Patient and Restoration Related Factors Influencing The Clinical Longevity of Direct Restorations

Year 2025, Volume: 3 Issue: 3, 58 - 62, 31.12.2025

Gülensu Türkyılmaz Açıl , Fatma Aytaç Bal , Begum Busra Cevval Ozkocak

https://doi.org/10.62243/edr.1814501

Abstract

Aim This multicenter cross-sectional study aimed to evaluate the clinical longevity of direct restorations and to identify patient- and restoration-related factors affecting restoration failure in a Turkish population.
Material and method A total of 2,366 direct restorations (1,676 composite, 660 amalgam, 30 glass ionomer) from 1,324 patients were clinically evaluated using the FDI World Dental Federation criteria. Patient-related factors (age, gender, oral hygiene, recall frequency, education level, treatment setting) and restoration-related factors (material type, service time) were recorded. Interactions were tested using the Pearson chi-square or Fisher’s exact tests (α = 0.05), and variables with p < 0.05 were entered into multivariate logistic regression models to identify independent predictors of failure.
Results Restoration fracture (15.1%), secondary caries (13.4%), and discoloration (12.1%) were the most frequent causes of failure, followed by overhanging restoration (10.0%) and anatomical form loss (9.8%). Longer restoration age, treatment in public dental centers, poor oral hygiene, irregular recall frequency, and low education level were significantly associated with higher failure rates (p < 0.05). Multivariate logistic regression identified poor oral hygiene (OR = 2.48), irregular recall (OR = 2.10), restoration age > 5 years (OR = 1.61), female gender (OR = 1.46), and age ≥ 35 years (OR = 1.80) as independent predictors of failure.
Conclusion Both patient- and restoration-related factors significantly influence the clinical longevity of direct restorations. Regular recall visits, good oral hygiene habits, and appropriate clinical procedures are essential for long-term success.

Keywords

Amalgam , Composite resin , Glass ionomer , Restoration failure , Secondary caries

Ethical Statement

The study protocol was approved by the Bolu Abant İzzet Baysal University Clinical Research Ethics Committee (No: 2019/98)

Project Number

Not applicable.

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