PMID: 11922409Apr 2, 2002Paper

Multilevel survival analysis of amalgam restorations amongst RAF personnel

Community Dental Health
Mark S GilthorpeJohn S Bulman

Abstract

To introduce the concepts of multilevel survival analysis through an investigation into the longevity of amalgam restorations. The multilevel Cox proportional hazard model is illustrated using amalgam restoration data comprising three levels: repeated restorations at level-1, teeth at level-2, and subjects at level-3. The outcome was duration of amalgam restoration survival. Single-level and multilevel Cox methods are contrasted. The data were from a survey of amalgam restorations (reported elsewhere), involving 200 RAF personnel aged between 16 and 37 years at enlistment between 1947 and 1979, having served continuously for a minimum of 16 years prior to 1994. Differences existed between single-level and multilevel methods; the latter being the method of choice. Initial caries experience was a good predictor of longevity. Molar teeth fared worse than pre-molars and MOD & B, MOD & L, and MOD & BL restorations experienced considerably greater risk of failure than did MOD, MO, DO and MO/DO ext types, which in turn fared worse than occlusal restorations. Root-treated and pinned teeth also experienced an elevated risk of premature failure. There was a moderate but significant increase in restoration failure amongst subjects who wer...Continue Reading

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