Placement and replacement of restorations by selected practitioners

Background: There are few Australian data on the reasons for placement and replacement of restorations, and the extent to which these are carried out in general practice. Methods: A survey was carried out of approximately 100 consecutive restorations placed by each of 28 general dental practitioners. The data were coded and statistically analyzed for various associations. Results: Resin composite was used twice as frequently as amalgam as a restorative material, and nearly four times as often as glass-ionomer cement. Secondary caries was the principal reason for replacing restorations, affecting predominantly amalgam restorations in Class I and Class V cavities. Teeth restored with amalgam fractured nearly twice as often as teeth restored with resin composite. The average ages of amalgam, resin composite and glass-ionomers at replacement were 13.6, 7.1 and 5.7 years respectively. Conclusions: Amalgam has the longest clinical service life, but is associated with more tooth fracture. Secondary caries is the main reason for replacing restorations. The anti-cariogenic effect of glass-ionomer cement is equivocal.