Survival characteristics of composite restorations in primary teeth
December 2014
Date:
31 Dec 2014
Abstract
Objectives
This
retrospective study analyzed restoration survival of composite fillings
in children with at high caries risk in relation to age, sex, operator,
tooth type, filling extension, and material used.
Materials and methods
Among
667 children treated in 2004–2012 in a university setting without
sedation or general anesthesia, 2388 composite fillings were included.
Relevant data from regular recall intervals were retrieved from
patients’ records. Either total-etch or a self-etch adhesive combined
with flowable and/or (nano)hybrid composite was used. The Kaplan-Meier
estimator and Cox proportional hazard analysis with backward elimination
model were applied for survival analysis.
Results
For
the observation period of 8 years (mean 1.7 years), the cumulative
failure rate was 17.2 % with annual failure rates of 10.0 %. In 8.8 % of
the cases, fillings failed due to secondary caries. In 8.3 % technical
failure due to total filling loss, loosening, marginal gaps, or tooth
fracture occurred. Tooth type, filling extension, age, operator, dental
dam, and type of adhesive were significant for survival (p < 0.05).
Conclusions
Filling
survival was comparably lower to composite restorations observed in
prospective clinical studies on permanent teeth and other tooth-colored
restoratives used in primary teeth. Due to the very high caries risk and
young age of the population, frequent loss due to secondary caries was
observed. With respect to the high caries risk, composite restorations
can be used to treat carious primary teeth, though a strict caries
prevention regimen should be followed to minimize restoration failure.
Clinical relevance
Filling loss of composites in the primary dentition is associated with secondary caries on the long term.
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