Alternative treatments to replacement of defective amalgam restorations

Longitudinal Results of a 10-year Clinical Trial of Repair of Amalgam Restorations

“…The roughness of the repair group also scored a Charlie in the first year (5.3%), compared with no Charlie in the replacement group, but neither were statistically significant. This performance agrees with Gordan and others, 17 whom after seven years of amalgam repair observation noticed that there were no significant differences between study groups other than deterioration that had begun after the first two years.…”

“…The papers are related to the repair of restorations, 35 and many laboratory and clinical studies have shown that repairing amalgam restorations is possible and successful. 17,25,[36][37][38][39][40] This is the first prospective study that compared repair and replacement of localized restoration defects, and it was observed that both groups presented a similar level of quality after 10 years with the exception of the anatomic form parameter. This is easily explained, because repair included only a partial correction area of the restorations, and it is not possible to recover the total anatomy.…”

“…4,17,25,41 Most of the restorations were assessed as clinically acceptable (Alpha or Bravo) after 10 years, and only a small percentage of restorations showed a Charlie value at the end of the study.…”

“…A revised analysis is necessary to determine whether it is possible to repair the restoration again and increase longevity of the restoration with a minimally invasive additional treatment to recover the Alpha score; however, the Bravo score did not represent a high risk of immediate restoration failure. 17 For this study, limited and localized defects were considered as presence of secondary caries, undercontoured or overcontoured anatomic form, and marginal failures of occlusal, proximal, and cervical areas, clinically and radiographically detected. The accesses for repairing cervical and proximal defects included an occlusal approach in order to obtain complete visibility of the defect, given that the patients were mostly young adults; however, this practice could be different in the case of elderly patients, where probably, given gingival recession, the access to the cervical wall could be made by buccal or lingual faces or directly by the cervical area in some patients who had wide interproximal spaces.…”

“…5,[7][8][9][10][11][12][13][14][15][16] The replacement of failed restorations is the most common treatment in dentistry 10 years after initial placement, and long-term studies have shown that when failure takes place it typically happens within the first 24 months. 17 Dentists frequently replace restorations that could be treated in a more conservative manner. 18,19 When a restoration is replaced, a significant amount of healthy tooth structure is removed and the preparation is subsequently enlarged.…”