Defective amalgam restorations--repair or replace?

Area of Science:

• Dental Materials Science
• Evidence-Based Dentistry
• Clinical Trials Methodology

Background:

• Amalgam restorations are widely used in dentistry.
• Defective amalgam restorations may require repair or replacement.
• Evidence comparing repair versus replacement is limited.

Purpose of the Study:

• To systematically review randomized controlled trials comparing the repair and replacement of defective amalgam restorations in adults.
• To identify high-quality evidence to inform clinical practice and future research.

Main Methods:

• Comprehensive literature search of multiple databases (Cochrane Oral Health Group's Trials Register, CENTRAL, Medline, Embase, BIOSIS, Web of Science, Opengrey).
• Inclusion of randomized controlled trials (including split-mouth studies) on defective molar amalgam restorations in adults.
• Independent assessment of titles, abstracts, and full texts by two review authors.

Main Results:

• The search identified 201 potentially eligible studies.
• Upon full-text review, none of the retrieved studies met the inclusion criteria for this review.
• No published randomized controlled trials were found relevant to the review question.

Conclusions:

• There is a significant lack of high-quality randomized controlled trials comparing amalgam restoration repair versus replacement.
• Methodologically sound randomized controlled trials, adhering to CONSORT guidelines, are urgently needed.
• Future research should also explore patient perspectives on repair versus replacement, including factors like pain, anxiety, time, and cost.