Palotie Ulla, Tseveenjav Battsetseg, Vehkalahti Miira M
Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Institute of Dentistry, University of Turku, Finland; Department of Maxillofacial Surgery, Päijät-Häme Central Hospital, Päijät-Häme Joint Authority for Health and Wellbeing, Lahti, Finland.
J Dent. 2025 Oct;161:105991. doi: 10.1016/j.jdent.2025.105991. Epub 2025 Jul 21.
The aim of this register-based retrospective study was to evaluate the reasons recorded for early failures of direct posterior restorations involving two or three surfaces with extension occlusally, and to follow up the fate of these teeth after replacement or repair over 15 years.
Subjects were selected based on information from electronic patient files of 25- to 30-year-old patients with posterior restorations, either primary or re-restorations, performed in 2002 at the Helsinki City Public Dental Service (PDS). Patients with early failures, defined as any intervention procedure within the subsequent year after the 2002 restoration, were included (N = 331). Treatment procedures, both early failures and during follow-up, were grouped as restorations, endodontic treatments/retreatments, or extractions.
Caries was the reason for re-intervention in 15.7 % of early failures, while poor restoration, e.g. fracture or poor restoration anatomy, was reported in 28.7 %, pain or emergency in 30.5 %, and reason not specified in 25.1 %. Linear regression model revealed that accumulation of further failures was associated with whether the tooth had a primary intervention or re-restoration (p < 0.003) as well as the patient having fewer than 28 teeth (p < 0.001) and none healthy CPI sextants (p < 0.035). Following the re-interventions, 75 % of the teeth survived over a 15-year period.
Within this study's limitations, we found that pain and restoration deficiencies were the main reasons for re-intervention within one year in a selected Helsinki City PDS patient group. Re-interventions were more frequent in previously restored teeth and were generally successful in preserving most teeth, even those with large composite restorations.
Pain or posterior restoration deficiencies are the most common reasons for interventions carried out within a year. Re-interventions are more common in previously restored teeth than in teeth with primary restoration. Re-interventions can be effective in preserving most teeth, even in cases with large composite restorations, over a 15-year follow-up period.
本基于登记的回顾性研究旨在评估累及两个或三个面且咬合面有延伸的直接后牙修复早期失败所记录的原因，并随访这些牙齿在更换或修复后15年的转归情况。
根据2002年在赫尔辛基市公共牙科服务机构（PDS）为25至30岁有后牙修复（包括初次修复或再次修复）的患者的电子病历信息选取研究对象。纳入早期失败患者（定义为2002年修复后次年内进行的任何干预操作）（N = 331）。将早期失败及随访期间的治疗操作分为修复、牙髓治疗/再治疗或拔牙。
15.7%的早期失败再次干预原因是龋病，28.7%报告为修复不佳（如折断或修复体外形不佳），30.5%为疼痛或急症，25.1%原因未明确。线性回归模型显示，进一步失败的累积与牙齿是初次干预还是再次修复（p < 0.003）、患者牙齿少于28颗（p < 0.001）以及无健康的社区牙周指数（CPI）区段（p < 0.035）有关。再次干预后，75%的牙齿在15年内得以保留。
在本研究的局限性范围内，我们发现疼痛和修复缺陷是赫尔辛基市PDS特定患者组中一年内再次干预的主要原因。再次干预在先前已修复的牙齿中更频繁，并且通常成功保留了大多数牙齿，即使是那些有大复合树脂修复体的牙齿。
疼痛或后牙修复缺陷是一年内进行干预的最常见原因。再次干预在先前已修复的牙齿中比初次修复的牙齿更常见。在15年的随访期内，再次干预即使在有大复合树脂修复体的情况下也能有效保留大多数牙齿。
