2-year clinical evaluation of alternative treatments to replacement of defective amalgam restorations

Oper Dent. 2006 Jul-Aug;31(4):418-25. doi: 10.2341/05-112.

Abstract

Objective: To investigate the effectiveness of alternative treatments for replacing defective amalgam restorations through a prospective longitudinal cohort clinical study.

Methods: Forty-five patients aged 21 through 77 (mean=56) years with 113 defective amalgam restorations, which were independently diagnosed during treatment planning, participated in the study. These patients were assigned to 5 treatment groups: repair (n=20), sealing of defective margins (n=23), refurbishing (n=23), replacement (n=23) and no-treatment (n=24). The replacement and no-treatment groups served as comparison groups and received random assignment. Two clinicians examined the restorations (n=113) prior to and after the assigned treatment and at subsequent recalls, using a modified Ryge Criteria that included marginal adaptation, anatomy, contact, post-operative sensitivity and secondary caries.

Results: At 1- and 2-year recalls, 79 (70%) and 74 (65%) restorations were examined. Kruskal-Wallis Test showed significant differences for marginal adaptation and anatomic form for both 1- and 2- year recall exams (p<.05). The repair and replacement groups had significant differences when compared to the no-treatment group.

Conclusions: Defective restorations that have a Bravo rating for clinical characteristics other than marginal integrity and anatomical form do not need to be immediately replaced.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cohort Studies
  • Dental Amalgam* / chemistry
  • Dental Bonding
  • Dental Caries / etiology
  • Dental Marginal Adaptation
  • Dental Polishing
  • Dental Prosthesis Repair
  • Dental Restoration Failure*
  • Dental Restoration, Permanent / methods*
  • Dentin Sensitivity / etiology
  • Follow-Up Studies
  • Humans
  • Longitudinal Studies
  • Middle Aged
  • Prospective Studies
  • Recurrence
  • Resin Cements / chemistry
  • Retreatment
  • Surface Properties

Substances

  • Resin Cements
  • Dental Amalgam