Avaliação de restaurações em dentes posteriores na infância: análise numa coorte de nascimentos

Abstract

Dental caries is a dynamic process that affects individuals worldwide and is considered a public health problem on a global scale. Thus, there is still a great demand for dental restorative treatments nowadays. Although it has long been believed that the main factors responsible for the longevity of direct restorations were the properties of the materials, it is now well known that factors related to the dentist and the patient can influence restoration failures. However, until now there are no population-based longitudinal studies that have investigated the association between individual characteristics, type of restorative material, and failure of posterior tooth restorations in children. Therefore, the aim of the study is to evaluate the direct posterior dental restorations on the birth cohort of 2004, at the age of 12 years old, in relation to the type of restorative material and restoration quality, through a longitudinal prospective study developed from data collected from the birth cohort of 2004, in the city of Pelotas and Jardim América (Capão do Leão) neighborhood. All children born in 2004 in Pelotas were prospectively investigated and a representative sample of this cohort was evaluated for oral conditions at 12 years. The outcome of this study was the quality of posterior (satisfactory / unsatisfactory) restorations. The independent variables included socioeconomic, behavioral and oral health characteristics collected through interviews and clinical exams in the different waves of the cohort. The association between independent variables and quality of restorations was tested using multi-level logistic regression models with random effects, considering two levels of data organization (dental and individual level). A total of 1000 participants and 249 restorations were examined by dentists. After adjustment, receiving guidance on how to prevent caries and caries trajectory in childhood was associated with unsatisfactory restorations. Children whose parents received guidance on how to prevent their child from having caries before age 5 had a 91.0% lower chance of having an unsatisfactory restoration compared to children who had parents who never received guidance (95% CI 0.01-0, 59). In addition, the odds of presenting unsatisfactory restorations was 5.3 times higher in children with high-risk caries in the permanent dentition compared to children with low risk (95% CI 1.07-26.6). Low risk caries trajectory and guidance on how to prevent caries reduced the chance of restoration failure, showing that factors related to the individual play an important role in the quality of the restoration.