Survival of composite restorations after selective or total caries removal in primary teeth and predictors of failures: A 36-months randomized controlled trial

• Published in: Journal of dentistry 2020-02, Vol.93, p.103268-103268, Article 103268
• Main Authors: Liberman, J, Franzon, R, Guimarães, LF, Casagrande, L, Haas, AN, Araujo, FB
• Format: Article
• Language: English
• Subjects: Bleeding; Child; Composite materials; Composite resin; Composite Resins; Dental Caries; Dental pulp; Dental Restoration Failure; Dental Restoration, Permanent; Dentin; Dentistry; Failure; Humans; Longevity; Oral hygiene; Pediatrics; Preservation; Primary teeth; Regression models; Restoration; Selective caries removal; Statistical analysis; Studies; Success; Survival; Teeth; Tooth, Deciduous
• ISSN: 0300-5712; 1879-176X
• DOI: 10.1016/j.jdent.2019.103268

The aim of this study was to assess the survival of composite restorations after selective (SCR) or total caries removal (TCR) and determine predictors of failures after 36 months. 120 teeth with deep occlusal or occlusal-proximal carious lesions were randomly divided into control (TCR; n = 54; 69% Class II) and test (SCR; n = 66; 63% Class II) groups. Clinical evaluation was applied using the USPHS criteria, and the presence of Charlie or Delta scores at the marginal integrity were considered as a failure. The overall survival rate of restorations was 68% after 36 months, 81% for TCR and 57% for SCR (p = 0.004). The multivariable Cox Regression model demonstrated that restorations performed after SCR had 3.44 times greater probability of failure compared to TCR (p = 0.006). The other two predictors for failure of restorations were teeth with Class II cavities (hazard ratio = 3.3) and children with gingival bleeding over 20% (hazard ratio = 2.5). Performing composite restorations after SCR in primary teeth had success rate significantly lower than restorations performed after TCR. Complex cavities and worst patient´s oral hygiene were found to be predictors of failure of restorations. Although SCR has been demonstrating high rates of pulp preservation, clinicians should consider that composite restorations fail in a higher frequency compared to TCR in primary teeth and, in some circumstances, may be preferable in terms of restoration longevity.