title: The decision to repair or replace a defective restoration is affected by who placed the original restoration: findings from the National Dental PBRN.
abstract: OBJECTIVE
  To evaluate how restoration characteristics are associated with the decision to repair or replace an existing restoration. The following hypotheses were studied: dentists who placed the original restoration are more likely to repair instead of replace restorations (H1) that are in molar teeth; (H2) that are in the upper arch; (H3) that have amalgam restorative material; (H4) if a fracture is not the primary reason for the defect; and (H5) when the restoration comprises more than one surface.
  
  
  METHODS
  This cross-sectional study used a consecutive patient/restoration recruitment design. 194 dentists members of a dental practice-based research network recorded data on restorations in permanent teeth that needed repair or replacement.
  
  
  RESULTS
  For 6623 of the 8770 defective restorations in 6643 patients, the treatment was provided by the dentist who had not placed the original restoration (75%). The 2-way interaction revealed that dentists who had placed the original restoration often chose to repair when the defective restoration was in a molar, relative to premolar or anterior teeth (OR=2.2, p<.001); and chose to replace when the restoration had amalgam (OR=0.5, p<.001), and when it was a fracture compared to another reason (OR=0.8, p=001).
  
  
  CONCLUSIONS
  Most dentists are not conservative when they revisit a restoration that they originally placed regardless of type of failure, number of surfaces or material used. However, dentists who had placed the original restoration were significantly more likely to repair it when the defective restoration was in a molar tooth.
  
  
  CONCLUSIONS
  Most dentists who placed the original restoration were prone to replace it, however if the defective restoration was located in a molar tooth they would consider repairing it.
authors.affiliation: Department of Restorative Dental Sciences, Division of Operative Dentistry, University of Florida, Gainesville, FL, United States. Electronic address: vgordan@dental.ufl.edu.
authors.forename: Valeria V
authors.initials: VV
authors.lastname: Gordan
authors.affiliation: Department of Community Dentistry and Behavioral Sciences, University of Florida, Gainesville, FL, United States.
authors.forename: Joseph
authors.initials: J
authors.lastname: Riley
authors.affiliation: Department of Restorative Dental Sciences, Division of Operative Dentistry, University of Florida, Gainesville, FL, United States.
authors.forename: Saulo
authors.initials: S
authors.lastname: Geraldeli
authors.affiliation: Department of Biostatistics, Florida International University, Miami, FL, United States.
authors.forename: O Dale
authors.initials: OD
authors.lastname: Williams
authors.affiliation: Apollo Beach, FL, United States.
authors.forename: Joseph C
authors.initials: JC
authors.lastname: Spoto
authors.affiliation: Department of Clinical and Community Sciences, School of Dentistry, University of Alabama at Birmingham, Birmingham, AL, United States.
authors.forename: Gregg H
authors.initials: GH
authors.lastname: Gilbert
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D055812:Community-Based Participatory Research; D003188:Composite Resins / Q000737:chemistry; D003430:Cross-Sectional Studies; D003657:Decision Making; D003723:Dental Amalgam / Q000737:chemistry; D003731:Dental Caries / Q000628:therapy; D003764:Dental Materials / Q000737:chemistry; D017269:Dental Prosthesis Repair; D019232:Dental Restoration Failure; D003793:Dental Restoration, Permanent; D003815:Dentists / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008437:Maxilla; D008875:Middle Aged; D008963:Molar / Q000473:pathology; D019233:Retreatment; D013499:Surface Properties
chemical_list: D003188:Composite Resins; D003764:Dental Materials; D003723:Dental Amalgam
keywords: Decision; Defective; Practice-based research; Repair; Replacement; Restorations