Randomized controlled clinical trial of the 24-months survival of composite resin restorations after one-step incomplete and complete excavation on primary teeth. An atraumatic restorative treatment (ART) technique: evaluation after one year. One-year follow-up of Atraumatic Restorative Treatment(ART) for dental caries in children undergoing oncohematological treatment: a pragmatic trial Bilayer technique and nano-filled coating increase success of approximal ART restorations: a randomized clinical trial. Restoration of permanent teeth in young rural children in Cambodia using the atraumatic restorative treatment (ART) technique and Fuji II glass ionomer cement. Amalgam and ART restorations in children: a controlled clinical trial ART and Conventional Root Restorations in Elders after 12 Months Six-Year Success Rates of Occlusal Amalgam and Glass-Ionomer Restorations Placed Using Three Minimal Intervention Approaches Effectiveness of conventional treatment using bulk-fill composite resin versus Atraumatic Restorative Treatments in primary and permanent dentition: a pragmatic randomized clinical trial Outcomes of One-Step Incomplete and Complete Excavation in Primary Teeth: A 24-Month Randomized Controlled Trial Survival rate of approximal-ART restorations using a two-layer technique for glass ionomer insertion Longevity and Cariostatic Effects of Everyday Conventional Glass-ionomer and Amalgam Restorations in Primary Teeth: Three-year Results Is high-viscosity glass-ionomer-cement a successor to amalgam for treating primary molars? The longevity of amalgam versus compomer/composite restorations in posterior primary and permanent teeth: findings From the New England Children's Amalgam Trial. Survival of Fuji IX ART fillings in permanent teeth of primary school children in Tanzania. Clinical evaluation of multiple-surface ART restorations: 12 month follow-up. Clinical evaluation of atraumatic restorations in primary molars: a comparison between 2 glass ionomer cements. Effectiveness of ART and traditional amalgam approach in restoring single-surface cavities in posterior teeth of permanent dentitions in school children after 6.3 years. The atraumatic restorative treatment (ART) approach to restoring primary teeth in a standard dental clinic. Comparison of two tooth-saving preparation techniques for one-surface cavities. Cost-effectiveness of ART restorations in elderly adults: a randomized clinical trial. Atraumatic Restorative Treatment with Resin-Modified Glass Ionomer Material: Short-Term Results of a Pilot Study The 3.5-year survival rates of primary molars treated according to three treatment protocols: a controlled clinical trial
OBJECTIVE This r and omized clinical trial aim ed to compare the 24-months survival of  composite restorations in primary molars after partial caries removal ( PCR ) and total caries removal ( TCR ) . METHODS Forty-eight children aged 3 - 8 years with at least one molar with a deep carious lesion were included ( PCR ; n=66 ; TCR ; n=54 ) . For PCR , excavation was stopped when dentine with a leathery consistency was achieved ; in the TCR group , total absence of carious tissue was confirmed using a blunt-tipped probe . Pulpotomy was performed in cases of pulp exposure . Success was assessed by modified USPHS criteria with Alpha and Bravo scores recorded as success . RESULTS Pulp exposure occurred in 1 and 15 of the teeth treated with PCR and TCR respectively ( p<0.01 ) . The restorations survival rate after 24 months was 66 % ( PCR ) and 86 % ( TCR ) ( p=0.03 ) . When teeth that received pulpotomy were analyzed separately , the survival rate was 92 % ( p=0.09 ) . PCR performed in occlusoproximal restorations demonstrated the lowest success rate ( p=0.002 ) . PCR increases 2.90 times the probability of having a restorative failure compared to TCR ( p=0.03 ) , after adjusting for cavity type . When pulp exposure and restoration failure were considered as the outcome , there was no significant difference between the two groups ( p=0.10 ) with success rates of 64 % ( PCR ) and 61 % ( TCR ) . CONCLUSION Collectively , deciduous teeth su bmi tted to PCR prevented pulp exposure and , consequently , more invasive treatments ; otherwise , PCR yielded lower longevity for composite restoration compared to TCR , suggesting that PCR restorations need to be followed over time , especially when multi-surface restorations are involved . CLINICAL SIGNIFICANCE Composite restorations on carious remaining tissue