Restorative
Vishnu Reddy, DDS (he/him/his)
Pediatric Dentistry Resident
University of California - Los Angeles, CA
UCLA
Los Angeles, California, United States
Sean McGivern, DDS
UCLA
Eric Tranby, PhD, MA
CareQuest Institute for Oral Health
Daniela Silva, DDS, MS
Section of Pediatric Dentistry, School of Dentistry
Purpose: The aim of this longitudinal retrospective study was to compare the survival rates of different restorative procedures in children in the primary dentition stage (0-6 years) and transitional dentition stage (6-12 years) from a diverse set of children across the United States.
Methods: De-identified CareQuest claims data between 2012-2020 was used to identify 41,870 teeth with restorations in children ages 0-6 years and 129,230 teeth with restorations in children ages 6-12 years from all 50 U.S. states. Restorations were categorized using the Code on Dental Procedures and Nomenclature (CDT) based on type of material used at initial restoration (Amalgam, Composite, Stainless Steel Crowns (SSC), and Protective Restorations) along with the number of surfaces. Follow-up data from subsequent visits were used to identify 8,918 of these restorations that required re-treatment.
Results: Amalgam restorations had an average re-treatment rate of 5.81% compared to 5.95% of composite restorations. SSCs had a lower average rate of needing re-treatment of 3.76%. Protective restorations needed re-treatment roughly half (48.17%) of the time. For the restorations that needed re-treatment, the average time between initial treatment and re-treatment was 9.1 for amalgams, 8.3 months for composites, 6.6 months for SSCs, and 4 months for protective restorations.
Conclusion: SSCs showed the least need for re-treatment while amalgams and composites showed similar survival rates and time prior to re-treatment. Considering the non-zero risk of mercury exposure with amalgam restorations during a child's growth and development, composite restorations are a safer alternative with comparable longevity.