Longevity of composite restorations in patients with early childhood caries (ECC)

The aim of this retrospective study was to describe the type and extent of composite fillings in a high risk pediatric caries population and analyze restoration survival probability in relation to severity of decay, Black classification, and composite type. A total of 1,017 fillings in 855 primary teeth performed under general anesthesia from 2004-2007 were included into this study. All 157 patients had early childhood caries after the classification of Wyne and were recalled for at least 6 months. A total etch adhesive system, in combination with flowable and/or packable composites, was used. Failures were evaluated according to clinical criteria. Survival probability was calculated using Kaplan-Meier survival analysis. The mean observation period for restorations was 30.9 months, with a success rate of 81.5 %. In 125 cases, restorations failed after an average retention time of 23.6 months, resulting in an annual failure rate of 4.2 %. The reasons for failure were fracture or partial failure (9.6 %), secondary caries (44 %), or complete restoration loss (46.4 %). Fillings in patients with severe decay had significantly lower survival probabilities. No significant differences were found between flowable and packable composites. Composite fillings are a long lasting, high-quality treatment option in pediatric patients with a high risk of caries who are treated under general anesthesia. A strict caries prevention regimen should be followed to minimize the loss of restorations caused by secondary caries. Composite fillings are a long lasting, high-quality treatment option in children with early childhood caries treated under general anesthesia.