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Shi N, Peter T, Caplan DJ, Xie XJ, Dang CA, Welhaven A, Pendleton C, Allareddy V, Kolker JL, Marchini L. Predictors of survival of large non-occlusal non-incisal glass-ionomer restorations in older adults. SPECIAL CARE IN DENTISTRY 2024; 44:1228-1235. [PMID: 38449290 DOI: 10.1111/scd.12981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 02/09/2024] [Accepted: 02/10/2024] [Indexed: 03/08/2024]
Abstract
PURPOSE This study aimed to investigate the predictors of survival of non-occlusal non-incisal glass-ionomer restorations as a surrogate for root surface restorations among older adults. METHODS In a retrospective cohort analysis using the University of Iowa College of Dentistry electronic dental records, we included 721 patients aged 65+ who received 2+ surface non-occlusal non-incisal glass ionomer restorations placed from January 2005 - December 2011. Restorations were followed until September 2017 or until they were deemed to have failed. RESULTS At baseline, participants' mean age was 77.6 ± 8.2 years, and 45.8% were females. Most patients were self-pay (65.2%). Most restorations were placed by residents and dental students (82.7%) and included only two surfaces (95.6%). About half (49.1%) failed during follow-up, with a median survival time of 3.7 years. The time ratio for lower incisors compared to other teeth was 0.6 (p = .006), for three-and-four-surface restorations compared to two was 0.7 (p = .007), for faculty as providers compared to residents and students was 1.4 (p = .039), and for the Geriatric & Special Needs Clinic compared to others was 0.8 (p = .013). Time ratios less than one indicate association with shorter durations for restorations, and time ratios greater than one indicate association with longer durations for restorations. CONCLUSION Tooth type, number of restored surfaces, provider type, and clinic were all significant factors associated with survival of these restorations.
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Affiliation(s)
- Nailin Shi
- University of Iowa College of Dentistry, Department of Preventive & Community Dentistry, Iowa City, USA
| | - Tabitha Peter
- University of Iowa College of Public Health, Department of Biostatistics, Iowa City, USA
- University of Iowa College of Dentistry, Iowa Division of Biostatistics and Computational Biology, Iowa City, USA
| | - Daniel J Caplan
- University of Iowa College of Dentistry, Department of Preventive & Community Dentistry, Iowa City, USA
| | - Xian Jin Xie
- University of Iowa College of Dentistry, Department of Preventive & Community Dentistry, Iowa City, USA
- University of Iowa College of Public Health, Department of Biostatistics, Iowa City, USA
- University of Iowa College of Dentistry, Iowa Division of Biostatistics and Computational Biology, Iowa City, USA
- University of Iowa College of Dentistry, Iowa Institute for Oral Health Research, Iowa City, USA
| | - Connor A Dang
- University of Iowa College of Dentistry and Dental Clinics, Iowa City, USA
| | - Anne Welhaven
- University of Iowa College of Public Health, Department of Biostatistics, Iowa City, USA
- University of Iowa College of Dentistry, Iowa Division of Biostatistics and Computational Biology, Iowa City, USA
| | - Chandler Pendleton
- University of Iowa College of Public Health, Department of Biostatistics, Iowa City, USA
- University of Iowa College of Dentistry, Iowa Division of Biostatistics and Computational Biology, Iowa City, USA
| | - Veeratrishul Allareddy
- University of Iowa College of Dentistry, Department of Oral Pathology, Radiology & Medicine, Iowa City, USA
| | - Justine L Kolker
- University of Iowa College of Dentistry, Department of Operative Dentistry, Iowa City, USA
| | - Leonardo Marchini
- University of Iowa College of Dentistry, Department of Preventive & Community Dentistry, Iowa City, USA
