Substitution of amalgam restorations: participative training to standardize criteria

Considering that the variations on clinical judgment with respect to replacement of restorations are a problem which affects dentistry, the aim of this study was to elaborate, implement and evaluate a programme of participative training to standardize criteria for the evaluation of amalgam restorations. Five professors of Integrated Clinic of the School of Dentistry of the University of Vale do Rio Doce (UNIVALE), Brazil, visually and radiographically evaluated 28 extracted permanent teeth presenting amalgam restorations. The research was developed in four distinct phases: first--the teeth were evaluated according to individual criteria to determine whether restorations should be replaced or not; second--the examiners participated in a training programme with the objective of standardizing the evaluation criteria; third--soon after the training, the teeth were re-evaluated using the adopted standardized criteria; fourth--five months after the training, the procedures on third phase were repeated. For each restoration the examiners registered the main reason for considering the restoration: satisfactory, requiring total substitution, requiring partial substitution or requiring finishing/polishing. After participating in the training programme the examiners presented a statistically significant reduction (sign test: Z = 0.4989, p = 0.0022) in indicating the need to substitute restorations, result which was maintained five months after training. This programme of participative training can be organized and implemented to standardize the criteria to evaluate amalgam restorations achieving satisfactory results with an impact on clinical practice.