Thesis
Repair Versus Replacement of Defective Restorations: A Cross-Sectional Study Among US Dentists
University of Iowa
Master of Science (MS), University of Iowa
Spring 2020
DOI: 10.17077/etd.005489
Abstract
Objectives:
Although minimally invasive dental procedures, such as restoration repairs, increase the longevity of the restored tooth, limited data exists pertaining to dentists’ attitudes and acceptance of this procedure. Therefore, the study objectives were to: 1- assess the acceptance of dental restoration repair; 2-determine the main variables related to restoration repair versus replacement; 3- identify the most common materials and surface treatments used for dental restoration repair.
Material and Methods:
A 15-item questionnaire was developed and then distributed electronically to the American Dental Association Clinical Evaluators (ACE) panel members (n=785) using Qualtrics after IRB approval was received. The survey was distributed twice in a period of two weeks in August 2019. Descriptive statistics, bivariate and multivariate analyses were conducted.
Results:
421 respondents completed the survey (unadjusted response rate=54%). In this study we included only the general dentists’ responses, which were 387 (91.9%) out of the 421. Of the respondents, 83.7% stated that they repair defective restorations, while 16% always replace defective restorations. Dentists forego a restoration repair usually due to defect size and depends on the caries lesion extension (42% of other) and negative personal experience/lack of success (37.9%). Respondents were likely to repair a defective restoration due to limited patient finances (67.08%) followed by whether a patient has a compromised health status (41.3%). Nearly half of the respondents (49.7%) reported they were more likely to replace a defective restoration if it was placed by another dentist, while the other half (48%) reported that this did not affect their decision. The most frequently (86%) cited condition for repairing a restoration was to repair a non-carious marginal restoration defect. Using resin composite to repair composite restoration was selected by 98.4% of the respondents, while 45.3% used composite to repair amalgam restorations. Prior to repairing composite restorations 33% of respondents use air abrasion as surface treatment versus 23% prior repairing amalgam restorations.
The study found that 85.5% of the male dentists’ repair restorations and 78.4% of the females repair restorations, which was not statistically significant (p-value = 0.13). The age group of practitioners was found to be significantly associated with the practice of restoration repair (p-value = 0.005). Younger dentists performed repairs at lower rates compared to other age groups.
The study found a significant association between the practitioner's practice setting and their practice of restoration repair (p-value = 0.0001). Of those who were employees, associates or contractors in dentist-owned or corporate settings, 64% performed repairs, while over 80% of all the other practice settings (partner, solo, and other) repaired restorations. There were significant differences in the dental practitioners’ perception of the longevity of repair versus replacement of defective restoration by age group (p-value <0.05) and by practice setting (p-value = 0.02). Older dentists (50 years and above) tend to think the results from both repair and replacement of restorations are comparable, while dentists in partner, solo, and other settings perceived the two methods as comparable more than those in employee/associate/contractor settings. There was no significant relationship between age and decision to repair when controlling for practice type, (p-value = 0.4). However, when controlling for age, there is a relationship between practice setting and repair (p-value = 0.01). In all age groups, employees/associates/contractors tended to replace rather than repair restorations at higher-than-expected rates.
Conclusion:
The majority of respondents perform restoration repair as a treatment option for managing defective restorations for both composite resin and amalgam dental restorations. The defect size and the presence of caries were also important when considering restoration repair. Practice setting significantly affected the dentists’ decision. Dentists who work in large practice settings were less likely to perform repair than those in other practice’s settings.
Details
- Title: Subtitle
- Repair Versus Replacement of Defective Restorations: A Cross-Sectional Study Among US Dentists
- Creators
- Wafaa Waddah Y Kattan
- Contributors
- Erica Teixeira (Advisor)Sandra Guzman-Armstrong (Committee Member)Justine Kolker (Committee Member)Michelle Renee McQuistan (Committee Member)
- Resource Type
- Thesis
- Degree Awarded
- Master of Science (MS), University of Iowa
- Degree in
- Oral Science
- Date degree season
- Spring 2020
- Publisher
- University of Iowa
- DOI
- 10.17077/etd.005489
- Number of pages
- xiv, 86 pages
- Copyright
- Copyright 2020 Wafaa Waddah Y Kattan
- Language
- English
- Description bibliographic
- Includes bibliographical references (pages 84-86).
- Public Abstract (ETD)
The placement of a filling (or restoration) is a common procedure in most dental offices. However, restorations might eventually fail for different reasons, such as: recurrent decay around an existing restoration, broken part of a restoration, and/or superficial discoloration. Replacing the entire restoration can have a number of consequences. One of the most negative aspects of replacing the entire restoration is the removal of more tooth which can result in weakening the tooth structure as well as irritation of the tooth nerve. This can be avoided in some situations by performing a repair when the repair does not interfere with the stability of the whole filling or weakens the tooth. This procedure is defined as the specific preparation of the defect (due to decay, broken parts, and/or superficial discoloration), and repairing it without removing the existing restoration and minimizing tooth structure removal.
It is unknown at this time how dentists perceive the repair of dental restorations. Five studies were done in the United States evaluating if dentists perform this type of procedure, and four out these studies were completed among one group which is the Dental Practice-Based Research Network (DPBRN). They concluded that dentists were more likely to replace the entire filling than repair it.
The aims of this study were to: 1- assess the acceptance of dental restoration repair; 2- to determine the main factors related to restoration repair versus replacement; and 3- identify the most common materials and surface treatments used for dental restoration repair. Our findings indicated that most of the dentists accept repair of defective restorations as a treatment option rather than replacing the whole restoration. The most common reason among dentists who replace restorations instead of repairing them was the lack of success of the repair or the negative experience among the dentists about the repair treatment. There was some patient related and dentists’ factors that influenced the dentists’ decision toward repair instead of replacing the defective restoration, such as: if the restoration was placed by a different dentist, limited patient finance, or if the patient has compromised health. Moreover, the defect size and the extension of the caries were limiting factors when considering restoration repair.
- Academic Unit
- Oral Pathology, Radiology and Medicine
- Record Identifier
- 9983949690902771
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