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Cited by 91Dental materials and restorationsEndodontics and Root Canal TreatmentsDental Health and Care Utilization

How Dentists Diagnose and Treat Defective Restorations: Evidence from The Dental Practice-based Research Network

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Gordan, V. V., Garvan, C. W., Richman, J. S., Fellows, J. L., Rindal, D. B., Qvist, V., Heft, M. W., Williams, O. D. +2 more·2009·Operative Dentistry
DOI 10.2341/08-131-cPMC PMC2843503
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Abstract

SUMMARY: Objectives: To (1) identify and quantify the types of treatment that dentists use to manage defective dental restorations and (2) identify characteristics that are associated with these dentists' decisions to replace existing restorations. The Dental Practice-Based Research Network (DPBRN) consists of dentists in outpatient practices from five regions: AL/MS: Alabama/Mississippi; FL/GA: Florida/Georgia; MN: dentists employed by HealthPartners and private practitioners in Minnesota; PDA: Permanente Dental Associates in cooperation with Kaiser Permanente's Center for Health Research and SK: Denmark, Norway and Sweden. Methods: A questionnaire was sent to all DPBRN practitioner-investigators who reported doing some restorative dentistry (n=901). Questions included clinical case scenarios that used text and clinical photographs of defective restorations. Dentists were asked what type of treatment, if any, they would use in each scenario. Treatment options ranged from no treatment to full replacement of the restoration with or without different preventive treatment options. The authors of the current study used logistic regression to analyze associations between the decision to intervene surgically (repair or replace) and the specific dentist, practice and patient characteristics. Results: A total of 65% of dentists would replace a composite restoration when the defective margin was located on dentin and 49% would repair it when the defective margin was located on enamel. Most (52%) dentists would not intervene surgically when the restoration in the scenario was amalgam. Dentists participating in a solo or small private practice (SPP) chose surgical intervention more often than dentists participating in large group practices (LGP) or in public health practices (PHP) (p<.0001). Dentists who do not routinely assess caries risk during treatment planning were more likely to intervene surgically and less likely to choose prevention treatment (p<.05). Dentists from the SK region chose the “no treatment” option more often than dentists in the other regions. Conclusions: Dentists were more likely to intervene surgically when the restoration was an existing composite, compared to an amalgam restoration. Treatment options chosen by dentists varied significantly by specific clinical case scenario, whether the dentist routinely performs caries risk assessment, type of practice and DPBRN region.

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  • Clinicians still do not routinely consider the repair or sealing of restorations as a viable treatment option for defective restorations.

    “clinicians still do not routinely consider the repair or sealing of restorations as a viable treatment option for the treatment of defective restorations [38-43].”

    From Translating research into everyday clinical practice: Lessons learned from a USA dental practice-based research network (2013) · cites this paper as [40]

    The Results (page unavailable) report that 65% of surveyed dentists would replace a composite restoration with a defective dentin margin, supporting reluctance to repair in that scenario. But 49% would repair one with a defective enamel margin, so the broader claim that clinicians do not routinely consider repair is overstated. These passages do not establish how routinely dentists consider sealing. (LLM, conf=0.84)

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  1. [35]Lundeen TF Roberson TM Sturdevant CM Roberson TM Heymann HO Sturdevant JR Cariology: the lesion, etiology, prevention, and control The Art and Science of Operative Dentistry 1995 St Louis, Missouri Mosby 60 128

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Authors
Gordan, V. V., Garvan, C. W., Richman, J. S., Fellows, J. L., Rindal, D. B., Qvist, V., Heft, M. W., Williams, O. D., Gilbert, G. H., & _, _.
Affiliations
  • University of Florida Health (US)
  • University of Florida (US)
  • University of Alabama at Birmingham (US)
  • Kaiser Permanente (US)
  • HealthPartners (US)
  • University of Copenhagen (DK)
Corresponding author
Gordan, V. V.
ORCID
Venue
Operative Dentistry
Publisher
Operative Dentistry
Published
2009-11
Volume
34
Issue
6
Pages
664-673
ISSN
  • 0361-7734 (ISSN-L)
  • 1559-2863
DOI
10.2341/08-131-c
PMC
PMC2843503
OpenAlex
W2069426592
Cited by
91
References
42
Citations by year
2026: 3 · 2024: 4 · 2023: 4 · 2022: 4 · 2021: 6 · 2020: 5 · 2019: 5 · 2018: 9 · 2017: 14 · 2016: 5 · 2015: 8 · 2014: 3 · 2013: 5 · 2012: 11
FWCI
6.59
Type
journal article
Language
en
Open access
Locations
  • Operative Dentistry (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
Funders
  • National Institutes of Health (DE-16746)
  • National Institute of Dental and Craniofacial Research (U01-DE-16746, U01DE016746, U01DE016747)
Topics
  • Health Sciences › Dentistry › Orthodontics › Dental materials and restorations
  • Health Sciences › Dentistry › Oral Surgery › Endodontics and Root Canal Treatments
  • Health Sciences › Dentistry › Periodontics › Dental Health and Care Utilization
Keywords
restoration replacement, restoration repair, composite resin restorations, amalgam restorations, restoration margins, caries risk assessment, dental practice characteristics, dentist decision-making, prophylaxis
MeSH terms
Dental Caries, Dental Restoration, Permanent, Female, Humans, Male, Practice Management, Dental, Surveys and Questionnaires, Dental Restoration Failure, Retreatment, Practice Patterns, Dentists'

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