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Gomez GGF, Wang M, Siddiqui ZA, Gonzalez T, Capin OR, Willis L, Boyd L, Eckert GJ, Zero DT, Thyvalikakath TP. Longevity of dental restorations in Sjogren's disease patients using electronic dental and health record data. BMC Oral Health 2024; 24:203. [PMID: 38326771 PMCID: PMC10848515 DOI: 10.1186/s12903-024-03957-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 01/30/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Decreased salivary secretion is not only a risk factor for carious lesions in Sjögren's disease (SD) but also an indicator of deterioration of teeth with every restorative replacement. This study determined the longevity of direct dental restorations placed in patients with SD using matched electronic dental record (EDR) and electronic health record (EHR) data. METHODS We conducted a retrospective cohort study using EDR and EHR data of Indiana University School of Dentistry patients who have a SD diagnosis in their EHR. Treatment history of patients during 15 years with SD (cases) and their matched controls with at least one direct dental restoration were retrieved from the EDR. Descriptive statistics summarized the study population characteristics. Cox regression models with random effects analyzed differences between cases and controls for time to direct restoration failure. Further the model explored the effect of covariates such as age, sex, race, dental insurance, medical insurance, medical diagnosis, medication use, preventive dental visits per year, and the number of tooth surfaces on time to restoration failure. RESULTS At least one completed direct restoration was present for 102 cases and 42 controls resulting in a cohort of 144 patients' EDR and EHR data. The cases were distributed as 21 positives, 57 negatives, and 24 uncertain cases based on clinical findings. The average age was 56, about 93% were females, 54% were White, 74% had no dental insurance, 61% had public medical insurance, < 1 preventive dental visit per year, 94% used medications and 93% had a medical diagnosis that potentially causes dry mouth within the overall study cohort. About 529 direct dental restorations were present in cases with SD and 140 restorations in corresponding controls. Hazard ratios of 2.99 (1.48-6.03; p = 0.002) and 3.30 (1.49-7.31, p-value: 0.003) showed significantly decreased time to restoration failure among cases and positive for SD cases compared to controls, respectively. Except for the number of tooth surfaces, no other covariates had a significant influence on the survival time. CONCLUSION Considering the rapid failure of dental restorations, appropriate post-treatment assessment, management, and evaluation should be implemented while planning restorative dental procedures among cases with SD. Since survival time is decreased with an increase in the number of surfaces, guidelines for restorative procedures should be formulated specifically for patients with SD.
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Affiliation(s)
- Grace Gomez Felix Gomez
- Department of Dental Public Health and Dental Informatics, Indiana University School of Dentistry, Indianapolis, IN, USA
- Center for Biomedical Informatics (CBMI), Regenstrief Institute, Indianapolis, IN, USA
| | - Mei Wang
- Department of Dental Public Health and Dental Informatics, Indiana University School of Dentistry, Indianapolis, IN, USA
| | - Zasim A Siddiqui
- Department of Dental Public Health and Dental Informatics, Indiana University School of Dentistry, Indianapolis, IN, USA
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA
| | - Theresa Gonzalez
- Department of Biomedical Sciences and Comprehensive Care, Indiana University School of Dentistry, Indianapolis, IN, USA
| | - Oriana R Capin
- Department of Cariology & Operative Dentistry, Indiana University School of Dentistry, Indianapolis, IN, USA
| | - Lisa Willis
- Department of Cariology & Operative Dentistry, Indiana University School of Dentistry, Indianapolis, IN, USA
| | - LaKeisha Boyd
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, USA
| | - George J Eckert
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Domenick T Zero
- Department of Cariology & Operative Dentistry, Indiana University School of Dentistry, Indianapolis, IN, USA
| | - Thankam Paul Thyvalikakath
- Department of Dental Public Health and Dental Informatics, Indiana University School of Dentistry, Indianapolis, IN, USA.
- Center for Biomedical Informatics (CBMI), Regenstrief Institute, Indianapolis, IN, USA.
