Long-Term Evaluation of Direct Composite Resin Restoration for Traumatic Anterior Crown Fractures in Children and Adolescents

Direct composite resin restorations are often the first choice in children and adolescents with anterior crown fractures. This study aimed to assess the long-term outcomes of direct composite resin restoration in children and adolescents with traumatic dental injuries. Patients with anterior crown fractures treated with direct composite resin restoration at the Department of Dentistry of Wonju Severance Hospital between March 2011 and February 2022 were included. A total of 86 teeth from 59 patients were evaluated. The survival rate according to the sex, age, history of pulp treatment, and ratio of the resin restoration to the clinical crown were statistically calculated using chi-square test, Fisher’s exact, and Kaplan-Meier methods. Factors associated with failure were evaluated using Cox regression analysis. Survival rates during the follow-up period were significantly different according to the patient’s age at the time of trauma (p = 0.036). The survival rate was not significantly different between the sexes (p = 0.632). The survival rate was not influenced by pulp treatment before resin restoration (p = 0.617). Based on the Kaplan-Meier method, the mean retention time of teeth with and without pulp treatment was 99.35 ± 9.98 and 79.68 ± 9.07 months, respectively. Additionally, there was no significant difference between both survival curves (p = 0.215). Furthermore, the survival rate was not significantly different according to the ratio of the resin restoration to the clinical crown (p = 0.334). Similar to the results from Fisher’s exact test, there was no significant difference in survival rates between Group I (ratio of the resin restoration to the clinical crown < 0.5) and Group II (ratio of the resin restoration to the clinical crown ≥ 0.5) (p = 0.228). This study demonstrates the clinical efficacy of direct composite resin restorations for anterior crown fractures in children and adolescents, with favorable survival rates observed over 10 years of follow-up suggesting it as a conservative and effective primary treatment option across various clinical conditions.