Abstract
Objective
The aim of this retrospective university-based study has been to evaluate the longevity and factors associated with failures of adhesive restorations performed in deep carious lesions of permanent molars after complete (CCR) and selective caries removal (SCR).
Materials and methods
The sample was composed of composite resin and resin-modified glass ionomer cement (RMGIC) restorations placed in permanent molars of children attending a university dental service who were followed up for up to 36 months. Information collected retrospectively from clinical records was used for analyzing data. The following factors were investigated: gender, caries experience, visible plaque and gingival bleeding indexes, operator’s experiences, number of restored surfaces, and type of capping and restorative materials. The Kaplan-Meier survival test was used to analyze the longevity of the restorations. Multivariate Cox regression analysis with shared frailty was used to assess the factors associated with failures (p < 0.05).
Results
Four hundred seventy-seven restorations carried out in 297 children (9.1 ± 1.7 years) were included in the analysis. The survival of the restorations reached 57.9 % up to 36 months follow-up with an overall annual failure rate of 16.7 %. There was no difference in restoration longevity when CCR or SCR was performed (p = 0.163); however, CCR presented more pulp exposure (p < 0.001). Multi-surface restorations showed more failures than single-surface (HR 3.22, 95 % CI 1.49; 6.97), and teeth restored with RMGIC had a lower survival rate than those restored with composite resin (HR 4.11, 95 % CI 1.91; 8.81). Patients with evidence of gingivitis had more risk of failure in their restorations (HR 2.88, 95 % CI 1.33; 6.24).
Conclusion
Overall, adhesive restorations performed in young permanent molars of high caries risk children presented limited survival, regardless of the caries removal technique. Risk factors for failure were identified as multi-surface fillings, RMGIC restorative material, and poor oral hygiene, reflected by gingival bleeding.
Clinical relevance
Composite fillings associated with a strict caries preventive regimen may play an important role in the survival of restorations placed in high caries risk children.
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References
Petersen PE (2003) The World Oral Health Report 2003: continuous improvement of oral health in the 21st century—the approach of the WHO Global Oral Health Programme. Community Dent Oral Epidemiol 31:3–24
SB BRAZIL (2010) National research on oral health 2010: main results
Schwendicke F, Stolpe M, Meyer-Lueckel H, Paris S, Dörfer CE (2013) Cost-effectiveness of one- and two-step incomplete and complete excavations. J Dent Res 10:880–887
Ricketts D, Lamont T, Innes NP, Kidd E, Clarkson JE (2013) Operative caries management in adults and children. Cochrane Database Syst Rev 3. doi:10.1002/14651858
Schwendicke F, Dörfer CE, Paris S (2013) Incomplete caries removal: a systematic review and meta-analysis. J Dent Res 92:306–314
Maltz M, Garcia R, Jardim JJ, de Paula LM, Yamaguti PM, Moura MS, Garcia F, Nascimento C, Oliveira A, Mestrinho HD (2012) Randomized trial of partial vs. stepwise caries removal: 3-year follow-up. J Dent Res 91:1026–1031
Ericson D (2007) The concept of minimally invasive dentistry. Dent Updat 34:9–10
Thompson V, Craig RG, Curro FA, Green WS, Ship JA (2008) Treatment of deep carious lesions by complete excavation or partial removal: a critical review. J Am Dent Assoc 139:705–712
Hayashi M, Fujitani M, Yamaki C, Momoi Y (2011) Ways of enhancing pulp preservation by stepwise excavation—a systematic review. J Dent 39:95–107
Schwendicke F, Meyer-Lueckel H, Dörfer C, Paris S (2013) Attitudes and behaviour regarding deep dentin caries removal: a survey among German dentists. Caries Res 47:566–573
Schwendicke F, Kern M, Meyer-Lueckel H, Boels A, Doerfer C, Paris S (2014) Fracture resistance and cuspal deflection of incompletely excavated teeth. J Dent 42(2):107–113
Hevinga MA, Opdam NJ, Frencken JE, Truin GJ, Huymans MC (2010) Does incomplete caries removal reduce strength of restored teeth? J Dent Res 89:1270–1275
Maltz M, Jardin JJ, Mestrinho HD, Yamaguti PM, Podestá K, Moura MS, de Paula LM (2013) Partial removal of carious dentine: a multicenter randomized controlled trial and 18-month follow-up results. Caries Res 47:103–109
Ainamo J, Bay I (1975) Problems and proposals for recording gingivitis and plaque. Int Dent J 25:229–235
Lang NP, Tonetti MS (2003) Periodontal risk assessment (PRA) for patients in supportive periodontal therapy (SPT). Oral Health Prev Dent 1:7–16
Bjorndal L, Larsen T, Thylstrup A (1997) A clinical and microbiological study of deep carious lesion during stepwise excavation using long treatment intervals. Caries Res 31:411–417
Barthel CR, Rosenkranz B, Leuenberg A, Roulet JF (2000) Pulp capping of carious exposures: treatment outcome after 5 and 10 years: a retrospective study. J Endod 26:525–528