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Thyvalikakath T, Siddiqui ZA, Eckert G, LaPradd M, Duncan WD, Gordan VV, Rindal DB, Jurkovich M, Gilbert GH. Survival analysis of posterior composite restorations in National Dental PBRN general dentistry practices. J Dent 2024; 141:104831. [PMID: 38190879 PMCID: PMC10866618 DOI: 10.1016/j.jdent.2024.104831] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 01/01/2024] [Accepted: 01/02/2024] [Indexed: 01/10/2024] Open
Abstract
OBJECTIVE Quantify the survival of posterior composite restorations (PCR) placed during the study period in permanent teeth in United States (US) general dental community practices and factors predictive of that survival. METHODS A retrospective cohort study was conducted utilizing de-identified electronic dental record (EDR) data of patients who received a PCR in 99 general dentistry practices in the National Dental Practice-Based Research Network (Network). The final analyzed data set included 700,885 PCRs from 200,988 patients. Descriptive statistics and Kaplan Meier (product limit) estimator were performed to estimate the survival rate (defined as the PCR not receiving any subsequent treatment) after the first PCR was observed in the EDR during the study time. The Cox proportional hazards model was done to account for patient- and tooth-specific covariates. RESULTS The overall median survival time was 13.3 years. The annual failure rates were 4.5-5.8 % for years 1-5; 5.3-5.7 %, 4.9-5.5 %, and 3.3-5.2 % for years 6-10, 11-15, and 16-20, respectively. The failure descriptions recorded for < 7 % failures were mostly caries (54 %) and broken or fractured tooth/restorations (23 %). The following variables significantly predicted PCR survival: number of surfaces that comprised the PCR; having at least one interproximal surface; tooth type; type of prior treatment received on the tooth; Network region; patient age and sex. Based on the magnitude of the multivariable estimates, no single factor predominated. CONCLUSIONS This study of Network practices geographically distributed across the US observed PCR survival rates and predictive factors comparable to studies done in academic settings and outside the US. CLINICAL SIGNIFICANCE Specific baseline factors significantly predict the survival of PCRs done in US community dental practices.
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Affiliation(s)
- Thankam Thyvalikakath
- Office of Dental Informatics & Digital Health, Indiana University School of Dentistry, IUPUI, Research Scientist & Director, Dental Informatics, Center for Biomedical Informatics, Regenstrief Institute, Inc., OH 144A, 415 Lansing Street, Indianapolis, IN 46202, USA.
| | - Zasim Azhar Siddiqui
- West Virginia University School of Pharmacy, Morgantown, WV, USA; Department of Public Health and Dental Informatics, Indiana University School of Dentistry, IUPUI, Indianapolis, IN 46202, USA
| | - George Eckert
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, 340W 10th St, Indianapolis, IN 46202, USA
| | - Michelle LaPradd
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, 340W 10th St, Indianapolis, IN 46202, USA; Syneos Health, 1030 Sync St, Morrisville, NC 27560, USA
| | - William D Duncan
- Department of Community Dentistry, University of Florida, College of Dentistry, Gainesville, FL, USA; Biomedical Data Science and Shared Resource, Roswell Park Cancer Center, Buffalo, NY, USA
| | - Valeria V Gordan
- University of Florida, College of Dentistry, Gainesville, FL, USA
| | - D Brad Rindal
- 8170 33rd Avenue South | P.O. Box 1524, MS 23301A Minneapolis MN 55440, USA
| | - Mark Jurkovich
- HealthPartners Institute, Minneapolis MN, USA; 8170 33rd Ave S, Bloomington, MN 55440, USA
| | - Gregg H Gilbert
- Department of Clinical and Community Sciences, School of Dentistry, SDB Room 109, University of Alabama at Birmingham, Birmingham, AL, USA; National Dental PBRN Collaborative Group, 1720 University Blvd, Birmingham, AL 35294, USA; University of Alabama at Birmingham, Birmingham, AL, USA
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Johnsen DC, Marchini L, Ettinger RL. How can dental research deliver better outcomes to frail older adults? Essay on considerations. SPECIAL CARE IN DENTISTRY 2023; 43:375-379. [PMID: 36715103 DOI: 10.1111/scd.12802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 11/04/2022] [Indexed: 01/31/2023]
Affiliation(s)
- David C Johnsen
- Department of Pediatric Dentistry, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, Iowa, USA
| | - Leonardo Marchini
- Department of Comprehensive Care, Case Western Reserve University School of Dental Medicine, Cleveland, Ohio, USA
| | - Ronald L Ettinger
- Department of Prosthodontics, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, Iowa, USA
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Turjanski S, Par M, Bergman L, Soče M, Grego T, Klarić Sever E. Influence of Ionizing Radiation on Fluoride-Releasing Dental Restorative Materials. Polymers (Basel) 2023; 15:polym15030632. [PMID: 36771932 PMCID: PMC9920463 DOI: 10.3390/polym15030632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 01/18/2023] [Accepted: 01/25/2023] [Indexed: 01/28/2023] Open
Abstract
This study aimed to investigate the effects of radiotherapy on the mechanical, chemical, and surface properties of two recently introduced restorative dental materials (a glass hybrid and an alkasite), while two conventional restorative materials served as references. Material specimens of the experimental groups (irradiated) were compared to the specimens of the control groups that underwent the same preparation procedure but without irradiation. The experimental groups of restorative material specimens were irradiated with a total of 70 Gy over 35 days (2 Gy/day × 35 days), while the control groups received no treatment. The following properties were evaluated: surface microhardness (Vickers), surface roughness, color change, flexural strength, flexural modulus, material reliability, and infrared spectra. For the experimental groups, measurements were performed 24 h after specimen preparation, i.e., before radiotherapy and after the completion of the irradiation protocol. For the control groups, measurements were performed after the corresponding periods of no treatment. A statistically significant increase in microhardness (p = 0.001-0.004) and surface roughness (p = 0.013) was observed as a result of material aging/maturation in both the control and experimental groups. However, the only statistically significant difference between the control and experimental groups was observed in the discoloration of the conventional reference material (p < 0.001). In conclusion, no statistically significant negative effects of a therapeutic dose of radiotherapy on any of the tested properties of the alkasite and glass hybrid materials were observed, whereas only a minor negative effect of radiotherapy in terms of discoloration was found for a conventional resin composite that was used as a reference material.