require monitoring over time , especially those performed in more than one surface . Even if the restorations present shortcomings over the time , the majority of them are subject to repair , allowing more conservative approaches for teeth with deep caries lesions Extraction is the most common dental treatment provided for people in rural and suburban areas in many less-industrialised countries . By comparison , restorative care is rarely provided . In order to improve such situations , a treatment technique has been developed based only on h and excavation of carious lesions and using glass-ionomer cement as a filling material and a sealant . This Atraumatic Restorative Treatment ( ART ) technique follows the concept of minimal intervention and does not require electrically driven equipment . This paper reports on the longevity of fillings and sealants placed using the technique under field conditions in rural Thail and .  Dental caries was treated using the ART technique in one village , whilst the population in a second village received restorative care ( amalgam fillings ) through mobile dental units . A third village was the control . After one year , 79 per cent of single surface ART fillings and 55 per cent of ART fillings of greater than one surface placed in deciduous teeth were judged successful . The success rate of ART fillings  in the permanent dentition ( mainly single surface fillings ) was 93 per cent and the retention rate for sealants was 78 per cent . Children were pleased at having received treatment by this technique and showed little fear . The ART technique is a promising caries treatment procedure for use in rural and sub-urban areas in less-industrialised countries Background The oral condition in children undergoing oncohematological treatment can have a negative impact on the course of disease . Little is known about survival of tooth restorations in these patients . The aim of this study was to evaluate the longevity of restorations and sealants performed by Atraumatic Restoration Treatment ( ART ) in patients undergoing oncohematological treatment . Methods ART single surface restorations and sealants were performed in the experimental group ( E ) , which comprised children ( 2–13 years old ) undergoing oncohematological treatment , and in the control group ( C ) , in which  patients did not undergo such treatment .  The same examiner evaluated the  ART  at 1 , 3 , 6 and 12 months after preparation , using the same criteria for restorations and sealants . ART was successful if the sealant or restoration did not need a repair in the follow-up assessment . Descriptive , bivariate and Cox ’s proportional hazard analyses were performed at a significance level of 5 % . Results The two groups , one including 24 children ( E ) and the other 14 children ( C ) , received 101 and 52 ART procedures , respectively . The success rates were 95.0 % ( E ) and 100 % ( C ) at 1 month ( P = 0.233 ) ; 81.2 % ( E ) and 92.3 % ( C ) at 3 months ( P = 0.009 ) ; 72.2 % ( E ) and 80.8 % ( C ) at 6 months ( P = 0.050 ) and 48.5 % ( E ) and 73.1 % ( C ) at 12 months ( P = 0.001 ) . The final Cox ’s regression model for occurrence of ART failure needing repair did not show differences between groups ( E : OR = 1.6 , 95 % CI 0.8–2.9 ) ; primary teeth had a shorter survival than permanent teeth ( OR = 2.1 , 95 % CI 1.2–3.7 ) . Conclusions Oncohematological treatment did not interfere with the longevity of  ART restorations and sealants , which suggests the potential use of this technique in children undergoing chemotherapy . Trial registration Brazilian Clinical Trials Registry ( REBEC ) RBR-2c3c52 . Registered 5 June 2014 . BACKGROUND The high-viscosity consistency of glass ionomer cement ( GIC ) may lead to its incorrect adaptation into the cavity and therefore to restoration failure . AIM To compare two different insertion techniques for GIC in approximal atraumatic restorative treatment ( ART ) restorations and two different surface protection material s. DESIGN Approximal caries lesion in primary molars from 208 schoolchildren was r and omly assigned into four groups : G1 , conventional GIC insertion protected with petroleum jelly ( PJ ) ; G2 , bilayer technique protected with PJ ; G3 conventional GIC insertion protected with nano-filled particles coating for GIC ( NPC ) ; G4 , bilayer technique protected with NPC . Restorations were evaluated after 1 , 6 , 12 , 18 , 24 , and 36 months . Kaplan-Meier survival analysis and