Effects of oral hygiene, residual caries and cervical marginal-gaps on the survival of proximal atraumatic restorative treatment approach restorations

Citation:
Kemoli AM, van Amerongen WE. "Effects of oral hygiene, residual caries and cervical marginal-gaps on the survival of proximal atraumatic restorative treatment approach restorations." Contemporary Clin Dent. 2011;2(4):318-323.

Abstract:

Aim: To investigate the effects of oral hygiene, residual caries and cervical marginalgaps on the survival rate of proximal restorations placed in primary molars using the atraumatic restorative treatment (ART) approach.
Materials and methods: A total of 804 children participated in the study. They had
their dental plaque levels assessed at baseline and after two years by trained examiners.
Each of the children also had one proximal carious lesion in a primary molar restored by
trained operators and their assistants using the ART approach, 3 brands of glass ionomer
cements and 2 tooth-isolation methods. The restorations were clinically evaluated soon
after placement and after 2 years. Post-operative bite-wing radiographs were also taken
immediately after restoring the teeth and evaluated. The data collected were analyzed
using SPSS version 14.
Results: The cumulative survival of the restorations decreased from 94.4% soon after
placement to 30.8% after 2 years. The plaque index changed from 2.34 (SD 0.46) at
baseline to 1.92 (SD 2.1) after 2 years. Higher plaque indices were associated with
higher restoration failure. Only 507 bite-wing radiographs out of the possible 804 of the restored teeth were of good quality for the study. A total of 48 (9.5%) restorations had residual caries, 63 (12.4%) cervical marginal gaps and 9 (1.8%) both residual caries and cervical marginal gaps related to them. The survival rate of the restorations with both residual caries and cervical marginal gaps was significantly lower (Chi-square, p= 0.003) when related to the restorations that did not have any.
Conclusions: Low survival rate of proximal restorations in the study was associated with the presence of cervical marginal restoration gaps.

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