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08 May 2019

Dental restoration: When and Why are they redone?

Simona Chirico


Survival of dental restorations presents temporal limits, despite the improvement of oral health education and the diffusion of fluoride treatments. Sooner or later, to be restored due to:

  • marginal defects; 
  • secondary caries;
  • fracture of the restoration; 
  • fracture of the tooth; 
  • discoloration and aesthetic inadequacy.  

MATERIALS AND METHODS 
In a review published in the Journal of Dentistry of May 2018, the authors studied the percentage of restorations redone, analyzing their motivations and duration. The studies included in the review were identified using electronic databases, until September 2017.Studies based on the Mjör protocol were selected, in which dentists were asked to complete a proforma each time a patient presented himself for a new restoration or for a restoration to be replaced. The dentists were asked to record all the restorations performed before and after 1998, in which they indicated if the restorations were done for the first time or second time.  

RESULTS
Twelve studies were included in the final review.  Before 1998, 32.697 restorations were performed: 44% were primary and 56% secondary restorations. After 1998, 54.023 restorations were performed: 42% were primary and 58% secondary restorations.
Comparing the review periods, there was a reduction in the use of amalgam from 65% (pre-1998) to 35% (post-1998), with a corresponding increase of resin composites from 43%  to 57% in the same period. 
Secondary caries has proved to be the most common cause of restoration replacement (59%).  

CONCLUSIONS
The redone of dental restorations concerns, at present, even more than half of the primary restorations, despite the strengthening of dental prevention maneuvers, patients education to the maintenance of oral health and the improvement of techniques and materials used by dentists.


For additional informations: 
An update on the reasons for placement and replacement of direct restorations

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