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Affiliation(s)
- Sarah Turjanski
- Department of Pedodontics, School of Dental Medicine, University of Zagreb, Gunduliceva 5, 10000 Zagreb, Croatia
| | - Matej Par
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gunduliceva 5, 10000 Zagreb, Croatia
- Correspondence:
| | - Lana Bergman
- Department of Prosthodontics, School of Dental Medicine, University of Zagreb, Gunduliceva 5, 10000 Zagreb, Croatia
| | - Majana Soče
- Department of Oncology, Radiotherapy Unit, University Hospital Centre Zagreb, 10000 Zagreb, Croatia
| | - Timor Grego
- Department of Oncology, Radiotherapy Unit, University Hospital Centre Zagreb, 10000 Zagreb, Croatia
| | - Eva Klarić Sever
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gunduliceva 5, 10000 Zagreb, Croatia
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Cárcamo-España V, Cuesta Reyes N, Flores Saldivar P, Chimenos-Küstner E, Estrugo Devesa A, López-López J. Compromised Teeth Preserve or Extract: A Review of the Literature. J Clin Med 2022; 11:jcm11185301. [PMID: 36142946 PMCID: PMC9504015 DOI: 10.3390/jcm11185301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 09/05/2022] [Accepted: 09/06/2022] [Indexed: 12/03/2022] Open
Abstract
Multiple systems and associated factors have been described in the literature to assess the prognosis of teeth with periodontal disease. Nowadays there is a tendency among clinicians to consider implants as the best solution after tooth extraction, in cases of teeth with a questionable prognosis. However, the value of the natural tooth must be considered, as the proprioception of the periodontal ligament is preserved, and it adapts to stress during functional loads. We first review the literature focusing on analyzing the factors that should guide decision-making to maintain or extract a tooth with a compromised periodontium. Then, we propose a schematic diagram of prognostic indicators to reflect the main factors to consider and the survival rate that each one represents when preserving or extracting a tooth.
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Affiliation(s)
- Valentina Cárcamo-España
- Department of Oral Medicine, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona Dental Hospital, University of Barcelona, 08907 Barcelona, Spain
- Correspondence: (V.C.-E.); or (J.L.-L.); Tel.: +34-606-45-73-62 (J.L.-L.)
| | - Nataly Cuesta Reyes
- Department of Oral Medicine, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona Dental Hospital, University of Barcelona, 08907 Barcelona, Spain
| | - Paul Flores Saldivar
- Department of Oral Medicine, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona Dental Hospital, University of Barcelona, 08907 Barcelona, Spain
| | - Eduardo Chimenos-Küstner
- Department of Odontostomatology and Oral Medicine, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona Dental Hospital, University of Barcelona, 08907 Barcelona, Spain
| | - Alberto Estrugo Devesa
- Department of Odontostomatology and Oral Medicine, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona Dental Hospital, University of Barcelona, 08907 Barcelona, Spain
| | - José López-López
- Department of Odontostomatology and Oral Medicine, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona Dental Hospital, University of Barcelona, 08907 Barcelona, Spain
- Correspondence: (V.C.-E.); or (J.L.-L.); Tel.: +34-606-45-73-62 (J.L.-L.)
