20 May 2023

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Defective direct restorations: repair or replacement?

Simona Chirico

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In the clinical practice of a dentist, it often happens that you must re-operate on restorations performed in the past and often the most common causes can be traced back to secondary caries, marginal defects, discoloration, wear and loss of anatomical structure.

The main dilemma that arises is whether to repair only the damaged part or conduct a complete restoration.

So, which is the best solution?

Materials and methods

In a study published in JADA in September 2021, the authors asked 785 American dentists this question, trying to figure out which of the two options they were more inclined to do.

Results

Of the 387 respondents, 83.7% said they repair faulty restorations and 16% said they always replace them.

The reasons that led the dentists interviewed to give up repairing the restoration were:

• the size of the defect and the extent of the carious lesion (42%)
• negative past experience or failure (37.9%)

The most cited patient and tooth condition-related reasons for choosing to repair restorations were the patient's limited finances (67%) and non-carious marginal defects (86%), respectively. Neither gender nor age group was significantly associated with the choice to repair the restoration.

The frequency of choosing to repair the fillings rather than completely redo them was found to be higher in practice owners than in employees or collaborators. The most significant primary reason for giving up on repairing the restoration was the negative experience or lack of success in the past.

Conclusions

Restoration repair is considered a valid treatment option for the management of defective restorations. Negative personal experience or lack of success from past cases influence dentists on the decision to repair or replace a defective restoration.

For more information: "Repair versus replacement of defective direct restorations. A cross-sectional study among U.S. dentists."