Attitudes towards and strategies for repair of dental direct restorations: Minimally Invasive Treatment approach

Abstract

Repair of defective dental restorations may often save the patient time, pain and money at the dentists. Repair seem to be good treatment as to the quality of restorations, and preservation of teeth on the long run. Good routines for treatment procedures will be of consequence for the result. DDS Frode Staxrud, lecturer at Dental Faculty, UiO, has in a thesis for the degree Dr. Philos., looked into attitudes among Norwegian dentists towards repair of old dental restorations. Two questionnaires have been carried out, where the amount of and reasons for restoration repair was assayed. The thesis also comprise three in vitro material studies carried out at NIOM (Nordic Institute of Dental Materials, Oslo). They aimed to assess the importance of different methods concerning the repair process. Five research projects, published in scientific journals, constitutes the base of the thesis. The questionnaires show that Norwegian dentists often want to perform minimal invasive repair. The answers ranged from doing as little as necessary, to restorations that are more comprehensive. The conclusion is that the dentists show respect to the patients’ needs and concerns. After the “amalgam ban”, 2008, we wanted to assay Norwegian dentists’ attitudes towards alternative materials. Already in 2009, the general view on composites was positive, although many at that time certainly missed their custom material. The research at NIOM investigated different material properties concerning restoration repair. First, we explored the role of bonding in repair of resin composite restorations. The conclusion is that bonding plays a very important role for the strength of repair interface. Secondly, silanizing agents before bonding, or as an additive, was tested. The conclusion to be drawn is that silanes create important contribution to repair strength. The third experiment tested the repair strength when repairing old amalgam restorations with composite- or glass-ionomer materials. The conclusion was that the latter does not adhere to amalgam at all, and that bonding agents creates moderate bond strength between composite and amalgam. The main conclusion is that repair of defective dental restorations is common among Norwegian dentists and the repair should be reliable when considering the above-mentioned factors