Review of 36,537 Patient Records for Tooth Health and Longevity of Dental Restorations

Abstract

To develop an automatic system for utilizing electronic dental records, a data mining system to extract the diagnostic and treatment codes from the records for an intermediate file and automatic drawing of Kaplan-Meier-type survival curves was first created. Then this intermediate file was analyzed with SAS software for the scientific determination of Kaplan-Meier survival of tooth/surface-specific healthy time and survival of restorations in each permanent tooth, health center, and age cohort and also combined. All patients born in 1985, 1990 or 1995 in 28 health centers in Finland were analyzed. Patients classified as caries-active were those who had caries in any first permanent molar under the age of 8 years, while resistant patients did not have caries in these teeth before 10 years. In the younger age cohorts, a shortening of survival of caries-free teeth was seen. The shortest caries-free survival was seen in mandibular and maxillary molars in the youngest age cohort. Occlusal surfaces of molars determined their caries onsets and proximal caries occurred equally in molars, incisors and premolars, whereas canines or mandibular incisors did not have caries in these age cohorts. Caries-prone subjects had the shortest survival in all their teeth. The median longevity of all restorations was 11.7 years, with great variation between health centers and teeth. Because of the great variation between individual teeth, the tooth-specific approach seems appropriate in both caries epidemiology and material sciences.

Longitudinal Results of a 10-year Clinical Trial of Repair of Amalgam Restorations

“…[4][5][6] Failures after this period have been associated with secondary caries, marginal deficiencies, degradation/wear, fracture, or loss of anatomic form. 5,[7][8][9][10][11][12][13][14][15][16] The replacement of failed restorations is the most common treatment in dentistry 10 years after initial placement, and long-term studies have shown that when failure takes place it typically happens within the first 24 months. 17 Dentists frequently replace restorations that could be treated in a more conservative manner.…”

A survey of practices of tunnel preparation among dentists who attended the 100th FDI Annual World Dental Congress

“…Since a class II replaces the marginal ridge, which the TR attempts to protect, it may be possible that the strength and longevity of modern composites may have reduced the need for conservative TR. A recent study found that the median lifespan of all dental restorations was 11.7 years with a large amount of variation between different health centers and different teeth in the study. More research is necessary to accurately determine the longevity of TR, and those findings must be weighed against each clinical case in the decision to choose TR as the treatment of choice.…”

Unilateral Maxillary First Molar Extraction in Class II Subdivision: An Unconventional Treatment Alternative

“…The first permanent molar has the shortest caries-free survival under the age of 8 years [ 10 ]. It also represents the most caries prone tooth in children older than 11 years [ 11 ]. In addition to this, first molars can suffer from developmental enamel hypomineralisation of unknown aetiology often affecting permanent incisors.…”