Repair vs Replacement of Defective Restorations
Author: Dr. David Dickerhoff, DDS, MAGD, FOCOI
In the clinical practice of a dentist, it often occurs that you must re-operate on restorations performed in the past and often can be traced back to secondary caries, marginal defects, discoloration, wear and loss of anatomical structure. The main dilemma that arises is whether to repair only the damaged part or conduct a complete restoration.
In a study published in the Journal of the American Dental Association in September of 2021, the authors asked 785 dentists the question this question, trying to figure out which of the two options they were more inclined to do. The results were that of the 387 respondents, 83.7% said they repair faulty restorations and 16% said that they replace them. The reason that led the dentists interviewed to give up repairing the restoration were the size of the defect and the extent of the carious lesion (42%) and the negative past experience or failure (37.9%).
The most cited patient and tooth condition-related reasons for choosing to repair restorations were the patient’s limited finances (67%) and non-carious marginal defects (86%) respectively.
The conclusions of the article were that restoration repair is considered a valid treatment option for the management of defective restorations. Negative personal experience or lack of success from past cases influences dentists on the decision to repair or replace a defective restoration.
My take on this study besides verifying that repair is a viable option, is that dentists believe in conservative therapy. Ethically, we always try to do what is in the patient’s best interests. When these decisions arise in dealing with our patients, having a discussion about what is best allows us to show this ethical, moral and conservative side to our nature. Having digital radiography and intraoral cameras in each operatory allows me to show my patients at Spring Lake Dental Group the finer points of my decision making.
Open up those questions and have a conversation with your dentist. Informed patients always make the best patients, and your dentist should not be intimidated by your questioning our options.
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