Fillings are used as part of general dental treatment to rebuild teeth after a patient develops tooth decay or damages the surface of their teeth in some way. Tooth-coloured filling materials (resin composites) have increasingly been used as an alternative to traditional amalgam or metallic fillings. As with any filling material, these fillings have a limited life-span and eventually problems will occur when they break down or become faulty. In the past, faulty fillings have been replaced, however this approach may lead to the loss of further bits of tooth as the cavity is emptied and refilled. An alternative approach is to repair the faulty filling. Repairing fillings can take less time, and may be less distressing for patients as sometimes they can be done without the patient having to undergo an anesthetic. Pain, anxiety, time and cost may all be lessened by repairing fillings rather than replacing them.
What was the research?
A systematic review to compare whether it is better to replace or repair resin composite fillings.
Who conducted the research?
The research was conducted by a team led by Mohammad O. Sharif from the University of Manchester, on behalf of the Cochrane Oral Health Group. Melanie Catleugh, Alison Merry, Martin Tickle, Stephen M. Dunne, Paul Brunton, Vishal R. Aggarwal and Lee Yee Chong were also on the team.
What did the evidence say?
Despite a thorough search of the literature, no randomised controlled trials were found for inclusion in this review.
How good was the evidence?
Currently there is no evidence to support repairing or replacing resin composite fillings for adults.
What are the implications for dentists and the general public?
In the absence of any high level reliable evidence, dentists should base their decisions on clinical experience, individual circumstances and in conjunction with patient’s preferences where appropriate.
What should researchers look at in the future?
Methodological sound randomized controlled trials are needed on this topic. They should be reported according to the CONSORT statement and important consideration should be given to the methods of randomization, allocation concealment and blinding of patients and outcome assessors. The review team have summarised the key features they would expect to find in a randomized controlled trial on this topic, follow the link to read more.
Sharif MO, Catleugh M, Merry A, Tickle M, Dunne SM, Brunton P, Aggarwal VR, Chong LY. Replacement versus repair of defective restorations in adults: resin composite. Cochrane Database of Systematic Reviews 2014, Issue 2. Art. No.: CD005971. DOI: 10.1002/14651858.CD005971.pub3.