A prospective 8-year follow-up of posterior resin composite restorations in permanent teeth of children and adolescents in Public Dental Health Service: reasons for replacement.

OBJECTIVES: The aim of the study was to investigate reasons for replacement and repair of posterior resin composite (RC) restorations placed in permanent teeth of children and adolescents attending Public Dental Health Service in Denmark. MATERIAL AND METHOD: All posterior RC placed consecutively by 115 dentists over a period of 4 years were evaluated at baseline and up to 8 years later. The endpoint of each restoration was defined when repair or replacement was performed. The influence of patient, dentist and material factors on reasons for repair or replacement was investigated. RESULTS: A total of 4,355 restorations were placed. Replacements comprised 406 and repairs 125 restorations. The cumulative survival rate at 8 years was 84 %. Failed restorations were most frequently seen due to secondary caries (57 %), post-operative sensitivity (POS) (10 %) and RC fracture (6 %). POS was observed in 1.5 % of the evaluations and reported more often in girls and from teeth restored with a base material. Older dentists showed lower proportion of replaced restorations due to secondary caries than younger dentists. CONCLUSION: Posterior RC restorations in children and adolescents performed in general practice showed a good durability with annual failure rates of 2 %. The main reason for failure was secondary caries followed by post-operative sensitivity and resin composite fracture. A high proportion of replaced/repaired RC restorations were caused by primary caries in a non-filled surface. CLINICAL RELEVANCE: Secondary caries was the main reason for failure of RC in children and young adults. More teeth with post-operative sensitivity and a shorter longevity of restorations were observed when a base material was used.

Longevity of posterior resin composite restorations in permanent teeth in Public Dental Health Service: a prospective 8 years follow up.

OBJECTIVES: To investigate in a prospective follow up the longevity of posterior resin composites (RC) placed in permanent teeth of children and adolescents attending Public Dental Health Service. METHODS: All posterior RC placed, in the PDHS clinics in the cities of Copenhagen and Frederiksberg in Denmark between November 1998 and December 2002, in permanent teeth of children and adolescents up to 18 years, were evaluated in an up to 8 years follow up. The endpoint of each restoration was defined, when repair or replacement was performed. Survival analyses were performed between subgroups with Kaplan-Meier analysis. The individual contribution of different cofactors to predict the outcome was performed with Cox regression analysis. RESULTS: Totally 2881 children with a mean age of 13.7 years (5-18) received 4355 RC restorations placed by 115 dentists. Eighty percent were placed in molars and 49% were Class I. Two percent of restorations with base material and 1% of the restorations without base material showed postoperative sensitivity (n.s.). Replacements were made in 406 and repairs in 125 restorations. Kaplan-Meier analysis showed a cumulative survival at 8 years of 84.3%, resulting in an annual failure rate of 2%. Lower patient age, more than one restoration per patient, placement of a base material and placement of RC: in molars, in cavities with high number of surfaces, in lower jaw teeth, showed all significant higher failure rates. Five variables had significant importance for the end point, replacement/repair of the resin composite restorations: age of patient, age of operator, jaw, tooth type and cavity size. SIGNIFICANCE: Posterior RC restorations placed in children and adolescents in Public Dental Health clinics showed an acceptable durability with annual failure rates comparable with those of randomized controlled RC studies in adults.