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7
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Kim KH, Caplan DJ, Kang S. Smoothed quantile regression for censored residual life. Comput Stat 2022. [DOI: 10.1007/s00180-022-01262-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Maes MS, Kanzow P, Hrasky V, Wiegand A. Survival of direct composite restorations placed under general anesthesia in adult patients with intellectual and/or physical disabilities. Clin Oral Investig 2021; 25:4563-4569. [PMID: 33449193 PMCID: PMC8310491 DOI: 10.1007/s00784-020-03770-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 12/30/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVES This 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 METHODS Survival 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%). RESULTS A 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. CONCLUSION Composite 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 RELEVANCE Survival 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.
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Affiliation(s)
- Mona Shaghayegh Maes
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Robert-Koch-Str. 40, D-37075, Göttingen, Germany
| | - Philipp Kanzow
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Robert-Koch-Str. 40, D-37075, Göttingen, Germany
| | - Valentina Hrasky
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Robert-Koch-Str. 40, D-37075, Göttingen, Germany
| | - Annette Wiegand
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Robert-Koch-Str. 40, D-37075, Göttingen, Germany.
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Huang Y, Song B, Zhou X, Chen H, Wang H, Cheng L. Dental Restorative Materials for Elderly Populations. Polymers (Basel) 2021; 13:polym13050828. [PMID: 33800358 PMCID: PMC7962827 DOI: 10.3390/polym13050828] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/02/2021] [Accepted: 03/04/2021] [Indexed: 01/26/2023] Open
Abstract
The incidence of dental caries, especially root caries, has risen in elderly populations in recent years. Specialized restorative materials are needed due to the specific site of root caries and the age-related changes in general and oral health in the elderly. Unfortunately, the restorative materials commonly used clinically cannot fully meet the requirements in this population. Specifically, the antibacterial, adhesive, remineralization, mechanical, and anti-aging properties of the materials need to be significantly improved for dental caries in the elderly. This review mainly discusses the strengths and weaknesses of currently available materials, including amalgam, glass ionomer cement, and light-cured composite resin, for root caries. It also reviews the studies on novel anti-caries materials divided into three groups, antimicrobial, remineralization, and self-healing materials, and explores their potential in the clinical use for caries in the elderly. Therefore, specific restorative materials for caries in the elderly, especially for root caries, need to be further developed and applied in clinical practice.
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Affiliation(s)
- Yuyao Huang
- State Key Laboratory of Oral Diseases, West China School of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu 610064, China; (Y.H.); (B.S.); (X.Z.)
- Department of Cariology and Endodontics, West China School of Stomatology, Sichuan University, Chengdu 610041, China
| | - Bingqing Song
- State Key Laboratory of Oral Diseases, West China School of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu 610064, China; (Y.H.); (B.S.); (X.Z.)
- Department of Cariology and Endodontics, West China School of Stomatology, Sichuan University, Chengdu 610041, China
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases, West China School of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu 610064, China; (Y.H.); (B.S.); (X.Z.)
- Department of Cariology and Endodontics, West China School of Stomatology, Sichuan University, Chengdu 610041, China
| | - Hui Chen
- Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou 510055, China;
| | - Haohao Wang
- State Key Laboratory of Oral Diseases, West China School of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu 610064, China; (Y.H.); (B.S.); (X.Z.)
- Department of Cariology and Endodontics, West China School of Stomatology, Sichuan University, Chengdu 610041, China
- Correspondence: (H.W.); (L.C.)
| | - Lei Cheng
- State Key Laboratory of Oral Diseases, West China School of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu 610064, China; (Y.H.); (B.S.); (X.Z.)
- Department of Cariology and Endodontics, West China School of Stomatology, Sichuan University, Chengdu 610041, China
- Correspondence: (H.W.); (L.C.)
