Research | Published:

The ultimate guide to restoration longevity in England and Wales. Part 5: crowns: time to next intervention and to extraction of the restored tooth

BDJ volume 225, pages 3348 (13 July 2018) | Download Citation

Subjects

Key points

  • Provides information on the survival of crowns in all teeth by analysis of the time to re-intervention on the crowns and time to extraction of the crowned tooth.

  • Approximately 1.2 million crowns were included in the study, of which circa 880,000 were metal-ceramic. Overall, 53% of crowns have survived at 15 years, with 63% having survived to 10 years and 77% to 5 years, with factors influencing survival being patient age and patient treatment need.

  • When the data are re-analysed with regard to time to extraction of the restored tooth, crowns perform poorly, with teeth restored with direct restorations in amalgam and resin composite having better times to extraction.

Abstract

Aim

It is the aim of this paper to present data on the survival of crowns in all teeth by analysis of the time to re-intervention on the crowns and time to extraction of the crowned tooth, and to discuss the factors which may influence this.

Results

Data for more than three million different patients and more than 25 million courses of treatment were included in the analysis. Included were all records for adults (aged 18 or over at date of acceptance). Overall, 1,202,005 crowns were included, of which 302,555 had a re-intervention over the duration of the dataset. Overall, 52% of crowns have survived at 15 years, with factors influencing survival being patient age, dentist age and patient treatment need. However, when the data are re-analysed with regard to time to extraction, while crowns provide a patient with a restoration which requires the least number of re-interventions, they perform poorly when time to extraction is examined. The placement of a pinned core appears to enhance the longevity of the subsequent crown, whereas the placement of a root filling or a metal post does not. With regard to tooth position, crowns placed on upper canine teeth perform worse than crowns placed on any other tooth, while crowns perform best on first molar teeth.

Conclusions

Crowns may provide a patient with a restoration which requires the least number of re-interventions. However, they perform poorly when time to extraction is examined.

Access optionsAccess options

Rent or Buy article

Get time limited or full article access on ReadCube.

from $8.99

All prices are NET prices.

References

  1. 1.

    , . The ultimate guide to restoration longevity in England and Wales. Part 1: methodology. Br Dent J 2018; 224: 709–716.

  2. 2.

    Information Centre for Health and Social Care, NHS Business Services Authority. Longitudinal Dental Treatment, 1990–2006. [data collection]. UK Data Service, 2012.

  3. 3.

    , , . Ten-year outcome of root fillings in the General Dental services in England and Wales. Int Endo J 2008; 41: 577–585.

  4. 4.

    . A comparison of restoration longevity in maxillary and mandibular teeth. J Amer Dent Assoc 1988; 116: 651–654.

  5. 5.

    , . The ultimate guide to restoration longevity in England and Wales. Part 2: Amalgam restorations – time to next intervention and to extraction of the restored tooth. Br Dent J 2018; 224: 789–800.

  6. 6.

    , . The ultimate guide to restoration longevity in England and Wales. Part 4: Composite restorations: time to next intervention and to extraction of the restored tooth. Br Dent J 2018; 224: 945–956

  7. 7.

    , , , , . In vitro cavity and crown preparations and direct restorations carried out by Foundation Dentists (FDs) in the Oxford and Wessex Deaneries: A comparison of performance at the start and end of the FD programme. Br Dent J 2017; 222: 605–611.

  8. 8.

    General Dental Council. Dentist Register, 2015. London: General Dental Council, 2015.

  9. 9.

    , . Adult Dental Health Survey 2009. London: Health and Social Care Information Centre, 2009.

  10. 10.

    , , . Moisture content of vital vs endodontically treated teeth. Endod Dent Traumatol 1994; 10: 91–93.

  11. 11.

    , , . Reduction in tooth stiffness as a result of endodontic and restorative procedures. J Endod 1989; 15: 512–516.

  12. 12.

    , , , . An evaluation of crowns and bridges in a general dental practice. J Oral Rehabil 1985; 12: 515–528.

  13. 13.

    . A 10-year longitudinal study of fixed prosthodontics: Clinical characteristics and outcome of single-unit metal-ceramic crowns. Int J Prosthodont 1999; 12: 519–526.

  14. 14.

    . Retrospective assessment of 546 all-ceramic anterior and posterior crowns in a general practice. J Prosthet Dent 2001; 85: 544–550.

  15. 15.

    , , , . A systematic review of the survival and complication rates of all-ceramic and meta-ceramic reconstructions after an observation period of at least 3 years. PartI: single crowns. Clin Oral Impl Res 2007; 18 (suppl. 3): 73–85.

  16. 16.

    , , , . Retrospective clinical evaluation of 1314 cast gold restorations in service from 1 to 52 years. J Esthet Rest Dent 2004; 16: 194–204.

  17. 17.

    . Dental cements for definitive luting: A review and practical clinical considerations. Dent Clin N Am 2007; 61: 643–658.

Download references

Acknowledgements

The authors acknowledge the support of the Economic and Social Data Service, the Health and Social Care Information Centre and the NHS Business Services Authority for collating and releasing this valuable data resource.

Author information

Affiliations

  1. Primary Dental Care Research Group, University of Birmingham School of Dentistry, College of Medical and Dental Sciences, Pebble Mill, Birmingham, B5 7EG, UK

    • F. J. T. Burke
    •  & P. S. K. Lucarotti

Authors

  1. Search for F. J. T. Burke in:

  2. Search for P. S. K. Lucarotti in:

Corresponding author

Correspondence to F. J. T. Burke.

About this article

Publication history

Accepted

Published

DOI

https://doi.org/10.1038/sj.bdj.2018.523