Anterior restoration longevity among nursing facility residents: a 30-year retrospective study.

Abstract

To assess factors influencing anterior dental restoration longevity among the institutionalized elderly. Among a sample of Eastern Iowa nursing facility dental patients, one anterior restoration placed from 1985 to 2014 was selected at random from each subject. Kaplan-Meier survival curves were generated, with restoration failures defined as subsequent restorative codes involving the same surface; endodontic procedures; or extractions. Bivariate and multivariable Cox proportional hazards modeling were performed. In multivariable analyses, the 1985 to 1999 cohort (n=496) had longer restoration survival in in females<75 years old versus males<75 years old (P=0.016), males ≥75 years old (P=0.026) and females ≥75 years old (P=0.030); one- versus three-surface restorations (P<0.001); and restorations placed by faculty/residents versus pre-doctoral students (P=0.009). The 2000 to 2014 cohort (n=521) had longer restoration survival in females<75 years old versus males ≥75 years old (P=0.012) and females ≥75 years old (P=0.019); residents who paid out-of-pocket versus those on Medicaid (P=0.019); and composite resin versus glass ionomer cement restorations (P<0.001). Knowing how long restorations last, and what factors affect their longevity, could improve treatment planning, informed consent, and communication with residents and caregivers, and also help inform practice guidelines for restorative care among the institutionalized elderly.