Keywords
Dental restoration repair
Dentists
Practice patterns
How to Cite
Funding data
-
Fundação para o Desenvolvimento da UNESP
Grant numbers Grant 0170/004/13-PROPe/CDC -
Fundação de Amparo à Pesquisa do Estado de São Paulo
Grant numbers 2012/10397-2
Abstract
Better understanding of dentists’ decision-making about defective restorations is needed to close the evidence-practice gap (EPG). This study aimed to quantify the EPG about defective restorations and identify dentist factors associated with this EPG. Methods: 216 dentists from São Paulo State, Brazil, completed a questionnaire about three clinical case scenarios involving defective composite restorations with cementum-dentin margins (case 1) and enamel margins (case 2), and an amalgam (case 3) restoration. Dentists were asked what treatment, if any, they would recommend, including preventive treatment, polishing, re-surfacing, or repairing the restoration, or replacing the entire restoration. Replacing the entire restoration in any of these three scenarios was classified as inconsistent with the evidence, comprising an EPG. Bivariate analyses using Chi-square, ANOVA, or multiple comparison tests were performed (p<.05). Results: for defective composite restorations, 49% and 55% of dentists chose to replace the entire restoration for cases 1 and 2, respectively. Twenty-nine percent of dentists chose to replace the entire amalgam restoration. Dentists were significantly more likely to choose to replace the defective amalgam restoration than the composite restoration with a defect at the cementum-dentin margins or the enamel margins (both at p < .001). Female dentists were more likely to choose a conservative treatment than male dentists for cases 1 (p=.034) and 2 (p=.009). Dentists with a higher percentage of patients interested in individualized caries prevention were also more conservative in case 1 (p=.045). Conclusion: a substantial EPG regarding treatment decisions for defective restorations exists, especially for composite restorations. This study adds to the international evidence that an EPG exists in this clinical area and that global strategies need to be developed to close the gap.
References
Cochrane LJ, Olson CA, Murray S, Dupuis M, Tooman T, Hayes S. Gaps between knowing and doing: understanding and assessing the barriers to optimal health care. J Contin Educ Health Prof. 2007 Spring;27(2):94-102. Doi: 10.1002/chp.106.
Elliott JH, Turner T, Clavisi O, Thomas J, Higgins JP, Mavergames C, et al. Living systematic reviews: an emerging opportunity to narrow the evidence-practice gap. Plos Med. 2014 Feb;11(2):e1001603. Doi: 10.1371/journal.pmed.1001603.
FDI. World Dental Federation. Repair of restorations: : Adopted by the General Assembly: September 2019, San Francisco, United States of America. Int Dent J. 2020 Feb;70(1):7-8. Doi: 10.1111/idj.12552.
Wilson N, Lynch CD, Brunton PA, Hickel R, Meyer-Lueckel H, Gurgan S, et al. Criteria for the Replacement of Restorations: Academy of Operative Dentistry European Section. Oper Dent. 2016 Sep;41(S7):S48-S57. Doi: 10.2341/15-058-O.
Kanzow P, Hoffmann R, Tschammler C, Kruppa J, Rödig T, Wiegand A. Attitudes, practice, and experience of German dentists regarding repair restorations. Clin Oral Investig. 2017 May;21(4):1087-93. Doi: 10.1007/s00784-016-1859-3.
Kanzow P, Dieckmann P, Hausdörfer T, Attin T, Wiegand A, Wegehaupt FJ. Repair restorations: questionnaire survey among dentists in the Canton of Zurich, Switzerland. Swiss Dent J. 2017 Apr 10;127(4):300-11.
Maria A, Charikleia P, Panagiotis L. Attitudes of Greek dentists towards repair of conservative restorations. An online survey. Int Dent J. 2017 Dec;67(6):351-9. Doi: 10.1111/idj.12319.
Kanzow P, Wiegand A, Göstemeyer G, Schwendicke F. Understanding the management and teaching of dental restoration repair: Systematic review and meta-analysis of surveys. J Dent. 2018 Feb;69:1-21. Doi: 10.1016/j.jdent.2017.09.010.
