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Patterns and Outcomes of Restorative Treatment in Primary Teeth in Germany

  • Background: Restorative treatment for children’s teeth is still an important aspect of dentistry. In the light of an only moderate caries decline in the primary dentition and a persistently low care index in Germany during the past years [DAJ 2010], there is still a demand for further work on recent patterns and outcomes of restorative treatments in primary teeth placed in everyday practices under the Germany National Health System. Objectives: The present study aimed firstly to describe the prevalence of caries and restorations in the primary teeth in Berlin and Germany from the representative Germany surveys [DAJ 2010], secondly, to describe the frequency and distribution of restorative treatment in primary teeth performed in everyday dental practice in Berlin including children age groups from 1- to 13-years of age, thirdly, to evaluate the outcomes of restorative treatment performed in everyday dental practices in these children and finally to compare results of the present study with data from the German National Health System [KZBV 2011] and randomized community data on the longevity of restorations in primary teeth in Denmark [Qvist et al. 2010a]. Material and Methodology: In the first part of present study data from representative German surveys [DAJ 2010] were interpreted to describe and compare the prevalence of caries and restorations in the primary teeth in Berlin and Germany. For the second and third parts data generated from German National Health System in Berlin (KZV-Berlin) on fillings done in everyday practices in primary teeth of 1- to 13-year-olds during 2010/2011 were collected. This data included: distribution of children with dental treatment regardless of the type of intervention provided, of children who received restorative treatments in primary teeth during dental care visits including total number of fillings per child, the number of filled tooth surfaces, retreatment with another filling, stainless steel crowns, pulp involvement and extractions after prior filling therapy. Information on the age of the original fillings at the time of retreatment was also included. The collected data then were entered into a data base for descriptive and analytical analysis. The results were compared with equivalent data from the German National Health System [KZBV 2011] and randomized community data from Denmark [Qvist et al. 2010a]. Results: Result showed a high similarity in patterns of caries and restorative treatment in primary teeth in Berlin and all of Germany as reported in the representative German surveys [DAJ 2010]. About of 84% of 1-13-year-olds insured in the German National Health System in Berlin received dental care during 2010/2011, with considerably lower rates in very young children. Fillings in primary teeth were performed in 31.17% of all children attending the dentist. Most restorations were placed in 5-8-year-olds. In 1-13-year-olds mostly just one filling was placed, more than five fillings were per child were recorded on average for very young age groups (1-4-year-olds). 55.60% of all fillings in primary teeth were two-surface restorations, whereas more than three-surface restorations comprised 6.17% of all fillings and they were performed most frequently in young children of 1-4-years of age. Retreatment to fillings in primary teeth was 7.66% of fillings placed in 1-13-year-olds. Most retreatments took place from 5 to 9 years of age with a peak in 6-year-olds. In 1-3-year-old children fillings showed shorter mean age at the time of retreatment compared to 7-year-olds and above. Retreatment of fillings in primary teeth by stainless steel crowns was very limited with only 5.16% of all retreatments and it was preferred in children from 3 to 7 years of age. The retreatment with pulp involvement was 11.27% of all retreatments. Extractions were almost as often as retreatment as another filling (ratio 4:5), but they were preferred in older children due to the course of exfoliation. Conclusions: Under the conditions of this retrospective study, the restorative treatment with fillings performed within the National Health System in primary teeth in Berlin was very successful with low rates of retreatment and the fillings shows comparable results to data on the longevity of restorations in primary teeth in Denmark. The study highlighted the need to a structured program for prevention in primary teeth, especially for very young children with high caries activity and possibly also different treatment structures with specialized dentists in this field who can perform oral rehabilitations with pulpotomies and stainless steel crowns.
  • Restaurative Behandlung für die Zähne von Kindern ist immer noch ein wichtiger Aspekt der Zahnheilkunde. Angesichts eines nur mäßigen Karies sinken im Milchgebiss und eine anhaltend niedrige Versorgung in Deutschland in den letzten Jahren [DAJ 2010], gibt es noch einen Bedarf für die weitere Arbeit an den letzten Patterns und Ergebnisse der restaurativen Behandlungen in der Milchzähne platziert in Alltagspraktiken unter dem Deutschland staatlichen Gesundheitsdienstes. Unter den Bedingungen dieser retrospektiven Studie, die restaurative Behandlung mit Füllungen innerhalb des staatlichen Gesundheitsdienstes in Milchzähnen in Berlin durchgeführt war sehr erfolgreich mit niedrigen Raten der Wiederaufarbeitung und die Füllungen zeigt vergleichbare Ergebnisse zu Daten über die Langlebigkeit der Restaurationen in Milchzähnen in Dänemark. Die Studie unterstrich die Notwendigkeit, ein strukturiertes Programm für die Prävention in Milchzähnen, insbesondere für sehr junge Kinder mit hohem Kariesaktivität und gegebenenfalls auch unterschiedliche Behandlungsstrukturen mit spezialisierten Zahnärzten in diesem Bereich, die orale Rehabilitationen mit Pulpotomien und Edelstahlkronen durchführen können.

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Metadaten
Author: Saad Dakilallah J. Alharbi
URN:urn:nbn:de:gbv:9-002338-4
Title Additional (German):Modelle und Ergebnisse der Füllungstherapie in Milchzähnen in Deutschland
Advisor:Prof. Dr. Christian Splieth
Document Type:Doctoral Thesis
Language:English
Date of Publication (online):2015/10/23
Granting Institution:Ernst-Moritz-Arndt-Universität, Universitätsmedizin (bis 31.05.2018)
Date of final exam:2015/10/21
Release Date:2015/10/23
Tag:Filling, Germany, Outcomes, Patterns, Primary teeth, Restoration, deciduous teeth
GND Keyword:Deutschland, Füllung, Milchzahn
Faculties:Universitätsmedizin / Poliklinik für Zahnerhaltung, Parodontologie und Endodontologie
DDC class:600 Technik, Medizin, angewandte Wissenschaften / 610 Medizin und Gesundheit