likely to repair instead of replace restorations (H1) that are in molar teeth; (H2) that are in the upper arch; (H3) that have amalgam restorative material; (H4) if a fracture is not the primary reason for the defect; and (H5) when the restoration comprises more than one surface. Methods This cross-sectional study used a consecutive patient/restoration recruitment design. 194 dentists members of a dental practice-based research network recorded data on restorations in permanent teeth that needed repair or replacement. Results For 6,623 of the 8,770 defective restorations in 6,643 patients, the treatment was provided by the dentist who had not placed the original restoration (75%). The 2-way interaction revealed that dentists who had placed the original restoration often chose to repair when the defective restoration was in a molar, relative to premolar or anterior teeth (OR = 2.2, p < .001); and chose to replace when the restoration had amalgam (OR = 0.5, p < .001), and when it was a fracture compared to another reason (OR = 0.8, p = 001). Conclusion Most dentists are not conservative when they revisit a restoration that they originally placed regardless of type of failure, number of surfaces or material used. However, dentists who had placed the original restoration were significantly more likely to repair it when the defective restoration was in a molar tooth.

Repair or replacement of restorations

“…Previous studies showed that restorations that were repaired due to fracture had a lower survival rate than restorations that were repaired due to other reasons 7, 29–30 . Fracture as a reason for failure and amalgam as a restorative material may jointly exert negative influences on the survival of restorations 30 .…”

Repair versus Replacement: A Questionnaire Examining the Repair Preferences of Turkish Dentists in Dental Restorations

“…The probable cause of this difference is that amalgam restorations cannot retain a dental material and tooth surface chemically, but RBCs can be bond each other [22]. In addition, the reason which increased the decision may be that amalgam has not sufficient aesthetic quality compatible with tooth colour [23].…”

Understanding Dental Caries

“…Deciding when and in which way to intervene appears to be inconsistent among dentists as they do not always use objective criteria (Bader and Shugars 1993 ;Gordan et al 2015 ). Deciding when and in which way to intervene appears to be inconsistent among dentists as they do not always use objective criteria (Bader and Shugars 1993 ;Gordan et al 2015 ).…”