Restorative
Chithu Abraham, BDS
Resident
Boston University, Boston, MA
Boston University
Boston, Massachusetts, United States
Christine Chiao, MPH, DMD
Clinical Assistant Professor
Boston University Henry Goldman School of Dental Medicine
Boston University Goldman School of Dental Medicine
Boston, Massachusetts, United States
Keri Discepolo, DDS, MPH
Post Graduate Program Director of Pediatric Dentistry
Boston University Henry Goldman School of Dental Medicine
Boston, Massachusetts, United States
Keri Discepolo, DDS, MPH
Post Graduate Program Director of Pediatric Dentistry
Boston University Henry Goldman School of Dental Medicine
Boston, Massachusetts, United States
Christine Chiao, MPH, DMD
Clinical Assistant Professor
Boston University Henry Goldman School of Dental Medicine
Boston University Goldman School of Dental Medicine
Boston, Massachusetts, United States
Objective: The purpose of this study was to compare the failure rate of different treatment modalities for primary molars treated under general anesthesia.
Methods: A retrospective chart review was conducted at Franciscan Children’s in Boston, MA. Subjects who were ages 7 and under, were seen for oral rehabilitation under general anesthesia from 2015 to 2017, and had at least one follow-up visit within 24 months after oral rehabilitation were included. Treatment failure was defined as a tooth requiring subsequent intervention such as extraction or restorative treatments. SPSS was used for data analysis.
Results: Of 199 charts, 1531 erupted primary molars were reviewed. The overall treatment failure rate of erupted primary molars was 11%. Analysis showed that stainless steel crowns (SSCs) had significantly fewer failures than all other treatments also no treatment (P < .001). Three percent of SSCs failed within two-year follow-up, whereas 22% of one-surface composites failed, 21% of multi-surface composites failed, and 25% of sealants failed. Of erupted primary molars that were not treated under general anesthesia, 27% required treatment within the two-year follow-up. A separate analysis was done for unerupted primary molars (n=61), which showed that 38% of these teeth required treatment within the two-year follow-up.
Conclusion: Significantly lower failure rates of SSCs compared to other restorative modalities support their continued use for pediatric patients with high caries risk. Potential for future caries on unerupted teeth should be considered when planning for very young pediatric patients to have dental treatment under general anesthesia.