IADR Abstract Archives
Direct Adhesive Restorations: Factors Affecting Long-term Intraoral Survival
Objectives: To retrospectively investigate the factors influencing the survival of direct adhesive restorations over long-term intraoral service.
Methods: Clinical records from patients who received a direct adhesive restoration between the last quarters of 2008 and 2009 and a dental examination in the first two quarters of 2018 at the Dental Clinic 1 in Erlangen were retrieved. Data were pseudonymized and information were collected on: patients oral health, age, restoration survival, failure reason, surgical procedure, material used and operator. No personal data were collected. Median survival times and Annual Failure Rates (AFRs) were calculated. Survival of direct adhesive restorations were assessed by Kaplan-Meier survival analyzes. The influence of the recorded factors on survival time was analyzed by multivariate Cox regression. Data were evaluated with SPSS Statistics 25 (IBM, Armonk, USA) at a significance level of 5% (p<0.05).
Results: A total of 242 fillings in 130 patients were evaluated with a mean observation period of 9 years. At baseline patient’s average age was 56 with a DMFT of 20. Restorations AFR was 5.3% with a 5-year survival of 70.2%. The main recorded failure reason was fracture of the filling (anteriors 39.5%, posteriors 27.4%) and secondary caries (26%). Significantly lower survival predictions of fillings were found with increasing patient age (p<0.05) and in patients with removable dentures (p<0.001). Bruxism led to a 2.7 increased restoration failure risk (p<0.001). Restorations on endodontically treated or periodontally compromised teeth, had significantly lower survival prognoses (p<0.001). The material used and operative procedures did not influence restorations long-term survival.
Conclusions: Within the limits of the present study it can be concluded that to increase the long-term survival of direct adhesive restorations prophylactic measures must be increased, especially for elder, periodontally compromised and bruxism patients. Fracture resistance of adhesive restorative materials has still to be increased.
Methods: Clinical records from patients who received a direct adhesive restoration between the last quarters of 2008 and 2009 and a dental examination in the first two quarters of 2018 at the Dental Clinic 1 in Erlangen were retrieved. Data were pseudonymized and information were collected on: patients oral health, age, restoration survival, failure reason, surgical procedure, material used and operator. No personal data were collected. Median survival times and Annual Failure Rates (AFRs) were calculated. Survival of direct adhesive restorations were assessed by Kaplan-Meier survival analyzes. The influence of the recorded factors on survival time was analyzed by multivariate Cox regression. Data were evaluated with SPSS Statistics 25 (IBM, Armonk, USA) at a significance level of 5% (p<0.05).
Results: A total of 242 fillings in 130 patients were evaluated with a mean observation period of 9 years. At baseline patient’s average age was 56 with a DMFT of 20. Restorations AFR was 5.3% with a 5-year survival of 70.2%. The main recorded failure reason was fracture of the filling (anteriors 39.5%, posteriors 27.4%) and secondary caries (26%). Significantly lower survival predictions of fillings were found with increasing patient age (p<0.05) and in patients with removable dentures (p<0.001). Bruxism led to a 2.7 increased restoration failure risk (p<0.001). Restorations on endodontically treated or periodontally compromised teeth, had significantly lower survival prognoses (p<0.001). The material used and operative procedures did not influence restorations long-term survival.
Conclusions: Within the limits of the present study it can be concluded that to increase the long-term survival of direct adhesive restorations prophylactic measures must be increased, especially for elder, periodontally compromised and bruxism patients. Fracture resistance of adhesive restorative materials has still to be increased.