EVIDENCE-PRACTICE GAP IN TREATMENT DECISIONS ABOUT DEFECTIVE COMPOSITE AND AMALGAM RESTORATIONS AMONG BRAZILIAN...

Area of Science:

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

Background:

• A significant gap exists between scientific evidence and clinical practice regarding the management of defective dental restorations.
• Understanding dentists' decision-making processes is crucial for bridging this evidence-practice gap (EPG).

Purpose of the Study:

• To quantify the evidence-practice gap (EPG) in dentists' treatment decisions for defective restorations.
• To identify dentist-specific factors associated with this evidence-practice gap.

Main Methods:

• 216 dentists in São Paulo State, Brazil, completed a questionnaire presenting three clinical scenarios with defective composite and amalgam restorations.
• Treatment recommendations (preventive, polishing, re-surfacing, repairing, or complete replacement) were assessed.
• Replacement was defined as evidence-inconsistent, constituting an EPG; bivariate analyses were performed.

Main Results:

• Nearly half of dentists opted to replace defective composite restorations (49% and 55% for different margin types).
• 29% of dentists chose to replace defective amalgam restorations.
• Amalgam replacement was significantly more frequent than composite replacement; female dentists and those with caries-prevention-focused patients showed more conservative choices.

Conclusions:

• A substantial evidence-practice gap exists in managing defective restorations, particularly composite ones.
• This study confirms an international EPG in restorative dentistry.
• Global strategies are required to address and close this evidence-practice gap.