Welcome to PracticeUpdate! We hope you are enjoying access to a selection of our top-read and most recent articles. Please register today for a free account and gain full access to all of our expert-selected content.
Already Have An Account? Log in Now
Predictors of Survival of Large Non-Occlusal Non-Incisal Glass-Ionomer Restorations in Older Adults
abstract
This abstract is available on the publisher's site.
Access this abstract nowPURPOSE
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.
Additional Info
Disclosure statements are available on the authors' profiles:
Predictors of survival of large non-occlusal non-incisal glass-ionomer restorations in older adults
Spec Care Dentist 2024 Mar 06;[EPub Ahead of Print], N Shi, T Peter, DJ Caplan, XJ Xie, CA Dang, A Welhaven, C Pendleton, V Allareddy, JL Kolker, L MarchiniFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
This retrospective cohort study, conducted by the University of Iowa College of Dentistry, assessed the predictors of survival of non-occlusal non-incisal glass-ionomer restorations among older adults. The study's robust analysis included 721 patients, and the authors utilized data collected from electronic dental records from 2005 to 2011, with a follow-up until 2017.
One of the standout features of this paper is its specific focus on the elderly population, a group often underrepresented in studies of this nature. The findings revealed significant predictors of restoration survival, including the tooth type, number of restored surfaces, provider type, and clinical setting. Notably, restorations performed on lower incisors and by less experienced providers (residents and students) exhibited a shorter lifespan. Moreover, the study indicated a better survival rate of restorations performed in nongeriatric clinics than that of restorations performed in geriatric and special needs clinics, likely reflecting the complex health profiles of patients in the latter.
The use of a retrospective cohort design is both a strength and a limitation; although this design allows for the analysis of real-world outcomes over a substantial period, it is susceptible to biases associated with retrospective data, such as incomplete datasets and potential unrecorded confounders.
This study makes a significant contribution to the field of geriatric dental care, emphasizing the need for tailored treatment strategies that consider both the physiological and clinical complexities of older adults. Future research should look to prospective studies to confirm these findings and extend the understanding of how different clinical environments impact the longevity of dental restorations.
The practical implications of this research are clear, suggesting more focused training for dental providers working with vulnerable elderly populations and a re-evaluation of clinical practices in geriatric settings to enhance the longevity of restorations.