Abstract
Background
Clinicians often encounter defective restorations and are faced with the difficult
decision of whether to repair the existing restoration or replace it.
Methods
An electronic survey on repairing or replacing defective restorations was developed
to assess how clinicians are making these decisions and the technical aspects considered
when making a repair. E-mails containing the survey link were sent to the American
Dental Association Clinical Evaluators (ACE) Panel on August 14, 2019, and the survey
remained open for 2 weeks. Nonrespondents were sent reminders 1 week after deployment.
Results
Approximately 4 of every 5 respondents repair defective restorations. The top 3 conditions
for making these repairs were noncarious marginal defects (87%), partial loss or fracture
of the restoration (79%), and crown margin repair due to carious lesions (73%). Among
respondents who repair defective restorations, almost all repair direct resin composite
(98%), whereas approximately one-third do not repair the other restorative materials
(that is, amalgam, glass ionomer, and fractured indirect all-ceramic crowns). Resin
composite is used most often to repair resin direct composite restorations, and likewise,
glass ionomer is used most often to repair glass ionomer restorations. Only 54% of
respondents use amalgam to repair amalgam restorations. Surface treatments varied
among the 3 available restorations types.
Conclusions
Many dentists are actively making restoration repairs, but choosing clinical scenarios
to make these repairs is material dependent.
Practical Implications
The repair of defective restorations is an acceptable and more conservative alternative
than restoration replacement, and its success depends on proper case selection, material,
and technique.
Article Info
Footnotes
∗ This question allowed for multiple answers.
† Thirty-one percent of respondents do not use a surface treatment when repairing amalgam restorations, 2% when repairing direct composite restorations, and 4% when repairing fractured indirect all-ceramic crown restorations.
Copyright © 2021 American Dental Association. Unlike other portions of JADA, the print and online versions of this page may be reproduced for in-office use by dental practices and for educational purposes by dental schools without reprint permission from ADA Publishing. Any other use, copying, or distribution of this material is prohibited without prior written consent of ADA Publishing.
Disclaimer. ADA Clinical Evaluator (ACE) Panel Report content is for informational purposes only, is neither intended to nor does it establish a standard of care or the official policy or position of the American Dental Association, and is not a substitute for professional judgment, advice, diagnosis, or treatment.
Acknowledgments. Wafaa Kattan, DDS, and Erica Teixeira, DDS, MS, PhD, from the University of Iowa for their contributions to the survey production, and Ana K. Bedran-Russo, DDS, MS, PhD, Nate Lawson, DMD, and Jacob Park, DDS.
This article has an accompanying online continuing education activity available at: https://ebusiness.ada.org/education/viewcourse.aspx?id=509.
Identification
DOI: https://doi.org/10.1016/j.adaj.2021.01.011
Copyright
© 2021 American Dental Association. All rights reserved.
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