Longevity of Anterior Composite Restorations in a General Dental Practice-Based Network

Abstract

This practice-based study investigated the performance of a large set of anterior composite restorations placed by a group of 24 general practices. Based on data from electronic patient files, the longevity of 72,196 composite restorations was analyzed, as placed in 29,855 patients by 47 general dental practitioners between 1996 and 2011. Annual failure rates (AFRs) were calculated, and variables associated with failure were assessed by multivariate Cox regression analysis with shared frailty for 2 age groups (5 to 24 y and ≥25 y). The observation time of restorations varied from 2 wk to 13 y, with a mean of 4.8 y, resulting in a mean AFR of 4.6% (95% confidence interval [95% CI], 4.5% to 4.6%) at 5 y. Among dentists, a relevant variation in clinical performance of restorations was observed, with an AFR between 2% and 11%. The risk for restoration failure increased in individuals up to 12 y old, having a 17% higher risk for failure when compared with the age group of 18 to 25 y (hazard ratio, 1.17; 95% CI, 1.03 to 1.34), and for the age group >65 y, having a 81% higher risk for failure when compared with 25 to 35 y (hazard ratio, 1.81; 95% CI, 1.66 to 1.98). In both multivariate models, there was a difference in longevity of restorations for different teeth in the arch, with fillings in central incisors being the most prone to failure and replacement. It was concluded that anterior composite restorations placed by general dental practitioners showed an adequate clinical performance, with a relevant difference in outcome among operators.

Anterior restoration longevity among nursing facility residents: a 30‐year retrospective study

“…Younger females in this population might experience longer restoration longevity if they have better oral hygiene or less functional trauma, both of which were possible but unverified in this sample. The finding that older age is a risk factor for restoration failure is consistent with McCracken et al, 17 who observed that the odds of restoration failure (both anterior and posterior) in patients who were ≥65 years old were twice that of patients who were 19-to 44-year-old (95% CI = 1.4 to 2.9) and Collares et al, 18 who reported that among anterior composite resin restorations, the hazards for failure were greater among those ≥65 of age compared to those 25 to 34 years of age (HR = 1.8, P < 0.001). However, in the McCracken et al 17 study, sex was not statistically significantly associated with restoration failure (HR = 1.2, 95% CI = 0.9 to 1.5), while in the study by Collares et al, 18 males had greater hazards for restoration failure than females (HR = 1.1, P < 0.001).…”

“…However, in the McCracken et al . study, sex was not statistically significantly associated with restoration failure (HR = 1.2, 95% CI = 0.9 to 1.5), while in the study by Collares et al., males had greater hazards for restoration failure than females (HR = 1.1, P < 0.001).…”

“…Similar results were reported by McCracken et al . who stated a significant association between restoration size and odds of restoration failure for both anterior and posterior teeth combined among all age groups; and Collares et al., who stated that restorations larger than 1‐surface had greater hazards of failure than 1‐surface restorations.…”

“…found that odds of restoration failure (both anterior and posterior) in patients at least 65 years of age were 2.0 (95% CI 1.4 to 2.9) times those of 19‐ to 44‐year‐old patients. Collares et al . analyzed the longevity of anterior composite resin restorations in a Netherlands general dental practice‐based network; over 10% (n = 6,028) of the restorations were in patients ≥65 years of age.…”

“…McCracken et al 17 found that odds of restoration failure (both anterior and posterior) in patients at least 65 years of age were 2.0 (95% CI 1.4 to 2.9) times those of 19-to 44-year-old patients. Collares et al 18 analyzed the longevity of anterior composite resin restorations in a Netherlands general dental practice-based network; over 10% (n = 6,028) of the restorations were in patients ≥65 years of age. In that study, hazards for restoration failure were greater (P < 0.001) among those ≥65 years old compared to those who were 25 to 34 years old (HR = 1.8), males compared to females (HR = 1.1), and 2-surface and ≥3-surface restorations compared to 1-surface restorations (HRs = 1.2 and 1.4, respectively).…”