Objective: The study aim was to identify the materials used to repair or replace failed restorations in Dental Practice-Based Research Network (DPBRN; www.DentalPBRN.org) practices and to determine which materials are more strongly associated with the decision to repair or replace. Methods: This cross-sectional study used a consecutive patient/restoration recruitment design. DBPRN practitioner-investigators recorded data for 50 or more restorations that needed repair or replacement on permanent tooth surfaces. 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, and Sweden).
Results: Data about the material in the existing restoration repaired or replaced were available from 8,431 restorations in 4,726 patients treated by 163 practitioner-investigators. Amalgam was the most common material present in defective restorations (AM=55%, n=4553), followed by direct resin-based composite (DRBC=35%, n= 2887). Less-common materials were metal ceramic (MC=5%, n=389), gold (GD=2%, n=187), glass ionomer (GI=2%, n=154), porcelain/ceramic (PC=1%, n=82), and indirect resin-based composite (IRBC< 1%, n=16). When multiple materials were present in the existing restoration, they were classified based on the material with the highest likelihood of failure (e.g., AM-GD was classified as AM). The existing material differed significantly as to whether the restoration was repaired or replaced (p=.001). GD (51%), PC (42%), MC (34%), and DRBC (30%) restorations were the most likely to be repaired instead of replaced, whereas GI (25%), AM (19%) and IRBC (19%) restoration were the least likely to be repaired instead of replaced entirely.
Conclusion: The decision to repair or replace a defective restoration was associated with the restorative material that was present in the existing restoration.