{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T17:35:45Z","timestamp":1790876145393,"version":"4.1.0"},"reference-count":54,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,11,2]],"date-time":"2024-11-02T00:00:00Z","timestamp":1730505600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Esthet Restor Dent"],"published-print":{"date-parts":[[2025,4]]},"abstract":"ABSTRACT<\/jats:title>Objectives<\/jats:title>This web\u2010based survey, conducted across multiple countries, sought to explore the factors that impact the decision\u2010making of clinicians when it comes to managing defective direct restorations.<\/jats:p><\/jats:sec>Methods<\/jats:title>A survey consisting of 14 questions was sent out to dentists in 21 countries through various online platforms. The survey consisted of two sections. The first contained five questions about demographic information, while the second involved eight clinical scenarios. In the second part, participants were tasked with deciding whether to repair or replace defective composite and amalgam restorations.<\/jats:p><\/jats:sec>Results<\/jats:title>Three thousand six hundred eighty dental practitioners completed the survey. For composite restorations, repair was preferred in scenarios like partial loss or fracture (RR:0.72; 95% CI: 0.58, 0.89; p<\/jats:italic>\u2009=\u20090.002), whereas replacement was favored for secondary caries (RR:2.43; 95% CI: 1.87, 3.16; p<\/jats:italic>\u2009<\u20090.001) and open\/defective margins (RR:3.93; 95% CI: 2.68, 5.76;p<\/jats:italic>\u2009<\u20090.001). Amalgam restorations were mostly replaced across all scenarios. The main factors influencing decision\u2010making were caries risk, restoration size, and patient oral hygiene. Substantial heterogeneity was observed across countries.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>This study underscores the complexity of the decision\u2010making process and the need for evidence\u2010based guidelines to inform clinicians' decisions regarding restoration management. Patient\u2010level factors predominantly influence decision\u2010making, emphasizing the need for individualized approaches.<\/jats:p><\/jats:sec>Clinical Significance<\/jats:title>The study reveals that the material type in the original restoration is a critical determinant, with composite restorations being repaired in specific scenarios, while amalgam restorations are consistently replaced across different countries. Key patient and tooth\u2010level factors, such as high caries risk, poor oral hygiene, and restoration size, significantly impact clinicians' decisions, often favoring replacement over repair. These findings underscore the necessity for evidence\u2010based guidelines to assist clinicians in making informed choices, ultimately enhancing the quality of patient care.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jerd.13321","type":"journal-article","created":{"date-parts":[[2024,11,2]],"date-time":"2024-11-02T10:58:21Z","timestamp":1730545101000},"page":"977-991","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Clinical Decision\u2010Making of Repair vs. Replacement of Defective Direct Dental Restorations: A Multinational Cross\u2010Sectional Study With Meta\u2010Analysis"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4628-8551","authenticated-orcid":false,"given":"\u00d6mer","family":"Hatipo\u011flu","sequence":"first","affiliation":[{"name":"Department of Restorative Dentistry Recep Tayyip Erdogan University Rize Turkey"},{"name":"Department of Restorative Dentistry Nigde Omer Halisdemir University Ni\u011fde Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3473-5801","authenticated-orcid":false,"given":"Jo\u00e3o Filipe Brochado","family":"Martins","sequence":"additional","affiliation":[{"name":"ACTA Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0313-9695","authenticated-orcid":false,"given":"Mohmed Isaqali","family":"Karobari","sequence":"additional","affiliation":[{"name":"Department of Conservative Dentistry and Endodontics Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University Chennai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3233-8850","authenticated-orcid":false,"given":"Nessrin","family":"Taha","sequence":"additional","affiliation":[{"name":"Department of Conservative Dentistry Jordan University of Science and Technology Irbid Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1493-9492","authenticated-orcid":false,"given":"Thiyezen Abdullah","family":"Aldhelai","sequence":"additional","affiliation":[{"name":"Department of Orthodontics and Pediatric Dentistry, College of Dentistry Qassim University Buraydah Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daoud M.","family":"Ayyad","sequence":"additional","affiliation":[{"name":"Head of the Endodontics Department, Faculty of Dentistry Al\u2010Quds University Jerusalem Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6124-0129","authenticated-orcid":false,"given":"Ahmed A.","family":"Madfa","sequence":"additional","affiliation":[{"name":"Department of Restorative Dental Science, College of Dentistry University of Ha'il Ha'il Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4297-4220","authenticated-orcid":false,"given":"Benjamin","family":"Martin\u2010Biedma","sequence":"additional","affiliation":[{"name":"Universidade de Santiago de Compostela (USC) Rua Entrerr\u00edos s\/n A Coru\u00f1a Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1431-8373","authenticated-orcid":false,"given":"Rafael","family":"Fern\u00e1ndez\u2010Grisales","sequence":"additional","affiliation":[{"name":"Department of Endodontics, School of Dentistry CES University Medell\u00edn Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1545-7797","authenticated-orcid":false,"given":"Bakhyt A.","family":"Omarova","sequence":"additional","affiliation":[{"name":"Dentistry School, Department of Therapeutic Dentistry S. 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