title: Dental restorations: a risk factor for periodontal attachment loss?
abstract: BACKGROUND
  Dental caries and restorations in proximal tooth surfaces often impinge upon the periodontal biological width.
  
  
  OBJECTIVE
  This study examines whether these factors may contribute to risk for periodontal attachment loss at these sites.
  
  
  METHODS
  The study is based upon data from the Dunedin Multidisciplinary Health and Development Study, a long-standing cohort study. Approximal tooth surfaces of 884 study members were evaluated for restorations and caries at age 26 and again at 32 years, and probing depth and gingival recession were recorded in millimetres at age 32. Attachment loss was computed as the sum of pocket depth and gingival recession. Data were analysed using generalized estimating equations.
  
  
  RESULTS
  Where a caries/restorative event had occurred on an inter-proximal tooth surface before age 26, the age-32 attachment loss at the corresponding periodontal site was approximately twice more likely to be >or=3 mm than if the adjacent tooth surface had remained sound to age 32. This was also true where a caries/restorative event had occurred subsequent to age 26. The association remained after controlling for potential confounders, including smoking.
  
  
  CONCLUSIONS
  Site-specific periodontal attachment loss due to dental caries or restorative events occurs in adults in their third and fourth decades of life.
authors.affiliation: Department of Oral Sciences, School of Dentistry, The University of Otago, Dunedin, New Zealand. jonathan.broadbent@stonebow.otago.ac.nz
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Broadbent
authors.forename: Karen B
authors.initials: KB
authors.lastname: Williams
authors.forename: W Murray
authors.initials: WM
authors.lastname: Thomson
authors.forename: Sheila M
authors.initials: SM
authors.lastname: Williams
mesh_terms: D000328:Adult; D000367:Age Factors; D015331:Cohort Studies; D003731:Dental Caries / Q000150:complications; D003742:Dental Devices, Home Care; D003774:Dental Plaque Index; D003793:Dental Restoration, Permanent / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D005889:Gingival Recession / Q000209:etiology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009910:Oral Hygiene; D017622:Periodontal Attachment Loss / Q000209:etiology*; D010514:Periodontal Pocket / Q000209:etiology; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D013499:Surface Properties