Risk Factors for Dental Restoration Survival: A Practice-Based Study

Area of Science:

• Dental biomaterials and restorative dentistry
• Clinical epidemiology and public health

Background:

• Direct class II restorations are common dental procedures.
• Identifying factors influencing restoration survival is key to improving patient outcomes and dental care quality.

Purpose of the Study:

• To investigate practice, patient, tooth, and restoration-level risk factors affecting the survival of direct class II restorations.
• To analyze the influence of these factors on restoration longevity and reintervention rates.

Main Methods:

• A practice-based cohort study analyzing 31,472 direct class II restorations from 11 Dutch dental practices.
• Kaplan-Meier survival analysis, calculation of annual failure rates (AFRs), and multivariable Cox regression analysis were employed.

Main Results:

• The mean 2-year annual failure rate (AFR) was 7.8%, with significant variation among operators (3.6%–11.4%).
• Patient factors like elderly age, medical compromise, periodontal issues, high caries risk, parafunctional habits, molar location, endodontic treatment, and multisurface restorations increased failure risk.
• Restorations for fractures failed more than those for caries; socioeconomic status became significant when patient factors were excluded.

Conclusions:

• Restoration survival is influenced by a complex interplay of practice, patient, and tooth-level factors.
• Identifying and recording patient-specific risk factors is essential for personalized dental care and improving restoration success.
• Further research should incorporate these patient risk factors into data collection and analysis.