log-rank test were performed . Cox regression analysis ( α = 5 % ) was used to verify the influence of clinical factors . RESULTS Restoration survival was 52.8 % . Log-rank test indicated a better survival of the bilayer technique restorations , compared to conventional restorations ( P = 0.005 ) , whereas the coated conventional restorations presented higher survival than the uncoated ones ( P = 0.035 ) . Cox regression analysis showed no influence of any clinical tested variables . CONCLUSION The survival rate of the approximal ART restorations is positively influenced by the bilayer technique , and the application of nano-filled coating increases the longevity of the conventional approximal ART restorations UNLABELLED Several recent studies have demonstrated the success of the ART ( atraumatic restorative treatment ) technique under field conditions in developing countries . The ART technique involves removal of caries using only h and instruments , and placing a glass ionomer cement ( GIC ) restoration . OBJECTIVES To estimate the longevity of Fuji II GIC ART restorations placed in permanent teeth by dental nurse students under field conditions in rural Cambodia . DESIGN Clinical field trial . SETTING One high school in rural Cambodia . SAMPLE AND METHODS 53 subjects between the ages of 12 and 17 who had dental caries were selected to participate . Subjects were r and omly assigned to a dental nurse student for cavity preparation and placement of ART restorations ( without cavity conditioning ) . RESULTS 92.1 % of the carious lesions required class I or class V restorations , and 85.4 % were in the lower molars . 89 teeth were filled . At 1 and 3 years 86.4 % and 79.5 % of restorations were still present . Restorations were assessed by one dentist according to st and ard criteria . 76.3 % of the restorations were judged to be successful at 1 year , and 57.9 % at 3 years . CONCLUSIONS Factors which may have affected the success rates included : the material used , technical factors , failure to condition the cavity prior to restoration , and inexperience of the operators . The results suggest that ART restorations in permanent teeth using Fuji II GIC are only moderately successful after 3 years . Better results could be expected by using a dentine conditioner in conjunction with one of the newer stronger glass ionomer cements Objectives The aims of this study were to compare 2-year cumulative survival rates of  amalgam and atraumatic restorative treatment ( ART ) restorations in primary molars and to investigate the determinants of the survival rate of restorations . Material s and methods A controlled clinical trial using a parallel group design was carried out on 258 children aged 6–7 years old , allocated to two treatment groups : conventional restorative treatment using amalgam and ART using high-viscosity glass ionomer . A total of 364 amalgam restorations and 386 ART restorations were placed by three pedodontists in 126 and 158 children , respectively , and were evaluated after 0.5 , 1 , and 2 years . Restorations were placed in vital primary molars with neither pain nor signs of pulp involvement . The survival analysis was conducted using the proportional hazard rate regression model with frailty correction . Results The 2-year cumulative survival rates for all amalgam ( 77.3 % ) and ART ( 73.5 % ) restorations were not statistically significantly different , but there was an effect of “ type of surface ” ( single/multiple ) and “ cavity filling time ” on the survival rates . Both amalgam and ART single-surface restorations had higher survival rates than multiple-surface restorations of the same material . Secondary caries was responsible for 36 and 38 % of failures in amalgam and ART restorations , respectively . Mean time for restoring all type of cavities with amalgam and ART restorations was 13.6 and 13.7 min , respectively . Conclusions Amalgam and ART restorations presented similar survival rates over a 2-year period for all , single-surface , and multiple-surface restorations . Clinical relevance In the cause of finding alternatives to amalgam , ART restorations using high-viscosity glass ionomer might be a suitable option for managing cavitated dentine carious lesions in vital primary molars Successful use of atraumatic restorative treatment ( ART ) in children has been reported , but little information is available regarding its use in older adults . The hypothesis of this study was that survival rates of