Six commonly used composite resin materials and recommended bonding systems were tested to assess shear bond strength at the interface between aged and new composites with and without bonding. Test specimens were aged in water for 60 d before new composite was placed. Shear bond strength was assessed after 22 ± 2 h (Test 1) and after additional ageing by thermocycling (5-55°C/5,000 cycles) (Test 2). After an additional 180 d in water, the aged specimens were randomly divided into three groups to blind the test with respect to the aged composite. New composites were placed on aged specimens (two groups with and one without bonding agent) and thermocycled (Test 3). After 24 h (Test 1), the mean shear bond strength of the test specimens was 21-26 MPa when bonding agents were used, as opposed to 10-15 MPa without bonding agents. After thermocycling (Test 2), the mean shear bond strength was 16-23 MPa with a bonding agent and 17 MPa without a bonding agent. After 180 d in water and subsequent thermocycling (Test 3), the mean shear bond strength was 9-13 MPa with bonding agent and 2-3 MPa when no bonding agent was used. The results of this study therefore indicate that the use of bonding agents significantly improves the quality of composite repair.

Silanising agents increase the bond strength of the resin composite repair.

The idea of "minimal intervention dentistry" seems to have great influence among dentists in PDS (Norway), as they seek to preserve dental hard tissue as much as possible by choosing repair before replacement. No gender differences were observed, but older dentists seem to favour repair compared with the younger dentists.

Amalgam was banned as a dental restorative material in Norway in 2008 due to environmental considerations. An electronic questionnaire was sent to all dentists in the member register of the Norwegian Dental Association (NTF) one year later, to evaluate dentists’ satisfaction with alternative restorative materials and to explore dentists’ treatment choices of fractured amalgam restorations. Replies were obtained from 61.3%. Composite was the preferred restorative material among 99.1% of the dentists. Secondary caries was the most commonly reported cause of failure (72.7%), followed by restoration fractures (25.1%). Longevity of Class II restorations was estimated to be ≥10 years by 45.8% of the dentists, but 71.2% expected even better longevity if the restoration was made with amalgam. Repair using composite was suggested by 24.9% of the dentists in an amalgam restoration with a fractured cusp. Repair was more often proposed among young dentists (p < 0.01), employees in the Public Dental Service (PDS) (p < 0.01) and dentists working in counties with low dentist density (p = 0.03). There was a tendency towards choosing minimally invasive treatment among dentists who also avoided operative treatment of early approximal lesions (p < 0.01). Norwegian dentists showed positive attitudes towards composite as a restorative material. Most dentists chose minimally- or medium invasive approaches when restoring fractured amalgam restorations.