title: 2-year clinical evaluation of alternative treatments to replacement of defective amalgam restorations.
abstract: OBJECTIVE
  To investigate the effectiveness of alternative treatments for replacing defective amalgam restorations through a prospective longitudinal cohort clinical study.
  
  
  METHODS
  Forty-five patients aged 21 through 77 (mean=56) years with 113 defective amalgam restorations, which were independently diagnosed during treatment planning, participated in the study. These patients were assigned to 5 treatment groups: repair (n=20), sealing of defective margins (n=23), refurbishing (n=23), replacement (n=23) and no-treatment (n=24). The replacement and no-treatment groups served as comparison groups and received random assignment. Two clinicians examined the restorations (n=113) prior to and after the assigned treatment and at subsequent recalls, using a modified Ryge Criteria that included marginal adaptation, anatomy, contact, post-operative sensitivity and secondary caries.
  
  
  RESULTS
  At 1- and 2-year recalls, 79 (70%) and 74 (65%) restorations were examined. Kruskal-Wallis Test showed significant differences for marginal adaptation and anatomic form for both 1- and 2- year recall exams (p<.05). The repair and replacement groups had significant differences when compared to the no-treatment group.
  
  
  CONCLUSIONS
  Defective restorations that have a Bravo rating for clinical characteristics other than marginal integrity and anatomical form do not need to be immediately replaced.
authors.affiliation: University of Florida, College of Dentistry, Department of Operative Dentistry, Health Science Center, Gainesville, USA. vgordan@dental.ufl.edu
authors.forename: Valeria V
authors.initials: VV
authors.lastname: Gordan
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Riley
authors.forename: Paul K
authors.initials: PK
authors.lastname: Blaser
authors.forename: Ivar A
authors.initials: IA
authors.lastname: Mjör
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003723:Dental Amalgam / Q000737:chemistry; D001840:Dental Bonding; D003731:Dental Caries / Q000209:etiology; D018772:Dental Marginal Adaptation; D003775:Dental Polishing; D017269:Dental Prosthesis Repair; D019232:Dental Restoration Failure; D003793:Dental Restoration, Permanent / Q000379:methods*; D003807:Dentin Sensitivity / Q000209:etiology; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D019279:Resin Cements / Q000737:chemistry; D019233:Retreatment; D013499:Surface Properties
chemical_list: D019279:Resin Cements; D003723:Dental Amalgam