Five-year Survival Rate of Bonded Dental Restorations in Frail Older Adults
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
INTRODUCTION: Frail older adults residing in long-term care (LTC) facilities are among the most vulnerable to dental caries due to poor oral hygiene (OH), medication-related salivary hypofunction, carbohydrate-rich diets, and limited access to dental care. Providing dental restorations for LTC patients is challenging, and there are few studies investigating the longevity of restorations in this cohort. Multiple restorative materials have been used to restore tooth anatomy as well as address caries prevention using fluoride-based materials. OBJECTIVES: This study examined the longevity of bonded direct restorations placed in LTC patients. Specifically, we examined whether a difference in survival exists between resin composite (RC) and glass ionomer cement (GIC) direct restorations in frail older adults residing in LTC. METHODS: Tooth-colored restorations placed in LTC patients between 2007 and 2012, within the University of British Columbia Geriatric Dentistry Program, were followed annually up to 5 y or until they incurred an event (i.e., re-restoration or tooth extraction) or the patient was lost to follow-up or deceased. Restoration status was documented within the Clinical Oral Disorder in Elders (CODE) Index annual oral health assessments. Mixed-effect logistic regression was calculated to determine hazard ratios, address within-patient correlation, and measure the effect size of multiple covariates. RESULTS: A total of 3,201 dental restorations placed in 846 LTC patients were followed. This cohort of patients had a mean age of 86 y and high levels of oral and systemic disease. Over half were wheelchair bound and had compromised ability to perform OH. The overall 5-y survival rate was 60.3%, and there was no statistically significant difference in survival between RC and GIC. CONCLUSION: Tooth-colored restorations had reasonable longevity in LTC patients and had comparable survival to restorations placed in functionally independent, community-dwelling geriatric populations. No difference between RC and GIC was found with regards to restoration longevity in this population. KNOWLEDGE TRANSFER STATEMENT: Direct restorations provided to frail older adults residing in LTC have reasonable longevity and should be expected to survive for the remainder of the patient's life. As no detectable difference exists in survival rates between RC and GIC, operators should select appropriate restorative materials based on clinical conditions, patient factors, physical properties, and personal preference.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it