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Longevity of direct restorations in Dutch dental practices. Descriptive study out of a practice based research
Mark Laske1, Niek J M Opdam1, Ewald M Bronkhorst1
1Radboud university medical center, Department of Dentistry, Radboud Institute for Health Sciences, Philips van Leydenlaan 25, Internal postal code 309, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
Objectives:
The aim of this retrospective practice-based study was to investigate the longevity of direct restorations placed by a group of general dental practitioners (GDPs) and to explore the effect of practice/operator, patient, and tooth/restoration related factors on restoration survival.
Methods:
Electronic Patient Files of 24 general dental practices were used for collecting the data for this study. From the patient files, longevity of 359,548 composite, amalgam, glass-ionomer and compomer placed in 75,556 patients by 67 GDPs between 1996 and 2011 were analyzed. Survival was calculated from Kaplan-Meier statistics.
Results:
A wide variation in annual failure rate (AFR) exists between the different dental practices varying between 2.3% and 7.9%. Restorations in elderly people (65 years and older, AFR 6.9%) showed a shorter survival compared to restorations placed in patients younger than 65 years old (AFR 4.2%-5.0%). Restorations in molar teeth, multi-surface restorations and restorations placed in endodontically treated teeth seemed to be more at risk for re-intervention.
Conclusion:
The investigated group of GDPs place restorations with a satisfactory longevity (mean AFR 4.6% over 10 years), although substantial differences in outcome between practitioners exist. Several potential risk factors on practice/operator, patient, and tooth/restoration level have been identified and require further multivariate investigation.
