Survival and Associated Risk Factors of Composite Restorations in Children with Early Childhood Caries: A Clinical Retrospective Study

Purpose: The purpose of this clinical retrospective study was to assess survival and risk factors associated with failures of resin composite restorations placed in patients with early childhood caries. Methods: Seventy-eight restorations in primary teeth from records of 24 high caries risk children were included in the study. The restorations' longevity up to 30 months of follow-up was assessed using the Kaplan-Meier survival test. Multivariate Cox regression analysis with shared frailty was used to evaluate the factors associated with failures (P<0.05). Results: Mean survival time was 26 months (95 percent confidence interval = 24.5 to 26.7). The survival of the restorations reached 34.8 percent up to 30 months, with an overall annual failure rate of 20 percent. Restorations involving two or more surfaces had 2.50 times more risk of failure than restorations involving single surface (P=0.03). Restorations performed in vital teeth had a lower risk of failure than those performed in teeth that underwent pulp intervention (hazard ratio equals 0.25; 95 percent confidence interval = 0.10 to 0.65; P=0.00). Patients with a plaque index more than 20 percent had 3.63 times more risk of failure in their restorations (P=0.01). Conclusion: Clinical variables, such as the number of restored surfaces, pulp therapy, and poor biofilm control, may affect the survival of composite restorations performed in patients with early childhood caries.