Placement and replacement of composite restorations in Germany

From 15 September to 15 October 1991, 102 dentists practicing in a rural area of Germany provided information on 3375 composite resin fillings. The purpose of this cross-sectional study was to record the reasons for placement and replacement of composite resin restorations, including any change of material when replacing a filling, and to register the age of any failed restoration. First placements because of primary caries were made in 50.6% of all cases; 49.4% were replacements of failed restorations. Composite resins were used as a material for the first placement of a restoration in 19.2% of primary teeth and in 47.8% of permanent teeth. More amalgams were replaced by composites than vice versa. Secondary caries was the most frequent reason for replacement in permanent teeth and in restorations with less than four surfaces, whereas fracture caused most failures in primary teeth and in fillings with four surfaces. The median age of the replaced restorations was 43.5 months. Failed restorations with four surfaces had the lowest median age.