The survival and clinical performance of anterior composite resin restorations and posterior indirect and cast restorations used to treat generalised tooth wear.

Abstract

Abstract Objective To evaluate the survival and clinical performance of various restorative materials used in the rehabilitation of generalised severe tooth wear within a UK NHS hospital and postgraduate institute. Methods The clinical performance of 527 restorations on 20 patients with generalised severe tooth wear was reviewed after mean period of 5 years. The anterior teeth were restored with direct composite resin and posterior teeth restored with indirect restorations. The study used modified United States Public Health Service (USPHS) criteria for the assessment of the restorations. Survival of the restorations was analysed using Kaplan-Meier survival curves, the log-rank test, and the Cox proportional hazards regression analysis. Results The sample included 20 participants (13 males, 7 females). The median age was 51.8 years (range 33–73 years). The results indicated that the median survival time for all restorations was 11.3 years when major failures were considered and 5.9 years for restorations when all types of failure were considered. A median survival time of 5.9 years for composite resin restorations and over 7 years for cast restorations was found when considering all failures. The composite resin restorations commonly failed as a result of fracture, wear and marginal discoloration. The factors that significantly influenced the survival of these restorations were the material used, aetiology, incisal relationship and tooth location. Compliance with post-treatment occlusal splint therapy was poor with 6/18 patients using the splints at the time of assessment. The biological complications associated with this treatment regime were rare. Patient satisfaction remained generally high, with greatest dissatisfaction related to treatment time. Conclusions The use of composite resin restorations with posterior indirect restorations to treat generalised severe tooth wear at an increased occlusal vertical dimension is a viable treatment modality with very few major complications.