Risk factors for secondary caries in direct composite restorations in primary teeth.
BACKGROUND
Secondary caries or caries adjacent to restorations is the most frequent reason for replacement of dental restorations. Though, limited data is available on variables influencing the development of secondary caries in primary teeth.


OBJECTIVE
To investigate risk factors for the development of secondary caries adjacent to direct composite restorations in primary teeth.


METHODS
For this retrospective study, data of 2417 composite restorations, which were placed due to primary carious lesions, were considered. A total of 212 restorations failed due to secondary caries within a maximum observation period of 8 years. A control group was randomly selected. Mann-Whitney U-test, binomial logistic regression with backward elimination and Cox regression with frailty model were performed (P < 0.05).


RESULTS
The overall caries experience amounted to 6.3 dmft and 13.3 dmfs. 72.5% of restorations failed within the first 2 years. Older children and children from families with a higher socio-economic status showed a lower risk for secondary caries. Further, the dentist and the adhesive had a significant influence on the longevity. Posterior restorations had a higher risk to fail in comparison with anterior restorations.


CONCLUSIONS
Within the limitation of this study, it is concluded that the development of secondary caries is influenced by several factors. Nevertheless, the secondary caries rate was found to be relatively low in this high-risk population.
Department of Conservative Dentistry, Ludwig-Maximilians University Munich, Munich, Germany.
Isabel
I
Metz
Department of Conservative Dentistry, Ludwig-Maximilians University Munich, Munich, Germany.
Katrin
K
Rothmaier
Department of Conservative Dentistry, Ludwig-Maximilians University Munich, Munich, Germany.
Vinay
V
Pitchika
Institute for Medical Informatics, Biometry and Epidemiology, Ludwig-Maximilians University Munich, Munich, Germany.
Alexander
A
Crispin
Department of Conservative Dentistry, Ludwig-Maximilians University Munich, Munich, Germany.
Reinhard
R
Hickel
Department of Bioscience Research, University of Tennessee Health Science Center, Memphis, TN, USA.
Franklin
F
Garcia-Godoy
Department of Conservative Dentistry, Ludwig-Maximilians University Munich, Munich, Germany.
Katharina
K
Bücher
Department of Conservative Dentistry, Ludwig-Maximilians University Munich, Munich, Germany.
Jan
J
Kühnisch
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003188:Composite Resins / Q000009:adverse effects*; D003731:Dental Caries / Q000209:etiology* / Q000473:pathology; D003737:Dental Cavity Preparation; D019232:Dental Restoration Failure / Q000706:statistics & numerical data; D003793:Dental Restoration, Permanent / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D014094:Tooth, Deciduous
D003188:Composite Resins