Same, same, but different? A systematic review of protocols for restoration repair

Philipp Kanzow; Annette Wiegand; Falk Schwendicke; Gerd Göstemeyer

doi:10.1016/j.jdent.2019.05.021

Same, same, but different? A systematic review of protocols for restoration repair

J Dent. 2019 Jul:86:1-16. doi: 10.1016/j.jdent.2019.05.021. Epub 2019 May 17.

Authors

Philipp Kanzow¹, Annette Wiegand², Falk Schwendicke³, Gerd Göstemeyer³

Affiliations

¹ Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Germany. Electronic address: philipp.kanzow@med.uni-goettingen.de.
² Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Germany.
³ Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Germany.

PMID: 31108118
DOI: 10.1016/j.jdent.2019.05.021

Abstract

Objectives: While repairs are increasingly recommended to manage partially defective restorations, performing the repair (including bonding to different substrates) can be challenging, and dentists should adhere to established repair protocols. We aimed to systematically assess the consistency and quality of repair protocols.

Data: 808 records were initially identified and 71 repair protocols based on 84 sources included. The number of published sources over time increased exponentially (p < 0.001). Recommended treatment steps varied widely. Some treatment steps were only recommended by a minority of protocols, while others were consistently recommended (e.g. surface roughening, hydrofluoric acid etching of silicate ceramics, application of an adhesive/bonding agent). The overall quality of included sources was moderate (mean ± SD 3.7 ± 0.9 out of 7 points).

Sources: Electronic databases (Medline via PubMed, Embase) were searched, hand searches using Google and Google Scholar conducted, and the reference lists of included full texts screened and cross-referenced.

Study selection: (Non-)systematic reviews, working instructions, and textbooks with protocols on direct composite repair restorations for partially defective (1) composite, (2) amalgam, (3) porcelain-fused-to-metal (PFMs) with exposed metal base, (4) ceramic/PFMs without exposed metal base, and (5) full metal restorations were included. Data synthesis was performed by tabulation of recommended treatment steps and descriptive statistics. The quality of included sources was assessed based on a checklist for guideline appraisal (MiChe).

Conclusions: The main treatment steps were consistently reported across repair protocols.

Clinical significance: Dentists may want to adopt widely recommended treatment steps when performing repairs of different restoration materials in their daily practice.

Keywords: Decision-making; Evidence-based practice; Minimally invasive dentistry; Restoration repair; Systematic review.

Publication types

Systematic Review

MeSH terms

Ceramics
Composite Resins
Dental Materials
Dental Porcelain
Dental Restoration Failure
Dental Restoration, Permanent*

Substances

Composite Resins
Dental Materials
Dental Porcelain