Prevalence of unsatisfactory dental restorations in posterior primary teeth and associated factors

Abstract The aim of this study was to investigate the prevalence of unsatisfactory dental restorations on posterior primary teeth and associated factors in school children aged six to ten years. A cross-sectional study was conducted with children randomly selected from public schools in a small Brazilian town. Questionnaires were sent to the guardians addressing socioeconomic and behavioral aspects of the child. Oral examinations were performed at the schools to determine the quality of dental restorations, visible biofilm, and presence of moderate/extensive untreated caries (scores 3-6 ICDAS). This examination was performed by two previously trained and calibrated examiners. Associations were tested using multilevel logistic regression. Among the 400 children evaluated, 98 had restorations (217 teeth). The prevalence of unsatisfactory restorations was 34.6%. Restorations in amalgam were less likely to fail compared to those in glass ionomer cement (OR = 0.11; 95%CI: 0.02–0.49; p = 0.005). Children with moderate/extensive untreated caries were more likely to have unsatisfactory restorations (OR = 6.79; 95%CI: 2.20–20.93; p = 0.001). Children with a visible plaque index ≥ 20% were also more likely to have unsatisfactory restorations (OR = 2.28 95%CI: 1.05–4.92; p = 0.036). The prevalence of unsatisfactory restorations was high. The occurrence of this outcome was associated with restorative material, presence of caries, and visible plaque.

摘要
本研究旨在探究6~10岁学龄儿童乳磨牙不良修复体的患病率及其相关影响因素。本研究采用横断面研究设计，研究对象为巴西某小型城镇公立学校中随机抽取的学龄儿童。研究人员向儿童监护人发放问卷，以收集儿童的社会经济状况与行为特征相关信息。在学校内开展口腔检查，评估牙修复体质量、可见菌斑生物膜情况，以及中至重度未治疗龋病（ICDAS评分3~6分）的发生情况。本次检查由两名经过统一培训并校准的口腔医师完成。采用多水平logistic回归分析检验各因素与不良修复体的关联。
本次研究共纳入400名受检儿童，其中98名儿童存在乳磨牙修复体，共计217颗修复牙。不良修复体的患病率为34.6%。与玻璃离子水门汀（glass ionomer cement）修复体相比，银汞合金（amalgam）修复体的失败风险更低（比值比OR=0.11；95%置信区间CI：0.02~0.49；p=0.005）。存在中至重度未治疗龋病的儿童，其修复体出现不良预后的风险更高（OR=6.79；95%CI：2.20~20.93；p=0.001）。可见菌斑指数≥20%的儿童，其修复体不良预后风险同样更高（OR=2.28；95%CI：1.05~4.92；p=0.036）。
本研究中不良修复体的患病率较高，修复体不良预后的发生与修复材料类型、龋病存在情况及可见菌斑指数显著相关。