Gordan VV. How to Bridge Research Results to Everyday Clinical Care? Oper Dent. 2017 Jan/Feb;42(1):1-9. Doi: 10.2341/16-154-B.
Gordan VV, Garvan CW, Richman JS, Fellows JL, Rindal DB, Qvist V, et al. How dentists diagnose and treat defective restorations: evidence from the dental practice-based research network. Oper Dent. 2009 Nov-Dec;34(6):664-73. Doi: 10.2341/08-131-C.
Kakudate N, Yokoyama Y, Sumida F, Matsumoto Y, Yamazaki H, Touge T, et al. Evidence-practice gap in minimal intervention dentistry: Findings from a dental practice-based research network. J Dent. 2020 Nov;102:103469. Doi: 10.1016/j.jdent.2020.103469.
Sales GC, Marques MG, Rubin DR, Nardoni DN, Leal SC, Hilgert LA, et al. Are Brazilian dentists and dental students using the ICCC recommendations for caries management? Braz Oral Res. 2020 Jun;34:e062. Doi: 10.1590/1807-3107bor-2020.vol34.0062. Erratum in: Braz Oral Res. 2020;34:e062err.
Tagliaferro EPS, Ridolfi LML, Matos M, Rosell FL, Valsecki Junior A, Silva SRC, et al. [Translation and Brazilian adaptation of the “Assessment of caries diagnosis and caries treatment questionnaire”] Arq odontol. 2017;53:1-15. Portuguese.
Staxrud F, Tveit AB, Rukke HV, Kopperud SE. Repair of defective composite restorations. A questionnaire study among dentists in the Public Dental Service in Norway. J Dent. 2016 Sep;52:50-4. Doi: 10.1016/j.jdent.2016.07.004.
Lins AS, Ishikiriama Á, Rizzante FAP, Furuse AY, Mondelli J, Ishikiriama SK, et al. Use of restorative materials for direct and indirect restorations in posterior teeth by Brazilian dentists. RSBO. 2014;11(3):237-44.
Da Silva Pereira RA, da Silva GR, Barcelos LM, Cavalcanti KGBA, Herval ÁM, Ardenghi TM, et al. Practice-based analysis of direct posterior dental restorations performed in a public health service: Retrospective long-term survival in Brazil. Plos One. 2020 Dec;15(12):e0243288. Doi: 10.1371/journal.pone.0243288.
Worthington H V, Khangura S, Seal K, Mierzwinski-Urban M, Veitz-Keenan A, Sahrmann P, et al. Direct composite resin fillings versus amalgam fillings for permanent posterior teeth. Cochrane Database Syst Rev. 2021 Aug;8(8):CD005620. Doi: 10.1002/14651858.CD005620.pub3.
The United Nations Environment Programme. The Minamata Convention on Mercury is a global treaty to protect human health and the environment from the adverse effects of mercury. [cited 2022 Apr 4]. Available from: https://www.mercuryconvention.org/en/about.
Anvisa - National Health Surveillance Agency. Brazil. [News: Anvisa prohibits mercury and powder for amalgam alloy used in dentistry]. 2018 Dec 19 [cited 2022 Apr 18]. Available from: https://aps.saude.gov.br/noticia/4954. Portuguese.
Blum IR, Özcan M. Reparative Dentistry: Possibilities and Limitations. Curr Oral Health Rep. 2018;5(4):264-9. Doi: 10.1007/s40496-018-0191-1.
Blum IR. The Assessment and minimally invasive management of existing restorations. Dent Update. 2020 Nov;47(10):823-8.
Blum IR. Restoration Repair as a Contemporary Approach to Tooth Preservation: Criteria for Decision Making and Clinical Recommendations. Prim Dent J. 2019 May;8(1):38-42. Doi: 10.1308/205016819826439466.
Martins BMC, Silva EJNLD, Ferreira DMTP, Reis KR, Fidalgo TKDS. Longevity of defective direct restorations treated by minimally invasive techniques or complete replacement in permanent teeth: a systematic review. J Dent. 2018 Nov;78:22-30. Doi: 10.1016/j.jdent.2018.09.001.
