Criteria for the Replacement of Restorations: Academy of Operative Dentistry European Section

Abstract

The replacement of a restoration is one of the most common procedures in dentistry. However, the criteria for such intervention, excluding catastrophic failure and persistent discomfort and pain, continue to be the subject of considerable debate. The decision-making process remains subjective on the part of the treating clinician, while the evidence base for refurbishment and repair rather than replacement for the management of defective and failing restorations continues to grow and strengthen. This article, prepared as an Academy of Operative Dentistry European Section consensus publication, reviews existing criteria for the replacement of restorations and encourages practitioners to shift, if not already doing so, to considering the replacement of a restoration as a last resort rather than as a prudent action to be taken if in any doubt about clinical acceptability. Further research in the area, spanning the risk assessment of defective and failing restorations and new diagnostic tools and processes, together with work to enhance the evidence base of restoration repair vs replacement, would be of immense value.

Should my composite restorations last forever? Why are they failing?

“…The decision after clinically assessing an old restoration can vary from doing nothing, repairing or replacing. 11 The decision-making process is probably the most determinant factor for the longevity of restorations. In the past, most studies would concentrate on the clinical performance of different composite materials.…”

Clinical evaluation of direct and indirect resin composite veneer restorations: 1 year report

“…Before applying the second composite layer, the first increment's bonding site was treated as follows: grinding with 1,000-grit silicon-carbide (SiC if not removed by polishing, can also cause marginal discoloration. 34 For these reasons, more attention was paid to the finishing and polishing procedures of the restorations.…”

Understanding the interaction of resin composite with light for predictable aesthetic results in anterior teeth: A case report

“…On the other hand, it is well known that these restorations might fail at some point due to the adhesive failure by hydrolytic and enzymatic degradation, pigmentation of restorative materials or teeth, cohesive fracture, microleakage, marginal discoloration, unsatisfactory aesthetic or the sum of all these factors. Thus, regardless of whether restorations are made of resin composite or ceramic, the patients will need to replace them [4][5][6][7][8][9].…”

“…The optical proprerties, mechanical behavior and the adherence presented by resin composites to dental tissues allow conservative approaches with a wide range of indications and long-term permanence in the oral environment as well as promoting health, function, morphology stability and biocompatibility with the surrounding tooth tissues [3,7].…”