Objective: Quantify the reasons for repair or replacement of existing restorations in Dental Practice-Based Research Network (DPBRN; www.DentalPBRN.org) practices.
Methods: This cross-sectional study used a consecutive patient/restoration recruitment design. Practitioner-investigators recorded data for 50 or more enrolled restorations that needed repair or replacement on permanent teeth. DPBRN is a consortium of participating practices and dental organizations mainly from five regions: Alabama/Mississippi; Florida/Georgia; dentists employed by HealthPartners and private practitioners in Minnesota; Permanente Dental Associates in cooperation with Kaiser Permanente Center for Health Research; and Scandinavia (Denmark, Norway, Sweden). Data collected included the primary reason for repair or replacement of the restoration and the type of tooth.
Results: Data about the main reason for failure of the existing restoration were available from 8,406 restorations in 4,793 patients treated by 165 practitioners-investigators. The most common reasons for repair or replacement was secondary caries (43%, n=3590), followed by restoration fracture (28%, n=1326), and ditched margin (8%, n=656). The reason(s) for choosing to replace the entire restoration were pain-sensitivity (95%), restoration discoloration (92%), missing restoration (89%), and patient request (88%). The most common reasons for choosing a repair over a replacement were restoration fracture (29%), secondary caries (29%), and discolored margins (24%). Secondary caries was the most common reason for repair or replacement of restorations in molar teeth (both at 27%). Restoration fracture was the most common reason for repair or replacement in a lower molar (35%). Ditched margin was the most common reason for repair or replacement in a upper molar (29%).
Conclusion: Secondary caries was the most common reason for the repair or replacement of an existing defective restoration and most often occurred on a lower molar.