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Grey areas in restorative dentistry: part 6. Direct or Indirect Restoration Robert L Caplin Dental Update 2025 52:4, 287-292.
Authors
Robert LCaplin
BDS, MSc, DGDP (RCS Eng), Dip Teach Ed (King's), Retired Senior Teaching Fellow, Faculty of Dentistry and Oral and Craniofacial Sciences, King's College London; General Dental Practitioner, London
The aim of restorative dentistry, by and large, is to restore damaged, ill shaped, malpositioned, or malfunctioning teeth so that they look good and function well. This objective can be achieved by either direct or indirect restorations; sometimes just a single tooth may be involved, or at other times several teeth may be involved, commonly when there is tooth wear. The dental practitioner is faced with having to make decisions, on a frequent basis, as to which to choose. While it is good to have a choice, it is essential that the practitioner understands the risks and the benefits of each option, and the skill and expertise required for their successful execution. It is also important to have a protocol for assessing distressed teeth so that an informed decision can be made. This can then be discussed with the patient.
CPD/Clinical Relevance: The choice between a direct or indirect restoration and the material to be used for a particular tooth is a frequent challenge for dental practitioners.
Article
Restoration is defined as ‘an act of restoring or the condition of being restored, such as bringing back to a former position or condition’1 and is a broad term applied to any material or prosthesis that restores or replaces lost tooth structure, teeth or oral tissues.2 This is especially applicable to restorative dentistry, whose aims, by and large, are to restore damaged, ill-shaped, malpositioned or malfunctioning teeth so that they look good and function well.
In this context there are three words beginning with ‘F’ that are important to know and apply (Figure 1).
It is imperative that in achieving these aspects when restoring a tooth, the patient is left with a situation that provides for the maintenance of good oral health and wellbeing. Practically, this means providing good access for plaque control, good occlusal harmony, and patient satisfaction with the aesthetics. It seems counterintuitive to satisfy aesthetic demands while leaving the patient with situations that do not allow for adequate prevention of disease processes and the prospect of early failure. Each of these parameters demand equal consideration (Figure 2).
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