An up to 50-year follow-up of crown and veneer survival in a dental practice

Abstract

Statement of problem: Indirect restorations are an important treatment in dental practice, but long-term survival studies are lacking.

Purpose: The purpose of this retrospective study was to report on the outcome of indirect restorations, which were followed up annually for up to 50 years in a dental practice.

Material and methods: A retrospective survival study was undertaken at a mixed National Health Service (NHS)/private dental practice in London, UK. Data were collected for restorations placed between 1966 and 1996 by 1 experienced operator. It was a requirement that patients had been followed up annually with clinical and radiographic examinations for up to 50 years. Patients were enrolled on a strict preventive policy and had excellent oral hygiene. Oral hygiene, restoration location, sensitivity, occlusion, and other details (preparation design, taper, cement used) were recorded. Restoration outcome was recorded as successful and surviving, unknown, or failed. The data were described descriptively. Kaplan-Meier survival curves and hazard curves were used to assess the survival of crowns and the probability of failure over time.

Results: A total of 223 restorations were placed in 47 patients between 1966 and 1996 and reviewed annually for up to 50 years (until 2016). These restorations included 154 metal-ceramic crowns (101 posterior and 53 anterior), 25 posterior gold crowns, 22 anterior ceramic veneers, and 22 anterior ceramic crowns. Restorations were in occlusion. The mean survival for metal-ceramic crowns was estimated as 47.53 years (95% confidence interval [CI]: 45.59-49.47 years). Failures in metal-ceramic crowns (n=6, 3.9%) were due to periapical periodontitis. The remaining restoration types had 100% survival at 50 years.

Conclusions: This study showed that the survival of crowns and veneers is high over 50 years in clinical practice with annual follow-up and good oral hygiene. The proportion of teeth with loss of vitality, confirmed clinically and with radiographs, was minimal.