Cross-sectional clinical evaluation of recurrent enamel caries, restoration of marginal integrity, and oral hygiene status.

Both marginal quality and oral hygiene status have strong effects on the risk of recurrent caries. Although there was no statistically significant interaction between these two parameters in this study, the influence of each variable was dependent on its severity. There is a difference between the behavior or the likelihood of recurrent caries on occlusal surfaces as compared with smooth surfaces. On the smooth surfaces, there is a continued increased risk with decreasing marginal quality; the occlusal surfaces, however, show no change in vulnerability beyond a modified marginal quality score of 3. Variation in oral hygiene had a more pronounced effect on the probability of recurrent caries of restorations with moderate margin scores than it did on restorations with either very poor or very good cavosurface margins. This work further emphasizes the importance of technically good restorative care at the operative visit, which, coupled with conscientious oral hygiene, should have a positive effect on increasing the longevity of restorations and decreasing the need for replacement.