ABSTRACT
OBJECTIVE: To evaluate the survival over five years of Class V restorations placed by UK general practitioners, and to identify factors associated with increased longevity. DESIGN: Prospective longitudinal cohort multi-centre study. SETTING: UK general dental practices. MATERIALS AND METHOD: Ten general dental practitioners each placed 100 Class V restorations of varying sizes, using a range of materials and recorded selected clinical information at placement and recall visits. After five years the data were analysed using the Kaplan-Meier method, log-rank tests and Cox regressions models to identify significant associations between the time to restoration failure and different clinical factors. RESULTS: After five years 275/989 restorations had failed (27.8%), with 116 (11.7%) lost to follow-up. Cox regression analysis identified that, in combination, the practitioner, patient age, cavity size, moisture contamination and cavity preparation were found to influence the survival of the restorations. CONCLUSIONS: At least 60.5% of the restorations survived for five years. The time to failure of Class V restorations placed by this group of dentists was reduced in association with the individual practitioner, smaller cavities, glass ionomer restorations, cavities which had not been prepared with a bur, moisture contamination, increasing patient age, cavities confined to dentine and non-carious cavities.
Subject(s)
Dental Cavity Preparation , Dental Materials , Dental Restoration Failure/statistics & numerical data , Dental Restoration, Permanent/methods , Age Factors , Cohort Studies , Female , General Practice, Dental , Humans , Longitudinal Studies , Male , Proportional Hazards Models , Survival AnalysisABSTRACT
OBJECTIVE: To evaluate Class V restorations placed by UK general practitioners comparing those failing or surviving after two years, and to identify factors associated with early failure. DESIGN: Prospective longitudinal cohort multi-centre study. Setting UK general dental practices. MATERIALS & METHODS: Ten dentists each placed 100 Class V restorations and recorded selected clinical information at placement and recall visits. Univariate associations were assessed between recorded clinical factors and whether restorations had failed or not at two years. Multi-variable binary logistic regression was also undertaken to identify which combination of factors had a significant effect on the probability of early failure. RESULTS: At two years, 156 of 989 restorations had failed (15.8%), with 40 (4%) lost to follow-up. Univariate analysis showed a significant association between restoration failure and increasing patient age, payment method, the treating practitioner, non-carious cavities, cavities involving enamel and dentine, cavity preparation and restoration material. Multi-variable analysis indicated a higher probability of early failure associated with the practitioner, older patients, glass ionomer and flowable composite, bur-preparation and moisture contamination. CONCLUSIONS: Among these practitioners, both analytic methods identified significant associations between early failure of Class V restorations and the practitioner, cavity preparation method, restoration material and patient's age.
Subject(s)
Dental Restoration Failure , Dental Restoration, Permanent , General Practice, Dental , Age Factors , Analysis of Variance , Cohort Studies , Composite Resins , Dental Amalgam , Dental Bonding/methods , Dental Cavity Preparation/methods , Dental Restoration, Permanent/classification , Dental Restoration, Permanent/statistics & numerical data , Female , Glass Ionomer Cements , Humans , Logistic Models , Male , Middle Aged , Oral Hygiene Index , Patient Credit and Collection/methods , Prospective Studies , Tooth CervixABSTRACT
OBJECTIVE: Evidence on the survival of different restorations in general practice is scarce and so to address this need, a study was designed to monitor the outcome of Class V restorations placed in UK general practices. DESIGN: Prospective longitudinal cohort multi-centre study. SETTING: UK general dental practice. MATERIALS AND METHODS: Ten UK dentists each placed 100 Class V restorations and recorded selected clinical information at placement and at recall visits on record cards. Dentists selected materials and techniques which they felt appropriate to each clinical situation. RESULTS: Data cards for 11 restorations were incorrectly completed or information was missing leaving 989 for analysis. The majority of restorations were placed in patients between 51 and 60 years of age, in canines or premolars (68.4%) and under private contract (63%). Composite (40.85%) and compomer (23.46%) were the most frequently placed materials overall but were not the most frequently placed restorative by some dentists. CONCLUSIONS: Different dentists use different methods to manage Class V lesions but each dentist tends to use one restorative material predominantly. There is a degree of overlap among practitioners in the materials which they employ, but clear preferences were displayed in the materials used and handling techniques.
