Clinical outcomes of direct resin-composite restorations in primary maxillary incisors in patients with early childhood caries: a prospective non-controlled cohort study.

OBJECTIVES: Maxillary primary anterior teeth are primarily affected by early childhood caries (ECC), and treatments are challenging. The aim of this study was to evaluate the clinical outcomes and risk factors for chairside direct composite restorations of maxillary primary incisor caries in patients with ECC. MATERIALS AND METHODS: A total of 160 maxillary incisors from 54 children aged 23-47 months who were diagnosed with caries and received direct-bonded composite restoration treatments according to the standard protocol were included. At 1 year of follow-up, the restorations were evaluated using the modified United States Public Health Service (USPHS) criteria. A restoration was defined as successful when Alpha or Bravo scores were obtained for all parameters. The presence of secondary caries, fracture or restoration loss, and pulpal or periapical pathosis were recorded as failures. RESULTS: Forty-six patients completed the 1-year follow-up visit, and 133 restorations were analysed, with a recall rate of 83.1% for restorations and 85.2% for patients. Ninety-two restorations (69.2%) were judged as successful. Secondary caries was found in 27 teeth (20.3%), fracture or restoration loss in 35 teeth (26.3%), and pulpal or periapical pathosis in 5 teeth (3.8%). Logistic regression analysis revealed that the number of carious surfaces was a risk factor for outcomes (OR 3.730, 95% CI 1.494 ~ 9.313, P value 0.005). CONCLUSIONS: Direct resin-composite could restore primary maxillary incisors in children with one to two caries-involved surfaces.