Longevity of repaired restorations: a practice-based study
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Longevity of repaired restorations: a practice-based study Langlebigkeit von reparierten Restaurationen: Eine praxisbasierte Studie Background: In some cases nowadays, a filling is often repaired rather than entirely replaced. The total replacement of a restoration requires a larger preparation surface and is, thus, associated with a higher risk for pulp complications. Admittedly, repair is gentler on the tooth substance and less expensive, but until now, there has been no clear evidence as to precisely when repair is advisible and when total replacement is the better choice. Many restoration-repair techniques have been tested in vitro, but they play no role in general practice. Of course, a new restoration has a better prognosis than a repaired restoration, as the bond between the new and old restorations is a potential weak point. The most frequent causes of restoration repair are active caries or bruxism, factors that reduce the longevity of all restorations, including those parts that are still intact after years of service. Aim: The present study by Opdam et al. [1] aimed to retrospectively evaluate the influence of repaired restorations on restoration longevity. Materials and methods: In a general practice 1202 amalgam and 747 composite class II (3–5 surface) restorations were implanted, of which 407 failed (amalgam 293; composite 114) during the observation time of up to 24 years. Of the damaged restorations, 161 were totally replaced and 246 fillings were repaired using composite resin. Repairs were completed by etching the preparation with 38% phosphoric acid, rinsing and applying an etch and rinse adhesive system (predominantly Clearfil™ PhotoBond Kuraray, Osaka, Japan) and a hybrid composite (predominantly Clearfil™ PhotoPosterior and Clearfil™ AP-X, Kuraray). The decision to replace or repair was based on the quality of the remaining restoration, the size of the restoration requiring repair, the risk for complications, and procedural difficulty. In addition, the treatment decision was taken after obtaining the informed consent of the patients in which the therapy's potential advantages and disadvantages were explained. Whenever a repaired restoration failed, it was classified as failed, although some restorations underwent repeated repairs. Success was defined as a restoration still in place not having required any intervention; survival was defined as a repaired restoration still functioning without any further intervention. Results: Of the 407 failed restorations (amalgam 293; composite 114), 161 were totally replaced and 246 restorations (amalgam 133; composite 113) were repaired. Of the amalgam-filling replacements 57% were due to tooth fractures, and of the
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J Orofac Orthop 2013 · No. 2 © Springer-Verlag Berlin Heidelberg
Hintergrund: Heutzutage wird in manchen Fällen die Reparatur einer Füllung bevorzugt vorgenommen statt diese vollständig zu ersetzen. Die vollständige Erneuerung der vorhandenen Restauration würde zu einer ausgedehnteren Präparation und dadurch zu einem höheren Risiko für Kom
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