UBC Theses and Dissertations
Five-year survival rate of bonded dental restorations In frail older adults Tong, Nicholas
Objectives: Frail older adults who reside in long-term care (LTC) facilities are among the most vulnerable to dental caries due to poor oral hygiene (OH), medication-related salivary hypofunction, diets high in carbohydrates, and limited access to dental care. Providing dental restorations for LTC patients is challenging and there is a lack of studies investigating the longevity of dental restorations in this cohort. Over the years, multiple dental restorative materials have been used to restore tooth anatomy in an aesthetic manner as well as to address dental caries prevention using fluoride-based materials. This study examined the longevity of direct bonded dental restorations placed in LTC patients. Specifically, we aimed to determine if there is a difference in survival between resin composite (RC) and glass ionomer cement (GIC) direct restorations in frail older adults residing in LTC. Methods: Tooth-coloured restorations placed in LTC patients between 2007-2012, within the University of British Columbia Geriatric Dentistry Program, were followed annually up to five years or until they incurred an event (i.e. re-restoration or tooth extraction), or the patient was lost to follow-up or deceased. Restoration status was documented within the Clinical Oral Disorder in Elders (CODE) Index annual oral health assessments. Mixed-effect logistic regression was calculated to determine hazard ratios, address within-patient correlation and measure the effect size of multiple covariates. Results: A total of 3,201 dental restorations placed in 846 LTC patients were followed. This cohort of patients had a mean age of 86 years, high levels of oral disease, systemic disease and polypharmacy, and had on average 2.5 carious teeth at presentation. Over 50% of patients were wheelchair-bound and had compromised ability to perform OH. The overall 5-year survival rate was 60.3% overall and there was no statistically significant difference in survival rates between RC and GIC restorations. Conclusion: Tooth-coloured dental restorations had reasonable longevity in LTC patients and had comparable survival to restorations placed in functionally independent, community-dwelling geriatric populations. No difference between RC and GIC was found with regards to restoration longevity in this population.
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