Two-year clinical evaluation of repair versus replacement of composite restorations

To investigate the effectiveness of alternative treatments to the replacement of resin-based composite (RBC) restorations through a prospective longitudinal cohort clinical study.

Forty patients aged 27 to 77 years (mean=55) with 88 RBC restorations, with one or more features that deviated from ideal, participated in the study. They were assigned to five treatment groups: repair (N=25), sealing of defective margins (N=13), resurfacing (N=18), replacement (N=16), and the no-treatment group (N=16). The replacement and no-treatment groups served as comparison groups and received random assignment. Two clinicians examined the quality of the restorations (N=88) prior to the assigned treatment, and at subsequent recalls (1 and 2 years) using a modified Ryge criteria (Alfa, Bravo, and Charlie, meaning clinically excellent, clinically acceptable with one or more features that deviated from ideal, and clinically unacceptable, respectively) that observed (1) color, (2) marginal adaptation, (3) anatomic form, (4) surface roughness, (5) marginal staining, (6) bulk discoloration, (7) contact, (8) secondary caries, (9) postoperative sensitivity, and (10) luster.

At 1- and 2-year recalls, 66 (75%) and 58 (66%) restorations were examined. Kruskal-Wallis Test showed significant differences for marginal adaptation and marginal staining for both 1- and 2-year recall exams (p < .05). The repair, sealant, and replacement groups presented significant improvement when compared with the no-treatment group for marginal adaptation. The repair and replacement groups showed superior results when compared with the no-treatment group for marginal staining.

RBC restorations that present less-than-ideal marginal adaptation and stained margins are better off being repaired.

Repair of resin-based composite (RBC) restorations is a conservative option for treatment of RBC restorations with inadequate marginal adaptation and marginal staining.