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Reparative Dentistry: Possibilities and Limitations.

Igor Robert Blum1, Mutlu Özcan2

  • 11King's College Hospital & King's College London Dental Institute, Division of Primary Dental Care and Maurice Wohl Dental Centre, Department of Restorative Dentistry, University of London, Bessemer Road, Denmark Hill, London, SE5 9RS UK.

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Restoring defective dental work by repairing it, instead of replacing it, offers similar survival rates and avoids unnecessary tooth structure removal. This minimally invasive approach enhances restoration longevity and reduces the need for further dental procedures.

Keywords:
AdhesionMinimally invasive dentistryRepairRestorative dentistry

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Area of Science:

  • Dentistry
  • Minimally Invasive Procedures
  • Restorative Dentistry

Background:

  • Defective dental restorations are common in general practice.
  • Replacement often involves sacrificing sound tooth structure, potentially harming pulp vitality and accelerating restoration cycles.
  • Advances in adhesive dentistry promote minimally invasive 'reparative dentistry'.

Purpose of the Study:

  • To highlight the detrimental biological effects of routine restoration replacement.
  • To provide an overview of current knowledge on restoration repair as a safe and effective alternative.
  • To advocate for repair as a key component of minimally invasive dental care.

Main Methods:

  • Literature review of clinical studies on dental restoration repair versus replacement.
  • Analysis of survival outcomes and clinical acceptability over time.
  • Evaluation of the impact on subsequent dental interventions.

Main Results:

  • Repaired restorations demonstrate comparable survival outcomes to replaced restorations in low and medium caries risk patients over a 12-year follow-up.
  • Repaired restorations are clinically acceptable and associated with a lower incidence of endodontic treatment or extraction.
  • Evidence supports repaired restorations as a viable alternative to replacement.

Conclusions:

  • Restoration repair should be prioritized as a minimally interventional procedure to maximize the longevity of restorations and teeth.
  • Restoration replacement should be reserved as a last resort when no other viable options exist.
  • Embracing reparative dentistry aligns with minimally invasive principles and improves patient outcomes.