Repair or replacement of restorations: do we accept built in obsolescence or do we improve the evidence?
BACKGROUND
Controversy surrounds decisions on whether to repair or replace defective dental restorations. The concept of built-in obsolescence, ie periodic replacement of dental restorations, is largely accepted as the modus operandi if not the default mode in restorative care. In this article we examine the current best available evidence underpinning the effectiveness of replacement versus repair of direct amalgam and resin composite restorations.


METHODS
This article builds on two recent Cochrane systematic reviews which have reported on the evidence base supporting the effectiveness of replacement versus repair of amalgam and direct resin composites and translates the results of their research conclusions into recommendations for the dental clinician.


RESULTS
As no relevant randomised controlled trials (RCTs) were identified in either of these systematic reviews, the evidence regarding the effectiveness of repair versus replacement of amalgam and composite restorations is weak and incomplete. The evidence as it currently stands seems to favour repair over replacement, but this is insufficient to make firm recommendations.


CONCLUSIONS
In view of the absence of high level evidence there is a need for further well designed RCTs. To add value to the evidence base these trials should be conducted in a general practice setting which will strengthen the generalisability and applicability of the research conclusions and enable dentists and patients to make informed decisions.
Sharif
M O
MO
University of Manchester, Manchester, M15 6LP, UK. mohammad.owaise.sharif@googlemail.com
Fedorowicz
Z
Z
Tickle
M
M
Brunton
P A
PA
D003188:Composite Resins / Q000737:chemistry; D003657:Decision Making; D003723:Dental Amalgam / Q000737:chemistry; D003731:Dental Caries / Q000628:therapy; D003764:Dental Materials / Q000737:chemistry; D058250:Dental Restoration Repair / Q000379:methods*; D003793:Dental Restoration, Permanent / Q000379:methods*; D055094:Evidence-Based Dentistry; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D012107:Research Design; D019233:Retreatment; D012196:Review Literature as Topic
D003188:Composite Resins; D003764:Dental Materials; D003723:Dental Amalgam