Class I restorations and restorations placed using rubber dam presented better AFR .
An elevated number of failures were observed due to recurrent caries , highlighting the need for professionals to work with a health-promoting approach .
BACKGROUND Several restorative material s with specific indications are used for filling cavities in primary teeth .
AIM To systematic ally review the literature in order to investigate the longevity of primary teeth restorations  and the reasons for failure .
Survival characteristics of composite restorations in primary teeth
Objectives This retrospective study analyzed restoration survival of  composite fillings in children with at high caries risk in relation to age , sex , operator , tooth type , filling extension , and material used . Material s and methods Among 667 children treated in 2004–2012 in a university setting without sedation or general anesthesia , 2388 composite fillings were included . Relevant data from regular recall intervals were retrieved from patients ’ records . Either total-etch or a self-etch adhesive combined with flowable and /or (nano)hybrid composite was used . The Kaplan-Meier estimator and Cox proportional hazard analysis with backward elimination model were applied for survival analysis . Results For the observation period of 8 years ( mean 1.7 years ) , the cumulative failure rate was 17.2 % with annual failure rates of 10.0 % . In 8.8 % of the cases , fillings failed due to secondary caries . In 8.3 % technical failure due to total filling loss , loosening , marginal gaps , or tooth fracture occurred . Tooth type , filling extension , age , operator , dental dam , and type of adhesive were significant for survival ( p < 0.05 ) . Conclusions Filling survival was comparably lower to composite restorations observed in prospect i ve clinical studies on permanent teeth and other tooth-colored restoratives used in primary teeth . Due to the very high caries risk and young age of the population , frequent loss due to secondary caries was observed . With respect to the high caries risk , composite restorations can be used to treat carious primary teeth , though a strict caries prevention regimen should be followed to minimize restoration failure . Clinical relevance Filling loss of composites in the primary dentition is associated with secondary caries on the long term
Class I restorations and restorations placed using rubber dam presented better AFR .
An elevated number of failures were observed due to recurrent caries , highlighting the need for professionals to work with a health-promoting approach .
BACKGROUND Several restorative material s with specific indications are used for filling cavities in primary teeth .
AIM To systematic ally review the literature in order to investigate the longevity of primary teeth restorations  and the reasons for failure .