Dental News - Dental filling failure linked to smoking, drinking and genetics

Dental Tribune International

Fri. 10. November 2017

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PITTSBURGH, U.S.: For a long time in dentistry, filling materials have been a topic of intense interest and now new research out of the U.S. and Brazil has added to the discussion. The study found that not only smoking and drinking but also a patient’s genetics can negatively affect the success of a filling, suggesting that personalized dental treatment could lead to improved outcomes.

The researchers, from the University of Pittsburgh School of Dental Medicine in the U.S. and the University of Pernambuco’s dental school in Brazil, investigated a large number of dental records from the Pittsburgh school’s Dental Registry and DNA Repository, which contains information on patient fillings and rates of failure up to five years after the restorative procedures. It also contains information on patient lifestyles, including smoking and drinking habits, and a DNA sample from each patient, allowing the team to investigate whether patient lifestyle and genetic factors may affect the failure rate of composite fillings.

The team found that, within two years of the procedure, fillings failed more often in patients who drank alcohol, and the overall filling failure rate was higher in men who smoked. Furthermore, a difference in the gene for matrix metalloproteinase (MMP2), an enzyme found in teeth, was linked to increased filling failure. The researchers then hypothesized that MMP2 might be able to degrade the bond between the filling and the tooth surface and potentially lead to failure. However, according to the researchers, more investigation needs to be done before any definitive conclusions can be drawn.

In an interesting turn in the debate between amalgam and composite fillings, it was found that there were no major differences between patients receiving either material in terms of filling failure rates. The researchers suggested that this shows composite fillings are at least as durable as amalgam fillings and offer a viable alternative with no toxic ingredients.

“A better understanding of individual susceptibility to dental disease and variation in treatment outcomes will allow the dental field to move forward,” said lead author Prof. Alexandre Vieira, from the Pittsburgh dental school’s Department of Oral Biology. “In the future, genetic information may be used to personalize dental treatments and enhance treatment outcomes.”

The study, titled “A pragmatic study shows failure of dental composite fillings is genetically determined: A contribution to the discussion on dental amalgams,” was published on Nov. 6 in the open-access journal Frontiers in Medicine.