Repair of restorations--criteria for decision making and clinical recommendations

In the last decade, repair of restorations has become more and more popular while teaching repair of restorations is now included in most universities in Europe and North America. The aim of this paper was therefore to systematically review the clinical and the in vitro aspects of repair of restorations by considering different restorative materials--resin-based composites, amalgam, glass-ionomer cements, ceramics or metals. The paper gives also an overview of the occurrences of teaching repair in different universities. Furthermore, the paper outlines criteria for decision making when to treat a defect restoration with refurbishment, repair, replacement or no treatment.

The database search strategy for resin based composite restoration repair (n=360) and the following hand search (n=95) retrieved 455 potentially eligible studies. After de-duplication, 260 records were examined by the titles and abstracts. 154 studies were excluded and 106 articles were assessed for eligibility by analyzing the full texts. Following the same search and selection process, 42 studies for amalgam repair, 51 studies for cast, inlay or porcelain restoration repair and 8 studies for teaching were assessed for eligibility by analysis of the full texts.

Following databases were analyzed: Cochrane Library, MEDLINE, EMBASE, BIOSIS and PUBMED.

Papers were selected if they met the following criteria: replacement, refurbishment or repair of resin composite restorations or amalgam restorations or inlay, cast restoration or porcelain repair. Clinical studies, in vitro studies and reports about teaching were included.

Repair of restoration is a valuable method to improve the quality of restorations and is accepted, practiced and taught in many universities. However, there is a need for methodologically sound randomized controlled long-term clinical trials to be able to give an evidence based recommendation.