Gordan VV, Garvan CW, Heft MW, Fellows JL, Qvist V, Rindal DB, et al. Restorative treatment thresholds for interproximal primary caries based on radiographic images: findings from the Dental Practice-Based Research Network. Gen Dent. 2009 Nov-Dec;57(6):654-63; quiz 664-6, 595, 680.
Kakudate N, Sumida F, Matsumoto Y, Manabe K, Yokoyama Y, Gilbert GH, et al. Restorative treatment thresholds for proximal caries in dental PBRN. J Dent Res. 2012 Dec;91(12):1202-8. Doi: 10.1177/0022034512464778.
Riley JL 3rd, Gordan VV, Rouisse KM, mcclelland J, Gilbert GH; Dental Practice-Based Research Network Collaborative Group. Differences in male and female dentists' practice patterns regarding diagnosis and treatment of dental caries: findings from The Dental Practice-Based Research Network. J Am Dent Assoc. 2011 Apr;142(4):429-40. Doi: 10.14219/jada.archive.2011.0199.
Yusuf H, Tsakos G, Ntouva A, Murphy M, Porter J, Newton T, et al. Differences by age and sex in general dental practitioners' knowledge, attitudes and behaviours in delivering prevention. Br Dent J. 2015 Sep;219(6):E7. Doi: 10.1038/sj.bdj.2015.711.
Tagliaferro EPS, Silva SRC, Rosell FL, Valsecki Junior A, Riley III JL, Gilbert GH, et al. Methods for caries prevention in adults among dentists from a brazilian community. Brazilian J Oral Sci. 2020 Feb;19:e206624. Doi: 10.20396/bjos.v19i0.8656224.
Lee H, Chalmers NI, Brow A, Boynes S, Monopoli M, Doherty M, et al. Person-centered care model in dentistry. BMC Oral Health. 2018 Nov 29;18(1):198. Doi: 10.1186/s12903-018-0661-9.
Bervian J, Tovo MF, Feldens CA, Brusco LC, Rosa FM da. Evaluation of final-year dental students concerning therapeutic decision making for proximal caries. Braz Oral Res. 2009 Jan-Mar;23(1):54-60. Doi: 10.1590/s1806-83242009000100010.
Morita MC, Uriarte Neto M, Fontanella VRC, Haddad AE. The unplanned and unequal expansion of Dentistry courses in Brazil from 1856 to 2020. Braz Oral Res. 2020 Nov;35:e009. Doi: 10.1590/1807-3107bor-2021.vol35.0009.
Geibel MA, Carstens S, Braisch U, Rahman A, Herz M, Jablonski-Momeni A. Radiographic diagnosis of proximal caries-influence of experience and gender of the dental staff. Clin Oral Investig. 2017 Dec;21(9):2761-70. Doi: 10.1007/s00784-017-2078-2.
Chana P, Orlans MC, O'Toole S, Domejean S, Movahedi S, Banerjee A. Restorative intervention thresholds and treatment decisions of general dental practitioners in London. Br Dent J. 2019 Oct;227(8):727-32. Doi: 10.1038/s41415-019-0849-7.
Sampaio FC, Rodrigues JA, Bönecker M, Groisman S. Reflection on the teaching of cariology in Brazil. Braz Oral Res. 2013 May-Jun;27(3):195-6. Doi: 10.1590/S1806-83242013000300001.
Tagliaferro E, Valsecki Junior A, Rosell FL, Silva S, Riley JL, Gilbert GH, et al. Caries diagnosis in dental practices: results from dentists in a brazilian community. Oper Dent. 2019 Jan/Feb;44(1):E23-E31. doi: 10.2341/18-034-C.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2022 Elaine Pereira da Silva Tagliaferro, Joseph L. Riley III, Gregg H. Gilbert, Silvio Rocha Correa da Silva, Fernanda Lopez Rosell, Aylton Valsecki Junior, Valeria Veiga Gordan
Downloads
