A multi-variate retrospective analysis of factors influencing completion time of multi-disciplinary clinic care in a cohort of hypodontia patients

Objectives: Dental treatment times can be lengthy for patients with developmental absence of their secondary dentition (hypodontia). This retrospective analysis of a cohort of multi-disciplinary-treated hypodontia patients aimed to assess factors influencing length of treatment in a single UK NHS Specialist referral centre.
Methods: Clinical Records (Paper and electronic) from hypodontia patients completing multidisciplinary hypodontia treatment were retrospectively analysed from patients attending for dental care at The Royal London Dental hospital (Barts Health NHS Trust). Both the amount of time and number of appointments in active treatment from orthodontic bond-up until fit of final prosthetic restoration were selected as the primary dependent outcome variables. Patients (n=50) (Female=32, Male=18) were randomly selected from a local database of those completing MDT care and had a median age of 12.7yrs (range 6.8-44.5yrs) at initial referral. The severity distribution of hypodontia was; Mild (1-2 teeth) (n=18;36%), Moderate (3-5 teeth) (n=18;36%) and severe (≥6 teeth) (n=14;28%). Patients were treated in line with normal standards of care and received Resin Bonded Bridges (RBBs) (62%), Implants (20%) or combinations of RBBs and Implants (12%) with 6% not receiving any restorations. Stepwise multivariate linear regression was carried out to assess the influence of a range of independent predictor variables on time in active treatment.
Results: On average patients spent 5.2 years in overall treatment with 3.1 years in orthodontics and 10.8 months in Restorative care. Multivariate linear regression revealed that number of missing teeth pre-operatively, poor attendance and missing lower canines were significantly associated with increased treatment times.
Conclusions: Knowledge of both pre-operative and decision-influenced factors can help better predict treatment time in multidisciplinary hypodontia treatment and improve our understanding of the treatment journey.