Longevity of posterior restorations

The efficacy of restorative dentistry is dependent on a number of factors, including material quality, operator proficiency and the oral hygiene of the patient. The sum effect of all factors can be measured by recording the longevity of the restorations. Many studies focus on the age of restorations at the time of failure, others include the longevity of restorations which remain in situ. The surveys may be either longitudinal, prospective or retrospective, or cross-sectional retrospective studies of dental records. They are all hampered by the lack of uniform criteria defining when to place and replace restorations and by variations in decision-making between clinicians. The present review paper shows that the longevity of amalgam restorations has been studied most frequently. About 50 per cent of all amalgam restorations exceed 8-10 years in age, cast gold restorations may last longer and multisurfaced composite restorations have a shorter life-span. Glass ionomer cements lack the physical properties needed for large posterior restorations. The results of detailed longevity studies should be the basis for selection of materials and techniques in operative/conservative treatment. The cost of dental treatment should be related to the expected lifetime of the tooth rather than to the immediate cost of a simple restoration.