Since the global number of patients with direct restorations increases, and the amalgam represents a significant percentage of this segment, we must focus our attention on the perirestorative odontal pathology and on the required therapeutic options. The purpose of the study was the evaluation of the inter and intra examiner reliability in relation to the decision of replacing amalgam restorations.
Materials and method: 120 amalgam fillings were clinically assessed via inspection and palpation by 3 different examiners; the subjects were 50 patients who were successively examined twice at a two months interval. After these examinations, the reliability was evaluated at an inter and intra examiner level in regard to the reasons for replacing restorations with the help of Cohen’s Kappa method of statistical analysis. Results: the obtained Kappa values showed a variable inter examiner level of agreement: weak between A and C (K=0.195) at the first examination and substantial between A and B (K=0.727) at the second examination. The first reason, at a global level, for the replacement of the restorations was given by secondary caries, followed by marginal grooves and marginal coloration.
Conclusions: without a prior training session during which the replacement indications of amalgam restoration are clearly stated, the inter and intra examiner reliability have questionable values, that can be further perfected. Apart from the clinical examination, for the assessment of the perirestorative odontal pathology we must also perform a series of paraclinical examinations, such as: radiology, LASER fluorescence (Diagnodent etc.).