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The Timing of Subsequent Treatment for Teeth Restored with Large Amalgams and Crowns: Factors Related to the Need for Subsequent Treatment

¹ University of Michigan, School of Dentistry, Department of Cariology, Restorative Sciences, and Endodontics, 1011 N. University Ave., Ann Arbor, MI 48109-1078, USA;
² University of Iowa, Department of Preventive and Community Dentistry;
³ University of Iowa, Department of Biostatistics;
⁴ University of North Carolina, Department of Dental Ecology;
⁵ University of Iowa, Department of Operative Dentistry;
⁶ University of Iowa, Department of General Internal Medicine; and
⁷ University of Iowa, Public Policy Center;

^* corresponding author, jkolker{at}umich.edu

Crowns and large amalgams protect structurally compromised teeth to various degrees in different situations. The aim of this investigation was to evaluate the survival of teeth with these two types of restorations and the factors associated with better outcomes. Retrospective administrative and chart data were used. Survival was defined and modeled as: (1) receipt of no treatment and (2) receipt of no catastrophic treatment over five- and 10-year periods. Analyses included: Kaplan-Meier survival curves, Log-Rank tests, and Cox proportional hazards regression modeling. Crowns survived longer with no treatment and with no catastrophic treatment; however, mandibular large amalgams were least likely to have survived with no treatment, and maxillary large amalgams were least likely to have survived with no catastrophic treatment. Having no adjacent teeth also decreased survival. Crowns survived longer than large amalgams, but factors such as arch type and the presence of adjacent teeth contributed to the survival of large amalgams.

KEY WORDS: dental amalgam • crowns • longitudinal study • survival analysis • treatment outcome

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