Re-Treatment Decisions for Failed Posterior Restorations among Dentists in Kuwait

OBJECTIVES: To compare re-treatment choices for MOD amalgam or resin composite restorations with or without cusp fracture among dentists in Kuwait. METHODS: A random sample of 158 dentists completed a questionnaire designed to obtain socio-demographic, educational and work-related information and their choices for re-treatment of four scenarios of failed restorations on lower first molars: 1. MOD amalgam restoration; 2. MOD composite restoration; 3. MOD amalgam restoration with cuspal fracture; 4. MOD composite restoration with cuspal fracture. Re-treatment options were: re-treating with amalgam; re-treating with composite; placing an onlay; or, placing a crown. For the purpose of analysis, responses were dichotomized into re-treatment with a direct or indirect restoration. RESULTS: For cases 1 and 2, most participants chose to re-treat with amalgam restoration and for cases 3 and 4, most chose to place an indirect restoration. In general, an increased tendency towards the indirect option was associated with increased age, being a male and being a specialist. Tendencies to place an indirect restoration did not differ between cases 1 and 2 (P=1.0) or cases 3 and 4 (P=0.317), although the tendency to do so was significantly greater in case 3 than 1 (P=0.000) and case 4 than 2 (P=0.000). CONCLUSIONS: The variation noted among dentists regarding their stated choices for re-treating failed posterior restorations appeared to be associated with gender, education and experience factors. A tendency towards indirect restorations was seen when the restoration is associated with a fractured cusp.