Figure 1: Failure of aproximal part of a three surface restoration (case 1)

Repair is the best treatment for defective restorations, most dentists in the Public Dental Service in Norway argue. In a questionnaire study from NIOM and University of Oslo, in which a selection of clinical cases with failed restorations were presented, up to 90 % of the respondents favoured repair rather than replacement of the restoration. The concept of “Minimal Intervention Dentistry” has been widely adopted by Norwegian dentists, the study concludes.

The dentists were asked to consider the best treatment for three different clinical patient cases with tooth/restoration fractures (Fig. 1-3). Repair was suggested by 90 % for case 1 and by 87 % for case 2. More than half the dentists (54 %) preferred composite repair for a fractured cusp of a bicuspid (case 3).

Figure 2: Fracture of the distobuccal cusp of a highly restored lower molar (case 2)

To guide the dentist, the survey offered the following treatment alternatives: repair with resin composite restorative material; replacement of the restoration with resin composite; replacement with ceramic restoration (CAD/CAM or dental technician); replacement with gold cast inlay; and full crown therapy.

Application of an acid etch and a bonding agent on the old restoration prior to repair was used by 83 % of the respondents. Eight of 10 dentists also created extra macro-mechanical retention prior to repair. The use of a silanizing agent, which has been suggested to improve repair bond strength, was used by only 7 %.

Figure 3: Fracture of palatal cusp of upper premolar with remaining three surface composite restoration
(case 3)

These results came from a study using a pre-coded
questionnaire sent electronically to all dentists in the Public-Dental-Service (PDS) in Norway. The response rate was 56 %, (70 % females and 30 % males). The respondents’ age varied from 25 – 77 years (average 41.8 years).

Read more
Repair of defective composite restorations. A questionnaire study among dentists in the Public Dental Service in Norway.
Staxrud F, Tveit AB, Rukke HV, Kopperud SE.
J Dent. 2016 ;52:50-4.