Teaching of direct composite restoration repair in undergraduate dental schools in the United Kingdom and Ireland

Aim: To investigate aspects of the teaching of restoration repair as a minimally invasive alternative to the replacement of defective direct composite restorations in teaching programmes in undergraduate curricula in dental schools in the United Kingdom and Ireland. Methods: An online questionnaire which sought information in relation to the current teaching of composite restoration repair was developed and distributed to the 17 established UK and Irish dental schools with undergraduate teaching programmes in Spring 2010. Results: Completed responses were received from all 17 schools (response rate= 100%). Fifteen schools reported that they included teaching of repair techniques for defective direct composite restorations in their programme. Of the two remaining schools, one indicated that it would introduce teaching of repair techniques during the next five years. The most common indication for a composite repair was that of 'tooth substance preservation' (15 schools). The defects in restorations considered appropriate for repair rather than replacement by the largest number of schools included partial loss of restoration (13 schools) and marginal defects (12 schools). The most commonly taught surface treatment when performing a repair was mechanical roughening of the existing composite with removal of the surface layer (14 schools). Thirteen schools taught etching and the application of an adhesive bonding agent to the prepared surfaces, while the most commonly taught material for completing the repair was a hybrid composite resin (12 schools). Popular finishing implements included diamond finishing instruments (13 schools) and finishing discs (11 schools). Conclusion: Not withstanding reluctance amongst general dental practitioners, the teaching of repair of a defective composite restoration, rather than total restoration replacement, is firmly established within UK and Irish dental school programmes. Repair techniques have clear advantages for patients, not least including a minimally invasive approach to treatment and avoidance of unnecessary loss of tooth tissue and pulpal damage. Dental practitioners should look more to repair techniques when managing defective composite restorations and clinical dental teachers should continue to research and refine composite repair techniques.