Re-intervention on crowns: what comes next?
OBJECTIVE
It is the aim of this paper to consider the treatment instituted when re-intervention is deemed necessary on a tooth which has previously been crowned.


METHODS
A detailed sample of treatment records of patients has been established at the NHS Business Services Authority (Dental Services Division), consisting of records containing indirectly placed restorations for patients of age 18 years or older from January 1991. For each tooth treated with a crown, the subsequent history of intervention on that tooth was recorded.


RESULTS
There were data on 47,474 crowns available for analysis, with metal-ceramic (bonded) crowns dominating the data (overall, 80% of crowns being these). There were 10,426 crowned teeth with re-interventions in the study period, with 36% of the re-interventions involving recementing, 17% being replacement crowns, 13% direct restorations, 12% root treatment, and 19% of crowned teeth being extracted and/or replaced by a denture. The longer the interval since crown placement, the higher the proportion of extractions or direct restoration and the lower the proportion of recementing.


CONCLUSIONS
Recementation is the most frequently recorded re-intervention, with the incidence of this decreasing with increasing age of the crown. In 17% of re-interventions, the next intervention was a replacement crown.
Burke
F J T
FJ
Primary Dental Care Research Group, University of Birmingham School of Dentistry, St. Chad's Queensway, Birmingham B4 6NN, UK. f.j.t.burke@bham.ac.uk
Lucarotti
P S K
PS
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002484:Cementation / Q000706:statistics & numerical data; D003442:Crowns / Q000706:statistics & numerical data*; D019992:Databases as Topic; D003776:Dental Porcelain / Q000592:standards; D017266:Dental Prosthesis / Q000706:statistics & numerical data; D004739:England; D006801:Humans; D008437:Maxilla; D016876:Metal Ceramic Alloys / Q000592:standards; D008875:Middle Aged; D019233:Retreatment / Q000706:statistics & numerical data; D012390:Root Canal Therapy / Q000706:statistics & numerical data; D013218:State Dentistry; D016019:Survival Analysis; D014081:Tooth Extraction / Q000706:statistics & numerical data; D016896:Treatment Outcome; D014852:Wales
D016876:Metal Ceramic Alloys; D003776:Dental Porcelain