Schwendicke F, Kern M, Blunck U, Dörfer C, Drenck J, Paris S (2014) Marginal integrity and secondary caries of selectively excavated teeth in vitro. J Dent 10:1261–1268
Yoshiyama M, Tay FR, Doi J, Nishitani Y, Yamada T, Itou K, Carvalho RM, Nakajima M, Pashley DH (2002) Bonding of self-etch and total-etch adhesives to carious dentin. J Dent Res 8:556–560
Demarco FF, Corrêa MB, Cenci MS, Moraes RR, Opdam NJ (2012) Longevity of posterior composite restorations: not only a matter of materials. Dent Mater 28:87–101
Pallesen U, van Dijken JW, Halken J, Hallonsten AL, Höigaard R (2013) Longevity of posterior resin composite restorations in permanent teeth in public dental health service: a prospective 8 years follow up. J Dent 4:297–306
De Munck J, Van Landuyt KL, Coutinho E, Poitevin A, Peumans M, Lambrechts P et al (2005) Fatigue resistance of dentin/composite interfaces with an additional intermediate elastic layer. Eur J Oral Sci 113:77–82
van de Sande FH, Da Rosa Rodolpho PA, Basso GR, Patias R, da Rosa QF, Demarco FF et al (2015) 18-year survival of posterior composite resin restorations with and without glass ionomer cement as base. Dent Mater 31:669–675
Azevedo MS, Vilas Boas D, Demarco FF, Romano AR (2010) Where and how are Brazilian dental students using glass ionomer cement? Braz Oral Res 24:482–487
Taha NA, Palamara JE, Messer HH (2009) Cuspal deflection, strain and microleakage of endodontically treated premolar teeth restored with direct resin composites. J Dent 37:724–730
Basso GR, Della Bona A, Gobbi D, Cecchetti D (2011) Fluoride release from restorative materials. Braz Dent J 22:355–358
Casagrande L, Dalpian DM, Ardenghi TM, Zanatta FB, Balbinot CE, García-Godoy F, De Araujo FB (2013) Randomized clinical trial of adhesive restorations in primary molars. 18-month results. Am J Dent 6:351–355
Barbosa RP, Pereira-Cenci T, Silva WM, Coelho-de-Souza FH, Demarco FF, Cenci MS (2012) Effect of cariogenic biofilm challenge on the surface hardness of direct restorative materials in situ. J Dent 40:359–363
Pinto Gdos S, Oliveira LJ, Romano AR, Schardosim LR, Bonow ML, Pacce M et al (2014) Longevity of posterior restorations in primary teeth: results from a paediatric dental clinic. J Dent 42:1248–1254
Da Rosa Rodolpho PA, Donassollo TA, Cenci MS, Loguercio AD, Moraes RR, Bronkhorst EM, Opdan NJ, Demarco FF (2011) 22-year clinical evaluation of the performance of two posterior composites with different filler characteristics. Dental Mater 27:955–963
Opdam NJ, Bronkhorst EM, Roeters JM, Loomans BA (2007) Longevity and reasons for failure of sandwich and total-etch posterior composite resin restorations. J Adhes Dent 9:469–475
Van Nieuwenhuysen JP, D’Hoore W, Carvalho J, Qvist V (2003) Long-term evaluation of extensive restorations in permanent teeth. J Dent 31:395–405
Broadbent JM, Thomson WM, Boyens JV (2011) Dental plaque and oral health during the first 32 years of life. Am J Dent 142:415–426
van de Sande FH, Opdam NJ, Rodolpho PA, Correa MB, Demarco FF, Cenci MS (2013) Patient risk factors’ influence on survival of posterior composites. J Dent Res 92:78–83
Moura FR, Romano AR, Lund RG, Piva E, Rodrigues Júnior SA, Demarco FF (2011) Three-year clinical performance of composite restorations placed by undergraduate dental students. Braz Dent J 22:111–116
Opdam NJM, Bronkhorst E, Cenci M, Huysmans MC, Wilson NHF (2011) Age of failed restorations: a deceptive longevity parameter. J Dent 39:225–230
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Author Alejandra Tejeda Seminario declares that she has no conflict of interest; author Marcos Britto Correa declares that he has no conflict of interest; author Stefanie Bressan Werle declares that she has no conflict of interest; author Marisa Maltz declares that she has no conflict of interest; author Flávio Fernando Demarco declares that he has no conflict of interest; author Fernando Borba de Araujo declares that he has no conflict of interest; and author Luciano Casagrande declares that he has no conflict of interest.
Funding
The costs of this retrospective study were funded by the researchers.
Ethical approval
All procedures performed in the present research were in accordance with the ethical standards of the Resolution of the National Council on Ethics in Research (n. 466,/2012) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent
Informed consent was obtained from the parents or guardians of all children included in the study. The protocol of this research was submitted and approved by the Research Committee (n. 26760) and the Ethic Committee (n. 35380414.2.0000.5347) of the Federal University of Rio Grande do Sul, Porto Alegre, RS - Brazil.
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Casagrande, L., Seminario, A.T., Correa, M.B. et al. Longevity and associated risk factors in adhesive restorations of young permanent teeth after complete and selective caries removal: a retrospective study. Clin Oral Invest 21, 847–855 (2017). https://doi.org/10.1007/s00784-016-1832-1
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DOI: https://doi.org/10.1007/s00784-016-1832-1