Is composite repair suitable for anterior restorations? A long-term practice-based clinical study

Area of Science:

• Dental Materials Science
• Restorative Dentistry
• Clinical Research

Background:

• Direct composite restorations are widely used for anterior teeth.
• Assessing the long-term success of these restorations requires clear definitions of failure, particularly regarding repair.
• Understanding the impact of repair on survival rates is crucial for clinical decision-making.

Purpose of the Study:

• To evaluate the survival rates of anterior composite restorations over 15 years.
• To compare survival outcomes when dental restoration repair is considered failure versus not considered failure.
• To identify factors influencing the failure of anterior composite restorations.

Main Methods:

• Retrospective analysis of 634 direct composite restorations (Class III, IV, veneer) in anterior teeth from a private practice (1994-2009).
• Data analysis included Kaplan-Meier, log rank test, and Cox regression, comparing outcomes with and without considering repair as failure.
• Statistical significance was set at p < .05.

Main Results:

• Class III/IV restorations showed 69% survival (2.4% annual failure rate) when repair was not failure, versus 64% survival (2.9% AFR) when repair was failure.
• Veneer survival dropped significantly when repair was considered failure (e.g., 52% at 10 years vs. 38%).
• Restorations in the upper jaw and central incisors had a higher failure risk.

Conclusions:

• Composite repair is a suitable alternative for Class III, IV, and veneer restorations, enhancing survival rates.
• Repairing anterior composite restorations offers benefits over replacement, including preserving tooth structure and reducing chair time.
• Considering repair as a successful outcome, rather than failure, provides a more optimistic view of restoration longevity.