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Clinical Decision-Making of Repair vs. Replacement of Defective Direct Dental Restorations: A Multinational
Ömer Hatipoğlu1,2, João Filipe Brochado Martins3, Mohmed Isaqali Karobari4
1Department of Restorative Dentistry, Recep Tayyip Erdogan University, Rize, Turkey.
Summary
Dentists prefer repairing composite restorations for fractures but replace them for secondary caries or defective margins. Amalgam restorations are generally replaced, with patient factors like caries risk influencing decisions.
Area of Science:
- Dental materials science
- Clinical dentistry
- Restorative dentistry
Background:
- Managing defective direct restorations is complex.
- Clinician decision-making is influenced by various factors.
- International variations in practice exist.
Purpose of the Study:
- To explore factors influencing clinician decisions on managing defective direct restorations.
- To compare decision-making for composite versus amalgam restorations.
- To identify key patient and tooth-level factors impacting management choices.
Main Methods:
- A 14-question online survey was distributed to dentists in 21 countries.
- The survey included demographic questions and eight clinical scenarios.
- Participants decided whether to repair or replace defective composite and amalgam restorations.
Main Results:
- Repair of composite restorations was favored for partial loss/fracture; replacement was preferred for secondary caries and defective margins.
- Amalgam restorations were predominantly replaced across all scenarios.
- Caries risk, restoration size, and patient oral hygiene were key decision-making factors, with significant international heterogeneity.
Conclusions:
- Clinician decisions on restoration management are complex and influenced by patient-level factors.
- Material type significantly impacts repair vs. replacement choices.
- Evidence-based guidelines are needed to support informed clinical decision-making and improve patient care.
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