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Risk factors for failure in the management of cervical caries lesions
R J Wierichs1, E J Kramer2, H Meyer-Lueckel3
1Department of Operative Dentistry, Periodontology and Preventive Dentistry, RWTH Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany. rwierichs@ukaachen.de.
Objectives:
The aim of this retrospective, non-interventional clinical study was to analyze factors influencing the survival of restorative treatments of active cervical (root) caries lesions (aCCLs) and the success of non-invasive treatment options of inactive cervical (root) caries lesions (iCCLs).
Material And Methods:
Records from patients who visited a single private practice regularly were searched for the presence of solely buccal CCLs. Data from 345 aCCLs and 232 iCCLs being detected at least 6 months before the last recall visit in 295 patients were recorded. Kaplan-Meier analyses were used to analyze time to failure in both groups. Cox proportional hazards models were used to evaluate the association between clinical factors and time until failure.
Results:
Within 120 months, 20 aCCLs had received a second restorative follow-up treatment. For iCCLs, 35 lesions had to be restored within 120 months. Median survival/success time was 111 months for aCCLs (annual failure rate 1.7%) and 120 months for iCCLs (annual "restoration" rate 4.3%). In multivariate Cox regression, active and inactive CCLs being checked up more than twice a year showed significantly higher failure/restoration rates than CCLs being checked up less than twice a year (p < 0.001).
Conclusion:
Low failure/restoration rates could be found for both treatment strategies for CCLs, and only the "number of check-ups per year" was significantly positively associated with failures.
Clinical Relevance:
Caries monitoring is a viable way to manage CCLs. However, individual check-up interval should be defined carefully, since higher rate of check-ups seems to lead to increased intervention rates in the management of CCLs. The study was registered in the German Clinical Trials Register (DRKS-ID: DRKS00010003).
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