Twelve-year survival of 2-surface composite resin and amalgam premolar restorations placed by dental students

Abstract

Statement of problem: Composite resin and amalgam restorations are indicated for the restoration of posterior teeth. With increased esthetic demands, long-term clinical studies are required to evaluate the restorative success and reasons for failure of these materials.

Purpose: The purpose of this retrospective study was to determine the survival and reasons for failure of directly placed 2-surface composite resin restorations and directly placed 2-surface amalgam restorations on premolars placed by Canadian dental students.

Material and methods: Using The University of Manitoba's dental management software and paper charts, all 2-surface composite resin and 2-surface amalgam restorations placed on premolars between January 1, 2002, and May 30, 2014, were included. Short-term failure (within 2 years), long-term failure, and reasons for failure were collected. A Kaplan-Meier survival estimate with an associated P value comparing composite resin to amalgam restoration curves was performed using SPSS statistical software.

Results: Over 12 years, 1695 composite resin and 1125 amalgam 2-surface premolar restorations were placed. Of these restorations, 134 composite resins (7.9%) and 66 amalgams (5.9%) failed. Short-term failures (2 years or less) consisted of 57 composite resin (4%) and 23 amalgam (2.3%) restorations. Long-term failures (greater than 2 years) consisted of 77 composite resin (4.5%) and 43 amalgam (3.8%) restorations. After 12 years of service, the survival probability of composite resin restorations was 86% and that of amalgam restorations 91.5%. The differences in composite resin and amalgam survival curves were also found to be statistically significant (P=.009 for Log-rank test). The main reasons for failure were recurrent caries and fracture of the tooth being restored.

Conclusions: Within the limitations of this study, both composite resin and amalgam restorations had acceptable success rates and similar failure modes. Recurrent caries was still the most common reason for failure.