Abstract
ObjectivesThis study aimed to assess the survival of direct composite restorations placed under general anesthesia in adult patients with intellectual and/or physical disabilities.Materials and methodsSurvival 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%).ResultsA 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.ConclusionComposite 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.Clinical relevanceSurvival 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
Highlights
Dental composites have been becoming the materials of choice for direct restorations in permanent teeth, especially when considering the phase down of amalgam
In children and adults with intellectual and/or physical disability, the 5-year survival of single- and multiple-surface composite restorations amounted to 100% and 66.9%, respectively
The following inclusion criteria were defined: direct anterior and/or posterior composite restoration placed in general anesthesia in permanent teeth of adult patients with intellectual and/or physical disability, general anesthesia performed between January 2011 and December 2019, restoration made from a nanohybrid composite placed in etch&rinse technique without rubber dam
Summary
Dental composites have been becoming the materials of choice for direct restorations in permanent teeth, especially when considering the phase down of amalgam. Recent systematic reviews and meta-analyses reported mean annual failure rates of 0 to 4% for anterior [1] and 0.6 to 4.2% for posterior [2] composite restorations. More recent studies rather focus on the survival of composite restorations, but on material-, tooth-, and patient-related factors. In elderly and geriatric patients, median survival of composite restorations ranged from 5.5 to 9.9 years [5, 6]. Tong et al [7] reported the 5-year survival of composite restorations in frail older adults to amount to 60.5%. In children and adults with intellectual and/or physical disability, the 5-year survival of single- and multiple-surface composite restorations amounted to 100% and 66.9%, respectively. Composite restorations placed under general anesthesia showed a better survival than restorations
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