Repair increases the survival of failed primary teeth restorations in high-caries risk children: a university-based retrospective study.

OBJECTIVES: We investigated factors associated with failure of adhesive restorations in primary teeth and whether repair may increase the survival of failed restorations placed in high-caries risk children. MATERIALS AND METHODS: The sample comprised children who attended a university dental service to perform restorative treatment in primary teeth. Data were collected retrospectively from clinical records to assess the longevity of restorations. The outcomes were calculated in two levels: "Success" (Level 1)-when any re-intervention was considered as failure; "Survival" (Level 2)-when repaired restorations were considered clinically acceptable. The Kaplan-Meier survival test was used to analyze the longevity of restorations. Multivariate Cox regression with shared frailty was used to assess factors associated with failures (p < 0.05). RESULTS: A total of 584 primary teeth restorations (178 patients) were included in the analysis. The longevity of restorations up to 36 months (Level 1) was 34.8% (AFR 29.6%). Multi-surface restorations showed significantly more failures than single-surface ones (HR 1.69; 95% CI 1.18, 2.41), and endodontically treated teeth presented more failures compared to vital teeth (HR 2.22; 95% CI 1.35, 3.65). There was an increase in restoration survival when repair was not considered as failure (p < 0.001). The survival of repaired restorations (Level 2) reached 43.7% (AFR 24.1%). CONCLUSIONS: Adhesive restorations placed in primary teeth of high-caries risk children showed restricted longevity; however, the repair of failed restorations has increased its survival over time. CLINICAL RELEVANCE: Repair is a more conservative and technically simple procedure that increases the survival of failed restorations in primary teeth.

Use of Dental Care Among Pregnant Women in the Brazilian Unified Health System.

PURPOSE: To assess the prevalence of and factors associated with the use of public Unified Health System-based dental services by pregnant women and recent mothers. MATERIALS AND METHODS: In this cross-sectional study, face to face interviews were conducted to collect data on the outcome of interest (prevalence of use of dental care) and independent variables (sociodemographic, pregnancy, and prenatal care data). A total of 302 pregnant women seen at public dental services in the municipality of Canoas, southern Brazil, were interviewed. Statistical analysis was performed using the chi-squared test and hierarchical Poisson regression with robust variance (p < 0.05). RESULTS: The prevalence of use of dental care among pregnant women was 50% (n = 151). Pregnant women who initiated prenatal care in the first trimester showed a 34% higher likelihood of using dental care (prevalence ratio [PR] 1.34; 95% confidence interval [95%CI] 1.27-1.61); this likelihood was 12% higher among multiparous women (PR 1.12; 95%CI 1.03-1.23), and 40% higher among women who received guidance to seek dental care (PR 1.40; 95%CI 1.30-1.51). CONCLUSION: The present findings suggest that starting prenatal care in the first trimester, being multiparous, and receiving guidance to seek dental care significantly contributed to the use of public dental services during pregnancy in the population assessed. These factors should be considered when planning public health policies for this population.

Does Endodontic Re-Treatment in Primary Teeth Increase the Functional Tooth Retention? A Clinical, Retrospective, University-Based Study

Objective: To investigate the longevity of endodontic treatments and the survival of endodontic re-treatments performed in primary teeth. Material and Methods: The sample included endodontic treatments and re-treatments conducted in anterior and posterior primary teeth without sedation or general anesthesia among children attending a university dental service. Information collected retrospectively from clinical records was used for analyzing data. The Kaplan-Meier estimator test was used to analyze the longevity and survival of endodontic treatment and re-treatments, respectively. Results: A total of 73 patients with endodontic therapy in primary teeth were included in the study, and 116 teeth were analyzed. After one year, the longevity of endodontic treatments performed on primary teeth was 65.74% with an annual failure rate (AFR) of 34.2%. From 47 endodontic treatment failures, 14 teeth (29.8%) were endodontically re-treated. When the endodontic re-treatment was considered as survival, the longevity of treatments reached 68.06% with 31.9% of AFR after one year of follow-up. There was a significant increase in functional tooth retention in those patients that received an endodontic re-treatment (p<0.001). Retreatment provided an additional mean survival time of 8.3 months. Conclusion: Endodontic treatments performed in primary teeth presented a limited longevity. Endodontic re-treatment is a more conservative alternative for endodontically treated primary teeth that have failed and significantly increase tooth retention.