Tooth-coloured restorative materials are being used increasingly more often in Class II preparations in permanent teeth. Using a practice-based study design, we aimed to assess the survival time of Class II restorations and to identify factors relevant to their longevity. Class II restorations (n = 4,030), consisting of resin composites (81.5%), compomers (12.7%), amalgams (4.6%), and glass-ionomer cement restorations (1.2%), were placed in 1,873 patients with a median age of 15 yr. In total, 92.7% of restorations were placed due to primary caries and 5.8% were replacements. After an average follow-up period of 4.6 yr, 61.6% of the restorations were successful, 11.2% had failed, and 27.2% were not available for evaluation (owing to patient drop-out). The mean annual failure rate was 2.9% for resin-composite restorations and 1.6% for amalgams. For resin-composite restorations, secondary caries was the most common reason for replacement (73.9%), followed by loss (8.0%), fracture (5.3%), and marginal defects (2.4%). Multilevel Cox-regression analyses identified young age of the patient, high previous caries experience, deep cavities, and saucer-shaped preparation technique as predisposing to shorter longevity of resin-composite restorations. One brand of resin composite had a shorter survival time than the others.
Dentists' choices of restorative material indicate that the majority prefer amalgam in more challenging restorations with respect to caries activity, lesion depth, and tooth type. The findings indicate that in a period when the use of amalgam was phasing out, resin composite was the predominant material of choice for Class II restorations in children and adolescents.
Knowledge of the patient's view is necessary, as patients' rights are an issue of increasing importance in dental practice. This study aimed to examine how dentists (n = 42), dental assistants (n = 65), and young dental patients (n = 306) in Norway and Denmark valued three attributes of dental restorations, namely, expected longevity, the appearance, and the risk of an adverse reaction. According to the discrete choice method, participants were presented with several scenarios, describing different levels of the attributes, for comparison of two restorations (A and B). The differences among patients, dentists, and dental assistants were examined by logistic regression analyses. The likelihood of a dentist favoring one restoration over another was very sensitive to the difference in the expected longevity of the restorations, and much less to differences in visibility. The patients had considerable sensitivity to differences in visibility and much less to differences in duration. Danish teenagers attach less importance to visibility of the restoration and greater importance to the risk of an adverse reaction than Norwegian teenagers. All differences were statistically significant. Preferences associated with properties of dental restorations differ between teenage patients and dental professionals and this should be addressed in clinical decision-making.
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