Clinical Decision-Making of Repair vs. Replacement of Defective Direct Dental Restorations: A Multinational Cross-Sectional Study With Meta-Analysis.

Autor: Hatipoğlu Ö; Department of Restorative Dentistry, Recep Tayyip Erdogan University, Rize, Turkey.; Department of Restorative Dentistry, Nigde Omer Halisdemir University, Niğde, Turkey., Martins JFB; ACTA, Amsterdam, The Netherlands., Karobari MI; Department of Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India., Taha N; Department of Conservative Dentistry, Jordan University of Science and Technology, Irbid, Jordan., Aldhelai TA; Department of Orthodontics and Pediatric Dentistry, College of Dentistry, Qassim University, Buraydah, Saudi Arabia., Ayyad DM; Head of the Endodontics Department, Faculty of Dentistry, Al-Quds University, Jerusalem, Palestine., Madfa AA; Department of Restorative Dental Science, College of Dentistry, University of Ha'il, Ha'il, Saudi Arabia., Martin-Biedma B; Universidade de Santiago de Compostela (USC) Rua Entrerríos s/n, A Coruña, Spain., Fernández-Grisales R; Department of Endodontics, School of Dentistry, CES University, Medellín, Colombia., Omarova BA; Dentistry School, Department of Therapeutic Dentistry, S. D. Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan., Lim WY; Department of Restorative Dentistry, National Dental Centre, Singapore, Singapore., Alfirjani S; Department of Conservative Dentistry and Endodontics, University of Benghazi, Benghazi, Libya., Nijakowski K; Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, Poznan, Poland., Sugumaran S; Department of cariology and comprehensive care Dentistry, NYU college of Dentistry, New York, United States.; Department of Conservative dentistry and Endodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India., Petridis X; Department of Endodontics, Section of Dental Pathology and Therapeutics, School of Dentistry, National and Kapodistrian University of Athens, Greece., Krmek SJ; Department of Endodontics and Restorative Dentistry, University of Zagreb School of Dental Medicine, Zagreb, Croatia., Wahjuningrum DA; Department of Conservative Dentistry. Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia., Iqbal A; Department of Restorative Dental Sciences, College of Dentistry, Jouf University, Sakaka, Saudi Arabia., Abidin IZ; Department of Restorative Dentistry, International Islamic University, Kuantan, Malaysia., Intriago MG; Endodontic Department of Dentistry, Universidad Central del Ecuador, Quito, Ecuador., Elhamouly Y; Department of Pediatric and Community Dentistry, Faculty of Dentistry, Pharos University in Alexandria, Alexandria, Egypt., Palma PJ; Center for Innovation and Research in Oral Sciences (CIROS), Faculty of Medicine, University of Coimbra, Coimbra, Portugal.; Institute of Endodontics, Faculty of Medicine, University of Coimbra, Coimbra, Portugal., Hatipoğlu FP; Department of Endodontics, Recep Tayyip Erdogan University, Rize, Turkey.
Jazyk: angličtina
Zdroj: Journal of esthetic and restorative dentistry : official publication of the American Academy of Esthetic Dentistry ... [et al.] [J Esthet Restor Dent] 2024 Nov 02. Date of Electronic Publication: 2024 Nov 02.
DOI: 10.1111/jerd.13321
Abstrakt: Objectives: This web-based survey, conducted across multiple countries, sought to explore the factors that impact the decision-making of clinicians when it comes to managing defective direct restorations.
Methods: A survey consisting of 14 questions was sent out to dentists in 21 countries through various online platforms. The survey consisted of two sections. The first contained five questions about demographic information, while the second involved eight clinical scenarios. In the second part, participants were tasked with deciding whether to repair or replace defective composite and amalgam restorations.
Results: Three thousand six hundred eighty dental practitioners completed the survey. For composite restorations, repair was preferred in scenarios like partial loss or fracture (RR:0.72; 95% CI: 0.58, 0.89; p = 0.002), whereas replacement was favored for secondary caries (RR:2.43; 95% CI: 1.87, 3.16; p < 0.001) and open/defective margins (RR:3.93; 95% CI: 2.68, 5.76;p < 0.001). Amalgam restorations were mostly replaced across all scenarios. The main factors influencing decision-making were caries risk, restoration size, and patient oral hygiene. Substantial heterogeneity was observed across countries.
Conclusion: This study underscores the complexity of the decision-making process and the need for evidence-based guidelines to inform clinicians' decisions regarding restoration management. Patient-level factors predominantly influence decision-making, emphasizing the need for individualized approaches.
Clinical Significance: The study reveals that the material type in the original restoration is a critical determinant, with composite restorations being repaired in specific scenarios, while amalgam restorations are consistently replaced across different countries. Key patient and tooth-level factors, such as high caries risk, poor oral hygiene, and restoration size, significantly impact clinicians' decisions, often favoring replacement over repair. These findings underscore the necessity for evidence-based guidelines to assist clinicians in making informed choices, ultimately enhancing the quality of patient care.
(© 2024 The Author(s). Journal of Esthetic and Restorative Dentistry published by Wiley Periodicals LLC.)
Databáze: MEDLINE
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