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Repair versus replacement of defective composite restorations: Teaching in dental schools in Canada

Daood U 1 , Malik NA 2 , Sidhu P 3 , Masood A 4 , Konanec T 5 , Tezvergil-Mutluay A 6 Show all authors , Bijle MN 7 , Sheikh Z 8 , Wilson NHF 9 , Lynch CD 10 , Al Waeli H 11 , Blum IR 12

Affiliations 

  • 1 Restorative Dentistry Division, School of Dentistry, IMU University Kuala Lumpur, 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Bukit Jalil, Wilayah Persekutuan, Kuala Lumpur, Malaysia; Centre for Translational Research (CTR), Institute for Research, Development and Innovation, (IRDI), IMU University, 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Bukit Jalil, Wilayah Persekutuan, Kuala Lumpur, Malaysia
  • 2 Deprtment of Conservative Dentistry and Prosthodontics, Faculty of Dentistry, Universiti Sains Islam Malaysia, Malaysia
  • 3 Restorative Dentistry Division, School of Dentistry, IMU University Kuala Lumpur, 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Bukit Jalil, Wilayah Persekutuan, Kuala Lumpur, Malaysia
  • 4 Department of Public Health Sciences, Health Services Academy, Islamabad, Pakistan
  • 5 Division of Restorative Dentistry, McGill University Faculty of Dental Medicine and Oral Health Sciences, 2001 McGill College Avenue, Suite 150, Montreal, QC, H3A 1G1, Canada
  • 6 Department of Restorative Dentistry and Cariology, Adhesive Dentistry Research Group, Institute of Dentistry, University of Turku, Turku, Finland; Turku University Hospital, TYKS, University of Turku, Turku, Finland
  • 7 Paediatric Dentistry, College of Dental Medicine, University of Sharjah, United Arab Emirates
  • 8 Biomaterials & Applied Oral Sciences (BAOS), Faculty of Dentistry, Dalhousie University, Halifax, NS, Canada; Dental Clinical Sciences (DCS), Faculty of Dentistry, Dalhousie University, Halifax, NS, Canada
  • 9 College of General Dentistry, UK
  • 10 Cork University Dental School & Hospital/ University College Cork, Wilton, Cork, Ireland
  • 11 Dental Clinical Sciences (DCS), Faculty of Dentistry, Dalhousie University, Halifax, NS, Canada. Electronic address: h.al-waeli@dal.ca
  • 12 Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, United Kingdom. Electronic address: igor.blum@kcl.ac.uk
J Dent, 2026 Oct 17;177:107119.
PMID: 42892357 DOI: 10.1016/j.jdent.2026.107119

Abstract

OBJECTIVE: The purpose of this paper is to report the outcome of an investigation of the teaching of repair versus replacement in the management of defective composite restorations in dental schools in Canada.

MATERIALS AND METHODS: The investigation was a cross-sectional study, using a validated questionnaire. The questionnaire sought information on both preclinical and clinical instruction, number and duration of modules, logistics of teaching, clinical requirements and teaching challenges. The data was collected and entered in an MS Excel spreadsheet. The results were collated and analysed.

RESULTS: A survey of all 10 Canadian dental schools revealed a 100% response rate, with all schools confirming they perform composite restoration repairs to extend clinical service. Currently, 70% of schools teach repair techniques in undergraduate clinical training, and 20% plan to introduce such techniques within five years. Furthermore, 100% of schools noted patient willingness to accept repairs. While 70% view repair as a definitive treatment, others see it as temporary (10%) or transitional (20%). Primary reasons for teaching repairs include tooth preservation, pulp protection, marginal defects, and secondary caries. For procedures, 70% teach rubber dam isolation, and 70% use diamond-finishing instruments. Most schools (60%) do not teach bevelling or review repaired restorations, while 60% utilise phosphoric acid etching, adhesive bonding, and nano-filled composites.

CONCLUSION: Undergraduate dental students at most Canadian dental schools are taught repair as an alternative to replacement in the management of defective composite resin restorations. Arrangements to harmonise the teaching of composite repair across Canada and beyond would greatly benefit patients and students nationally and internationally.

CLINICAL SIGNIFICANCE: Teaching composite restoration repair supports minimally invasive dentistry by promoting preservation of sound tooth structure and reducing unnecessary restoration replacement. Greater harmonisation of undergraduate teaching across Canadian dental schools could enhance consistency in clinical practise and improve long-term patient care.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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