Dental restorations: repair or replace?

Filling -amalgam

10 studies were included in this review of the effectiveness of minimally invasive repair or replacement of dental restorations. The reviewers suggest that seal and refurbishment techniques did not present a significant difference in clinical longevity in comparison to the replacement technique in permanent teeth. However, both the amount and the quality of the available evidence is limited.

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Primary teeth: which restorative material last longer?

PMC 2

This review of the longevity of posterior restoration in primary teeth included 31 studies. composite resin had the lowest annual failure rate while stainless steel crowns had the highest success rate. The studies all have a high risk of bias so the findings should be interpreted cautiously.

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Top Dental Elf Blogs of 2016

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During 2016 the Dental Elves has published 158 blogs covering a broad range of topics. The most popular blogs of each month are highlighted.

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Amalgam outperforms composite in range of posterior cavity types

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This review of failure rate of single-unit prostheses versus direct restorations in vital posterior teeth included 14 studies (5 RCTs) finding that composite had a significantly higher failure rate than amalgams, regardless of the remaining tooth structure. For teeth with fewer than 2 remaining walls, direct restorations presented significantly higher failure rates than crowns .

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Adhesively bonded amalgams – insufficient evidence of better performance

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This Cochrane review update only identified 1 RCT assessing the difference in survival between bonded and non-bonded amalgam restorations providing insufficient evidence to support or refute a difference.

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Crowns more effective than fillings for decay in primary molar teeth

PMC 2

Five RCTs were included in this Cochrane review comparing crowns with fillings for the management of caries in primary molars. Moderate evidence found crowns reduced the risk of major failure or pain in the long term compared to fillings

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Amalgam has lower failure rate than composite in restorations

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8 studies were included in this review comparing amalgam with composite in posterior restorations. There was a statistically significant benefit in favour of amalgam for both restoration failure and secondary caries.

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Composite resin restorations: no good evidence to assess impact on dental pulp

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Only 10 low quality studies were available for this review to assess if a vital pulp restored with composite resin is at greater risk of pulpal complications than one restored with other materials. Questions over the studies qualities make it difficult to draw any conclusions.

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Amalgam still an effective filling material for posterior teeth

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Amalgam has been used for filling teeth for around 150 years. Over that time amalgam restoration have been shown to be a predictable, successful and cost effective.  Concerns regarding aesthetics and their mercury content together with improvement in tooth-coloured dental resin cements have seen a decline in their use.  Recently the Minamata Convention on Mercury [read the full story…]

Currently no evidence to support repairing or replacing amalgam fillings for adults

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Dental amalgam has been the dental material of choice for many decades. Although, in recent years a greater focus on aesthetics and concerns related to the potential environmental impact of mercury coupled with a more conservative approach to cavity preparation and improvements in aesthetic restorative materials is leading to a decline it its use.  In [read the full story…]