title: Survival analysis of composite Dahl restorations provided to manage localised anterior tooth wear (ten year follow-up).
abstract: OBJECTIVE
  To evaluate ten-year survival and clinical performance of resin-based composite restorations placed at increased vertical dimension as a 'Dahl' type appliance to manage localised anterior tooth wear.Design A prospective survival analysis of restorations provided at a single centre.Setting UK NHS hospital and postgraduate institute.
  
  
  METHODS
  The clinical performance of 283 composite resin restorations on 26 patients with localised anterior tooth wear was reviewed after a ten year follow-up period. The study used modified United States Public Health Service (USPHS) criteria for assessing the restorations. Survival of the restorations was analysed using Kaplan-Meier survival curves, the log-rank test, and the Cox proportional hazards regression analysis.
  
  
  RESULTS
  The results indicated that the median survival time for composite resin restorations was 5.8 years and 4.75 years for replacement restorations when all types of failure were considered. The restorations commonly failed as a result of wear, fracture and marginal discoloration. The factors that significantly influenced the survival of these restorations were the incisal relationship, aetiology, material used, and the nature of opposing dentition. The biological complications associated with this treatment regime were rare. Patient satisfaction remained high despite the long term deterioration of the restorations.
  
  
  CONCLUSIONS
  With some degree of maintenance, repeated use of composite resin restorations to treat localised anterior tooth wear at an increased occlusal vertical dimension is a viable treatment option over a ten-year period.
authors.affiliation: UCL Eastman Dental Institute, 256 Gray’s Inn Road, London, WC1X 8LD. akilgulamali@aol.com
authors.forename: A B
authors.initials: AB
authors.lastname: Gulamali
authors.forename: K W
authors.initials: KW
authors.lastname: Hemmings
authors.forename: C J
authors.initials: CJ
authors.lastname: Tredwin
authors.forename: A
authors.initials: A
authors.lastname: Petrie
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003116:Color; D003188:Composite Resins / Q000737:chemistry*; D003481:Cuspid / Q000473:pathology; D018772:Dental Marginal Adaptation; D003764:Dental Materials / Q000737:chemistry*; D003766:Dental Occlusion; D017269:Dental Prosthesis Repair; D019232:Dental Restoration Failure; D019554:Dental Restoration Wear; D003793:Dental Restoration, Permanent / Q000592:standards*; D005260:Female; D005500:Follow-Up Studies; D005891:Gingivitis / Q000209:etiology; D006801:Humans; D007180:Incisor / Q000473:pathology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D019233:Retreatment; D013499:Surface Properties; D016019:Survival Analysis; D057085:Tooth Wear / Q000628:therapy*; D014716:Vertical Dimension
chemical_list: D003188:Composite Resins; D003764:Dental Materials