Influence of patient factors on age of restorations at failure and reasonsfor their placement and replacement

Objective: This study examined the reasons given by a selected group of den tal practitioners for placement and replacement of restorations and correla ted the data provided with patient factors, such as patients' age and gende r, caries risk, occlusal function and oral hygiene, with restoration longev ity. Method: A group of general dental practitioners (GDPs) were recruited to ta ke part in the study. Each participant was asked to record the reason for p lacement or replacement of restorations from a list of potential reasons. T he age and Class of the restoration being replaced was also recorded, as al so was the material being used and the material being replaced. Results: Details of reason for placement/replacement was received on 3196 r estorations from 32 GDPs. Of the restorations placed, 54% were amalgam, 32% composite, 8% compomer and 7% glass ionomer. The reasons for placement/rep lacement of the restorations were principally primary caries (28%), seconda ry caries (29%), margin fracture (10%), tooth fracture (7%), and non-cariou s defects (6%). Overall, the mean age of restorations at failure was 7.1 ye ars. Of the patients who received glass ionomer restorations, 29% were rate d as having poor oral hygiene, compared with 18% of the patients who receiv ed amalgam restorations, 18% of the patients who received composite restora tions and 23% of the patients who received compomer restorations. Of the pa tients who received glass ionomer restorations, 35% were rated as having hi gh caries susceptibility, compared with 27% of those receiving amalgam rest orations, 21% of those receiving composite restorations and 30% of those re ceiving compomer restorations. Conclusion: Primary caries was the principal reason for initial restoration s. Secondary caries was the most prevalent reason for replacement of restor ations. The results also indicate a selective application of different mate rials for different patients. (C) 2001 Elsevier Science Ltd. All rights res erved.