Quantify the survival of posterior composite restorations (PCR) placed during the study period in permanent teeth in United States (US) general dental community practices and factors predictive of that survival.A retrospective cohort study was conducted utilizing de-identified electronic dental record (EDR) data of patients who received a PCR in 99 general dentistry practices in the National Dental Practice-Based Research Network (Network). The final analyzed data set included 700,885 PCRs from 200,988 patients. Descriptive statistics and Kaplan Meier (product limit) estimator were performed to estimate the survival rate (defined as the PCR not receiving any subsequent treatment) after the first PCR was observed in the EDR during the study time. The Cox proportional hazards model was done to account for patient- and tooth-specific covariates.The overall median survival time was 13.3 years. The annual failure rates were 4.5-5.8 % for years 1-5; 5.3-5.7 %, 4.9-5.5 %, and 3.3-5.2 % for years 6-10, 11-15, and 16-20, respectively. The failure descriptions recorded for < 7 % failures were mostly caries (54 %) and broken or fractured tooth/restorations (23 %). The following variables significantly predicted PCR survival: number of surfaces that comprised the PCR; having at least one interproximal surface; tooth type; type of prior treatment received on the tooth; Network region; patient age and sex. Based on the magnitude of the multivariable estimates, no single factor predominated.This study of Network practices geographically distributed across the US observed PCR survival rates and predictive factors comparable to studies done in academic settings and outside the US.Specific baseline factors significantly predict the survival of PCRs done in US community dental practices. 

Survival analysis of posterior composite restorations in National Dental PBRN general dentistry practices.

The population is ageing and people are keeping their own teeth for much longer due in part to the efforts of the dental profession in restoring teeth and reducing the number of teeth being extracted. Along with this there is now an increasing expectation by patients that they will retain their own teeth as they age and that dental practitioners will have the knowledge and skills to help them retain their own teeth. Contemporary restorative materials and techniques have increased the range of options available to assist with maintaining the dentition, and many of these procedures enable minimally invasive and cost effective management of the teeth as an alternative to complex and expensive procedures. This paper discusses the restoration of compromised and failing teeth in the ageing patient, and looks at the various issues facing the ageing dentate patient and the dilemma of when to restore or when to extract. Ultimately it is hoped that maintaining healthy teeth for life may not only improve oral function and quality of life, but may in fact reduce the impact of the physical and psychological aspects of ageing.

Herodontics - is there a place for maintaining the apparently hopeless tooth?

This study aimed to assess the survival of direct composite restorations placed under general anesthesia in adult patients with intellectual and/or physical disabilities. Survival of composite restorations placed under general anesthesia in adult patients with intellectual and/or physical disabilities was retrospectively analyzed. Failure was defined as the need for replacement of at least one surface of the original restoration or extraction of the tooth. Individual-, tooth-, and restoration-related factors were obtained from dental records. Five-year mean annual failure rate (mAFR) and median survival time were calculated (Kaplan-Meier statistics). The effect of potential risk factors on failure was tested using univariate log-rank tests and multivariate Cox-regression analysis (α = 5%). A total of 728 restorations in 101 patients were included in the analysis. The survival after 5 years amounted to 67.7% (5-year mAFR: 7.5%) and median survival time to 7.9 years. Results of the multivariate Cox-regression analysis revealed physical disability (HR: 50.932, p = 0.001) and combined intellectual/physical disability (HR: 3.145, p = 0.016) compared with intellectual disability only, presence of a removable partial denture (HR: 3.013, p < 0.001), and restorations in incisors (HR: 2.281, p = 0.013) or molars (HR: 1.693, p = 0.017) compared with premolars to increase the risk for failure. Composite restorations placed under general anesthesia in adult patients with intellectual and/or physical disabilities showed a reasonable longevity as 67.7% survived at least 5 years. Survival of composite restorations depends on risk factors that need to be considered when planning restorative treatment in patients with intellectual and/or physical disabilities. NCT04407520

/pdf/survival-of-direct-composite-restorations-placed-under-38qkecuavv.pdf

Survival of direct composite restorations placed under general anesthesia in adult patients with intellectual and/or physical disabilities

Introduction:Frail older adults residing in long-term care (LTC) facilities are among the most vulnerable to dental caries due to poor oral hygiene (OH), medication-related salivary hypofunction, c...

/pdf/five-year-survival-rate-of-bonded-dental-restorations-in-3qy73144iw.pdf

Five-year Survival Rate of Bonded Dental Restorations in Frail Older Adults:

/pdf/diagnostic-methods-for-big-survival-data-1wow6pfekr.pdf

Diagnostic Methods for Big Survival Data

Introduction:Although the population is aging and retaining more teeth, there is a lack of studies that address the longevity of dental restorations placed among older adultsObjectives:This study 

https://journals.sagepub.com/doi/pdf/10.1177/2380084418799083

Dental Restoration Longevity among Geriatric and Special Needs Patients.

This study aimed to describe the survival trajectory of dental restorations placed among a population of geriatric and adult special needs patients over a 15-year span, with particular interest paid to longevity of subsequent restorations in teeth that received multiple restorations over time. Dental restorations of different types and sizes in patients age ≥65 years treated between 2000-14 at the University of Iowa College of Dentistry were followed until they were either replaced or the teeth were extracted or endodontically treated. Survival analysis and extended Cox regression models were used to generate hazards ratios for selected predictor variables. A total of 9184 restorations were followed in 1551 unique patients. 28.7 percent of the restorations failed during the follow-up period, and overall the restorations had an average lifespan of 2.48 years. Restoration size and restorative material were associated with restoration longevity. Restorations that were not the first eligible restoration for that tooth in the database also had poorer survival than the first restoration for that tooth. In this sample of elderly outpatients attending an academic dental clinic, restoration size, material, and sequence were related to restoration longevity over a 15-year period. This information could be helpful to elderly patients who are considering various restorative treatment options as they participate in dental treatment planning and informed consent.

https://www.biorxiv.org/content/early/2017/10/12/202069.full.pdf

Restoration longevity among geriatric and adult special needs patients

This study aimed to describe the survival trajectory of dental restorations placed in an outpatient population of geriatric and adult special needs patients over a 15-year span, with particular interest in longevity of subsequent restorations in teeth that received multiple restorations over time. Dental restorations of different types and sizes in patients age ≥65 years treated between 2000-14 at the University of Iowa, College of Dentistry were followed until they incurred an event (i.e., restoration replacement, extraction of the tooth, or endodontic treatment of the tooth). Survival analysis and extended Cox regression models were used to generate hazards ratios for selected predictor variables. A total of 9184 restorations were followed in 1551 unique patients. During the follow-up period, 28.7% of these restorations incurred an event; and overall the restorations had a median lifespan of 6.25 years. In multivariable regression models, after controlling for gender and age, composite restorations and greater number of restoration surfaces were associated with higher risks of failure; and the initial restoration recorded in the database for each subject tended to have lower risk of failure than restorations placed later that included any of those same surfaces. This information potentially could be helpful to elderly patients considering various restorative treatment options during the dental treatment planning and informed consent process.

https://www.biorxiv.org/content/biorxiv/early/2018/04/03/202069.full.pdf

Dental restoration longevity among geriatric and adult special needs patients

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Dental Restoration Longevity among Geriatric and Special Needs Patients.

Restoration longevity among geriatric and adult special needs patients

Dental restoration longevity among geriatric and adult special needs patients