196 - Primary Class II Composite Survival Analysis Compared To Medicaid Policy

Purpose: To determine if failure rate of class II composite restorations exceeds that of medicaid coverage frequency and evidence based-dentistry recommendations.

Methods: This retrospective chart review was conducted on patients of record at two private offices treating predominantly Medicaid enrolled patients. Inclusion criteria was patients who received a class II composite restoration in primary dentition and were seen for routine follow up visits. Radiographs were reviewed at 6-month intervals for 24 months and evaluated restoration survival. The resulting interval-censored filling survival data were analyzed using Bayesian accelerated failure time model that included Age at placement, Tooth type and and Sex as independent variables.

Results: The percent of surviving class II restorations decreases exponentially with time, with approximately 70% survival at 6 months and 40% survival at 12 months. It was also noted that the survival rate of Class II composite restorations in primary dentition increases with increase in patient age. There is no statistically significant difference in survival between primary 1st and 2nd molar restorations.

Conclusions: We recommend re-evaluation of the interval frequency for restoration placement under the current Medicaid managed care organization policy. Although our data is from a small targeted project, it shows that children and practitioners are at the mercy of their Medicaid state policy which does not align with evidence-based dentistry.

Identify Supporting Agency and Grant Number: HRSA (D88HP28504-06-00)