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Risk factors for failure in the management of cervical caries lesions



The aim of this retrospective, non-interventional clinical study was to analyze factors influencing the survival of restorative treatments of active cervical (root) caries lesions (aCCLs) and the success of non-invasive treatment options of inactive cervical (root) caries lesions (iCCLs).

Material and methods

Records from patients who visited a single private practice regularly were searched for the presence of solely buccal CCLs. Data from 345 aCCLs and 232 iCCLs being detected at least 6 months before the last recall visit in 295 patients were recorded. Kaplan-Meier analyses were used to analyze time to failure in both groups. Cox proportional hazards models were used to evaluate the association between clinical factors and time until failure.


Within 120 months, 20 aCCLs had received a second restorative follow-up treatment. For iCCLs, 35 lesions had to be restored within 120 months. Median survival/success time was 111 months for aCCLs (annual failure rate 1.7%) and 120 months for iCCLs (annual “restoration” rate 4.3%). In multivariate Cox regression, active and inactive CCLs being checked up more than twice a year showed significantly higher failure/restoration rates than CCLs being checked up less than twice a year (p < 0.001).


Low failure/restoration rates could be found for both treatment strategies for CCLs, and only the “number of check-ups per year” was significantly positively associated with failures.

Clinical relevance

Caries monitoring is a viable way to manage CCLs. However, individual check-up interval should be defined carefully, since higher rate of check-ups seems to lead to increased intervention rates in the management of CCLs.

The study was registered in the German Clinical Trials Register (DRKS-ID: DRKS00010003).

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Authors’ contributions

R.J.W. and H.M.-L. designed and planned the study, E.K. treated the patient and provided the patient files, R.J.W. performed the statistical analysis, R.J.W. and H.M.-L. wrote the manuscript, and E.K. commented on and revised the manuscript.

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Correspondence to R. J. Wierichs.

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Conflict of interest

The authors declare that they have no conflict of interest.


This study was funded by the authors and their institution.

Ethical approval

This study was a retrospective, non-interventional clinical study without the need for local review board approval according to European guidelines for good clinical practice (CPMP/ICH/135/95). This study conforms to the STROBE guideline for cohort studies [16].

Informed consent

For this type of study, formal consent is not required.

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Wierichs, R.J., Kramer, E.J. & Meyer-Lueckel, H. Risk factors for failure in the management of cervical caries lesions. Clin Oral Invest 21, 2123–2131 (2017).

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  • Risk factor
  • Root caries/resorption
  • Clinical studies/trials
  • Preventive dentistry
  • Restorative dentistry
  • Geriatric dentistry