Repair increases the survival of failed primary teeth restorations in high-caries risk children: a university-based retrospective study.

Abstract

We investigated factors associated with failure of adhesive restorations in primary teeth and whether repair may increase the survival of failed restorations placed in high-caries risk children. The sample comprised children who attended a university dental service to perform restorative treatment in primary teeth. Data were collected retrospectively from clinical records to assess the longevity of restorations. The outcomes were calculated in two levels: "Success" (Level 1)-when any re-intervention was considered as failure; "Survival" (Level 2)-when repaired restorations were considered clinically acceptable. The Kaplan-Meier survival test was used to analyze the longevity of restorations. Multivariate Cox regression with shared frailty was used to assess factors associated with failures (p < 0.05). A total of 584 primary teeth restorations (178 patients) were included in the analysis. The longevity of restorations up to 36months (Level 1) was 34.8% (AFR 29.6%). Multi-surface restorations showed significantly more failures than single-surface ones (HR 1.69; 95% CI 1.18, 2.41), and endodontically treated teeth presented more failures compared to vital teeth (HR 2.22; 95% CI 1.35, 3.65). There was an increase in restoration survival when repair was not considered as failure (p < 0.001). The survival of repaired restorations (Level 2) reached 43.7% (AFR 24.1%). Adhesive restorations placed in primary teeth of high-caries risk children showed restricted longevity; however, the repair of failed restorations has increased its survival over time. Repair is a more conservative and technically simple procedure that increases the survival of failed restorations in primary teeth.