Introduction
Direct restorations, in common with all other forms of restorations, suffer deterioration
as a result of “wear and tear”, and may be susceptible to secondary caries in clinical
service. Defects in restorations and lesions of secondary caries adjacent to restoration
margins are two of the most frequent clinical observations in general dental practice.
Replacement of restorations constitutes around half of the treatments performed by
general dental practitioners.1,2 However, total restoration replacement may be regarded
as excessively interventional in many situations, since in the large majority of cases,
most of the restoration (.80%) may be found to be clinically and radiographically
sound.3,4 Furthermore, restoration replacement invariably results in acceleration of the
“restoration death spiral”,5
with weakening of the remaining tooth structure through
the unnecessary removal of healthy tooth tissue in locations often distant from the
site of the deteriorating restoration. An additional risk associated with restoration
replacement is unnecessary and potentially fatal insult to the pulp. Consequently, good
decision-making in respect of “defective” restorations is central to effective restorative
treatment planning, particularly given the growing body of evidence confirming the
value and importance of procedures to repair defective restorations.