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A retrospective cross-sectional study of early patient-reported failures of direct restorations placed in a primary dental care setting

British Dental Journal volume 231, pages 43–48 (2021)Cite this article

Abstract

Introduction A retrospective cross-sectional study of early patient-reported failures of restorations was initiated to understand the reasons and factors associated with early failure. Early patient-reported failures are defined as restorations requiring replacement within three months of placement.

Aim To investigate if restorative material placed or any other tooth/restoration/patient factors may be associated with early patient-reported failures.

Methods In total, 360 restorations were replaced from January 2016 to December 2017. Multivariable analyses (logistic regression model) were used to identify any patient/tooth/restoration factors that were associated with early patient-reported failures.

Results Dislodgement, fracture and pain/sensitivity were the three main failure modes. There was significant association between restorative material type and dislodgement and restoration fracture. The odds of dislodgement for composite resin (CR) were 4.3 times higher compared to amalgam. The odds of dislodgement for glass-ionomer cement (GIC) and resin-modified GIC were 3.7 times higher compared to amalgam. The odds of fracture for CR were ten times lower compared to amalgam. The odds of pain for teeth with a history of restoration failure for a particular tooth were five times lower compared to no history of restoration failure for a particular tooth.

Conclusions Restorative material type affected patient-reported failures.

Key points

  • Investigates early patient-reported failures of direct restorations.

  • Dislodgement, fracture and pain/sensitivity were the three main failure modes for early failures in direct restorations.

  • Restorative material type was significantly associated with dislodgement and fracture.

  • A history of restoration failure for a particular tooth was significantly associated with pain.

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References

  1. Opdam N J, van de Sande F H, Bronkhorst E et al. Longevity of posterior composite restorations: a systematic review and meta-analysis. J Dent Res 2014; 93: 943-949.

  2. Sunnegardh-Gronberg K, van Dijken J W, Funegard U, Lindberg A, Nilsson M. Selection of dental materials and longevity of replaced restorations in Public Dental Health clinics in northern Sweden. J Dent 2009; 37: 673-678.

  3. Moraschini V, Fai C K, Alto R M, Dos Santos G O. Amalgam and resin composite longevity of posterior restorations: A systematic review and meta-analysis. J Dent 2015; 43: 1043-1050.

  4. Schwendicke F, Gostemeyer G, Blunck U, Paris S, Hsu L Y, Tu Y K. Directly Placed Restorative Materials: Review and Network Meta-analysis. J Dent Res 2016; 95: 613-622.

  5. Hickel R, Manhart J. Longevity of restorations in posterior teeth and reasons for failure. J Adhes Dent 2001; 3: 45-64.

  6. Demarco F F, Correa M B, Cenci M S, Moraes R R, Opdam N J. Longevity of posterior composite restorations: not only a matter of materials. Dent Mater 2012; 28: 87-101.

  7. Overton J D, Sullivan D J. Early failure of Class II resin composite versus Class II amalgam restorations placed by dental students. J Dent Educ 2012; 76: 338-340.

  8. Demarco F F, Collares K, Coelho-de-Souza F H et al. Anterior composite restorations: A systematic review on long-term survival and reasons for failure. Dent Mater 2015; 31: 1214-1224.

  9. Mjor I A. The reasons for replacement and the age of failed restorations in general dental practice. Acta Odontol Scand 1997; 55: 58-63.

  10. Letzel H, van 't Hof M A, Vrijhoef M M, Marshall Jr G W, Marshall S J. A controlled clinical study of amalgam restorations: survival, failures, and causes of failure. Dent Mater 1989; 5: 115-121.

  11. Mjor I A, Dahl J E, Moorhead J E. Age of restorations at replacement in permanent teeth in general dental practice. Acta Odontol Scand 2000; 58: 97-101.

  12. Rasines Alcaraz M G, Veitz-Keenan A, Sahrmann P, Schmidlin P R, Davis D, Iheozor-Ejiofor Z. Direct composite resin fillings versus amalgam fillings for permanent or adult posterior teeth. Cochrane Database Syst Rev 2014; DOI: 10.1002/14651858.CD005620.pub2.

  13. Jokstad A, Mjor I A, Qvist V. The age of restorations in situ. Acta Odontol Scand 1994; 52: 234-242.

  14. Opdam N J, Bronkhorst E M, Roeters J M, Loomans B A. A retrospective clinical study on longevity of posterior composite and amalgam restorations. Dent Mater 2007; 23: 2-8.

  15. Lee Y L, Liu J, Clarkson B H, Lin C P, Godovikova V, Ritchie H H. Dentin-pulp complex responses to carious lesions. Caries Res 2006; 40: 256-264.

  16. Magloire H, Bouvier M, Joffre A. Odontoblast response under carious lesions. Proc Finn Dent Soc 1992; 88 Suppl 1: 257-274.

  17. Murray P E, Windsor L J, Smyth T W, Hafez A A, Cox C F. Analysis of pulpal reactions to restorative procedures, materials, pulp capping, and future therapies. Crit Rev Oral Biol Med 2002; 13: 509-520.

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Acknowledgements

Dr Lee Eng Sing (Family Physician Senior Consultant, Clinical Research Unit), Sabrina Lee Poay Sian (Research Fellow, Clinical Research Unit), Koh Hui Li (Research Assistant, Clinical Research Unit) and Jeremy Lew Kaiwei (Executive, Clinical Research Unit).

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Authors and Affiliations

  1. Dental Surgeon, National Healthcare Group Polyclinics, Hougang, Singapore

    Vivian Yung Yee Wong

  2. Dental Surgeon, National Healthcare Group Polyclinics, Geylang, Singapore

    Yoke Kwan Chua

  3. Principal Dental Surgeon, National Healthcare Group Polyclinics, Ang Mo Kio, Singapore

    Holy JR Koh

  4. Dental Director, National Healthcare Group Polyclinics, Singapore

    Kenneth Meng Tze Low

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  1. Vivian Yung Yee Wong
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  2. Yoke Kwan Chua
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Correspondence to Vivian Yung Yee Wong.

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Wong, V., Chua, Y., JR Koh, H. et al. A retrospective cross-sectional study of early patient-reported failures of direct restorations placed in a primary dental care setting. Br Dent J 231, 43–48 (2021). https://doi.org/10.1038/s41415-021-3166-x

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