Trends in material choice for posterior restorations in an Israeli dental school: Composite resin versus amalgam

According to a recent American Dental Association survey, posterior composite resin restorations now outnumber amalgam restorations in the United States. Dental schools around the world vary considerably in the extent to which they teach the use of composite resins. We aimed to determine if there has been an increase in the placement of posterior composite restorations in an Israeli dental school and if faculty experience affects the type of posterior restoration placed. In this retrospective study, we recorded and analyzed all the restorations performed by undergraduate students in the last five academic years at the Hebrew University Hadassah School of Dental Medicine in Jerusalem. All clinical records of student treatments between 2004 and 2009 were screened, and direct restorations were registered. Out of 6,094 posterior restorations performed during the study period, 42.3 percent were made of composite resin, increasing from 36.8 percent in 2004-05 to 48.5 percent in 2008-09, an increase of 11.7 percent. When clinical instructors were asked to state their preference if they themselves were to undergo posterior restoration, similar results were obtained. Instructors with less than ten years' experience preferred posterior composite resin restorations in 54.8 percent of the hypothetical situations, compared with 37.2 percent preferred by instructors with ten years of experience or more. It appears that the use of composite resin was influenced mainly by the prevailing trend and was not based on scientific evidence. Dental faculties should define criteria, based on up-to-date clinical studies, for using new materials, taking into consideration differences among instructors regarding treatment concept.