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10
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Tong N, Wyatt CCL. Five-year Survival Rate of Bonded Dental Restorations in Frail Older Adults. JDR Clin Trans Res 2020; 6:77-86. [PMID: 32075488 DOI: 10.1177/2380084420905785] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Frail older adults residing in long-term care (LTC) facilities are among the most vulnerable to dental caries due to poor oral hygiene (OH), medication-related salivary hypofunction, carbohydrate-rich diets, and limited access to dental care. Providing dental restorations for LTC patients is challenging, and there are few studies investigating the longevity of restorations in this cohort. Multiple restorative materials have been used to restore tooth anatomy as well as address caries prevention using fluoride-based materials. OBJECTIVES This study examined the longevity of bonded direct restorations placed in LTC patients. Specifically, we examined whether a difference in survival exists between resin composite (RC) and glass ionomer cement (GIC) direct restorations in frail older adults residing in LTC. METHODS Tooth-colored restorations placed in LTC patients between 2007 and 2012, within the University of British Columbia Geriatric Dentistry Program, were followed annually up to 5 y or until they incurred an event (i.e., re-restoration or tooth extraction) or the patient was lost to follow-up or deceased. Restoration status was documented within the Clinical Oral Disorder in Elders (CODE) Index annual oral health assessments. Mixed-effect logistic regression was calculated to determine hazard ratios, address within-patient correlation, and measure the effect size of multiple covariates. RESULTS A total of 3,201 dental restorations placed in 846 LTC patients were followed. This cohort of patients had a mean age of 86 y and high levels of oral and systemic disease. Over half were wheelchair bound and had compromised ability to perform OH. The overall 5-y survival rate was 60.3%, and there was no statistically significant difference in survival between RC and GIC. CONCLUSION Tooth-colored restorations had reasonable longevity in LTC patients and had comparable survival to restorations placed in functionally independent, community-dwelling geriatric populations. No difference between RC and GIC was found with regards to restoration longevity in this population. KNOWLEDGE TRANSFER STATEMENT Direct restorations provided to frail older adults residing in LTC have reasonable longevity and should be expected to survive for the remainder of the patient's life. As no detectable difference exists in survival rates between RC and GIC, operators should select appropriate restorative materials based on clinical conditions, patient factors, physical properties, and personal preference.
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Affiliation(s)
- N Tong
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada
| | - C C L Wyatt
- Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada
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Marchini L, Ettinger R, Hartshorn J. Personalized Dental Caries Management for Frail Older Adults and Persons with Special Needs. Dent Clin North Am 2019; 63:631-651. [PMID: 31470918 DOI: 10.1016/j.cden.2019.06.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Frail older adults and persons with special needs are at higher risk of oral diseases including dental caries. Considering the diverse background of the population, a personalized approach for each patient is mandatory to successfully manage their oral health needs. This article describes a succinct way to assess and categorize the risk of rapid oral health deterioration (ROHD) among this group. The procedures for assessing ROHD risk examine the ROHD risk categories, how risk factors impact treatment strategies, what techniques and materials exist for caries prevention and treatment, and how one effectively communicates caries management plans for this population.
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Affiliation(s)
- Leonardo Marchini
- Department of Preventive and Community Dentistry, The University of Iowa College of Dentistry and Dental Clinics, N337-1 Dental Science, Iowa City, IA 52242, USA.
| | - Ronald Ettinger
- Department of Prosthodontics, The University of Iowa College of Dentistry and Dental Clinics, N-409 Dental Science, Iowa City, IA 52242, USA
| | - Jennifer Hartshorn
- Department of Preventive and Community Dentistry, The University of Iowa College of Dentistry and Dental Clinics, W327 Dental Science, Iowa City, IA 52242, USA
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Meyers IA. Herodontics - is there a place for maintaining the apparently hopeless tooth? Aust Dent J 2019; 64 Suppl 1:S71-S79. [PMID: 31144327 DOI: 10.1111/adj.12698] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The population is ageing and people are keeping their own teeth for much longer due in part to the efforts of the dental profession in restoring teeth and reducing the number of teeth being extracted. Along with this there is now an increasing expectation by patients that they will retain their own teeth as they age and that dental practitioners will have the knowledge and skills to help them retain their own teeth. Contemporary restorative materials and techniques have increased the range of options available to assist with maintaining the dentition, and many of these procedures enable minimally invasive and cost effective management of the teeth as an alternative to complex and expensive procedures. This paper discusses the restoration of compromised and failing teeth in the ageing patient, and looks at the various issues facing the ageing dentate patient and the dilemma of when to restore or when to extract. Ultimately it is hoped that maintaining healthy teeth for life may not only improve oral function and quality of life, but may in fact reduce the impact of the physical and psychological aspects of ageing.
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Affiliation(s)
- I A Meyers
- The University of Queensland School of Dentistry, Brisbane, Qld, Australia
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