Status of Resin Based Composite restorations, reasons for failure and associated factors in adult patients who attended tertiary level dental clinics in Dar es salaam

Abstract

Background: Resin-based composite material has been known as a suitable restorative material for lost hard tooth tissue due to its esthetic tooth-color and compressive strength allowing for posterior and anterior restorations, respectively. In Tanzania, RBC has gained popularity as a restorative material; especially in cosmetic dentistry. However, information about its clinical outcome performance is not retrievable. Objective: Aim of this study was to assess the status, reasons for failure, and associated factors of resin based composite restorations in adult patients who attended tertiary dental clinics in Dar es Salaam. Methodology: The study was an analytical cross-sectional study, which was conducted at Muhimbili University of Health and Allied Science and Muhimbili National Hospital (MNH). A systematic random sampling method was used to select the participants. A total of 426 patients participated in this study, conducted from January to May 2021. Information was obtained using a structured questionnaire and clinical examination. All information obtained were coded, entered to a computer, and analyzed using SPSS version 20.0 software. Frequency distribution was used to determine the distribution of different variables. Chi square test was used to test bivariate associations between variables. Multivariate analysis was done using multiple logistic regressions. Results: A total of 426 adult patients treated from the year 2013 to 2018 participated in this study. More 237 (55.6%) than half of the participants were aged below 40 years, males were 243 (57.0%), and those with college education were 311 (73.0%). About 90.1% of the participants reported dental caries being the reason for RBC restoration, with 53.5% of the patients presenting with a failed RBC restoration. The mean age of the restoration was four years. Clinical elements assessed by the USPHS modified Ryge criteria, showed that majority (27.7%) of the failed restorations were due to marginal discoloration. Defective restorations were more common among those who were 60+ years (66.7%, p=0.001), widowers/ widows (64.7%, p= 0.032), and retired from employment (94.1%, p=0.003). Those with a duration of restoration of more than 60 months (70.7%) had failed restorations compared to those with lesser duration, (p= 0.000). On association between the patients’ factors with the status of RBC, patients with high caries risk and those with bruxism had a higher number of defective restorations, (p=0.001 and p=0.001, respectively). Multivariate logistic regression on socio-demographics, showed that participants aged 60+ years and those who were retired had a higher chance of having a defective restoration, (OR=2.18, 95% CI: 1.02-4.66 and OR= 19.657, 95%CI: 2.48 - 155.6, respectively). Also those who had bruxism and those with high caries risk had a higher chance of having a defective restoration, (OR=1.96, 95%; CI: 1.255 - 3.054 and OR=3.06, 95%CI: 1.462 - 6.419, respectively). Conclusion: Failure of RBC restorations among examined was substantial. Age of the participants, duration of restorations, high caries risk and bruxism contributed largely on the status of RBC restorations. Routine dental checkups are key for the success of RBC restorations.