Repair may increase survival of direct posterior restorations – A practice based study
Abstract
Objectives
To
investigate repairs of direct restorations by a group of Dutch general
dental practitioners (GDPs) and its consequences on longevity of
restorations.
Methods
Data set
was based on dental records of patients attending 11 general dental
practices (24 Dentists) in the Netherlands. Patients that received Class
II Amalgam or Composite restorations were included in the study. The
outcomes were considered in two levels: “Success” – When no intervention
was necessary on the original restoration, it was considered clinically
acceptable. “Survival” – Repaired restorations were considered
clinically acceptable. Kaplan–Meier statistics and Multivariate Cox
regression were used to assess restorations longevity and factors
associated with failures (p < 0.05).
Results
59,722
restorations placed in 21,988 patients were analyzed. There was a wide
variation in the amount of repairs among GDPs when a restoration had
failed (Level 1). Repairs of multi-surface restorations were more
frequent (p < 0.001). A total of 9,253 restorations (Level 1) or
6,897 restorations (Level 2) had failed in a 12-year observation time.
“Success” and “Survival” of the restorations reached 65.92%
(AFR = 4.08%) and 74.61% (AFR = 2.88%) at 10 years, respectively.
Patient (age, removable denture) and tooth/treatment-related factors
(molars, >2 restored surfaces, endodontic treatment, Amalgam) were
identified as risk factors for failure (p < 0.001).
Conclusion
Overall,
the GDPs showed satisfactory rates of restoration longevity over 10
years. Repair can increase the survival of restorations although,
substantial differences exist among practitioners in repair frequency
and AFRs. Molars, multi-surface restorations, presence of an endodontic
treatment and a removable denture were identified as risk factors for
failure.
Clinical Significance
Repair,
instead of total replacement of a defective restoration, is a Minimally
Invasive procedure which can increase the survival of the original
filling, reducing the risk for pulp complications and treatment costs.
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