root restorations placed by both ART and the conventional technique were similar . Root-surface caries lesions in 103 institutionalized elders in Hong Kong were treated r and omly by either : ( 1 ) the conventional approach — caries removed by dental burs , and the cavity filled with light-cured resin-modified glass ionomer ; or ( 2 ) the ART approach — caries removed by h and instruments , and the cavity filled with chemically cured high-strength glass ionomer . In total , 84 conventional and 78 ART restorations were placed . After 12 months , 63 conventional and 59 ART restorations were review ed , and the respective 12-month survival rates were 91.7 % and 87.0 % ( p > 0.05 ) . It is concluded that the survival rates of both types of root restorations were high and similar The present r and omised clinical trial was aim ed at comparing three minimally invasive restorative treatment approaches for managing dental caries in occlusal surfaces using a non-gamma-2 amalgam and a low-viscosity glass-ionomer as the restorative material . The treatment approaches tested in parallel groups were : conventional in a university setting , modified-conventional and ultraconservative ( Atraumatic Restorative Treatment , ART ) approaches in a field setting . A split-mouth design was used in which the two restorative material s were r and omly placed in 430 matched contralateral pairs of permanent molar teeth . A total of 152 children from five primary schools were recruited and treated by a dental therapist . The restorations were evaluated after 6 years by 2 calibrated independent examiners . The 6-year successes for all occlusal amalgam and glass-ionomer restorations were 72.6 and 72.3 % , respectively . There were no statistically significant differences observed between the successes for both amalgam and glass-ionomer restorations placed either by the ART ( 68.6 % , with 95 % CI = 61–76 % ) approach or by the conventional ( 74.5 % , with 95 % CI = 65–82 % ) and the modified-conventional ( 75.8 % , with 95 % CI = 67–83 % ) approaches after 6 years . There was also no statistically significant difference observed between the successes of occlusal ART restorations  with glass-ionomer ( 67.1 % , with 95 % CI = 56–77 % ) and occlusal conventional restorations with amalgam ( 74 % , with 95 % CI = 61–85 % ) after 6 years . ‘ Restoration fracture/marginal defects ’ and ‘ loss of material ’ were the most common causes for failure . The former was more often recorded in amalgam restorations and the latter in glass-ionomer restorations .  Secondary caries was observed for 2 % of glass-ionomer and for 10 % of amalgam restorations . This difference was statistically significant ( p = 0.001 ) . The ART approach using glass-ionomer performed equally well as conventional restorative approaches using electrically driven equipment and amalgam for treating dentinal lesions in occlusal surfaces after 6 years Background Clinical studies are being conducted in less strict conditions in order to establish an adequate scientific basis for decision making . The aim of this pragmatic r and omized clinical trial is to evaluate the effectiveness of single and multiple-surfaces restorations performed following the Atraumatic Restorative Treatment ( ART ) premises compared with Conventional Treatment ( CT ) using bulk fill composite restorations in primary and permanent teeth . Methods / design A total of 1,214 5-to-13 year-old children with at least one single or multiple-surface dentin caries lesion in primary or permanent molars will be selected in public schools of Barueri-SP , Brazil . The participants will be r and omly assigned into 2 groups : CT ( caries removal with bur and restoration performed with Scotchbond ™ Universal Adhesive system associated with Filtek Bulk Fill – 3 M/ESPE ) and ART ( Caries removal with h and instruments and restoration with high viscosity glass ionomer cement Ketac Molar Easy Mix – 3 M/ESPE ) . Ten untrained dentists will perform the treatment in in dental offices located at public schools . The restorations will be evaluated after 6 , 12 and 24 months by an independent trained and calibrated examiner . The restoration and tooth survival , the cost-effectiveness analysis between the two groups and the operators ’ preferences regarding the techniques will be also evaluated . Kaplan-Meier survival analysis and log-rank test will be applied for the restoration and tooth survival . All the average event rates in the two groups will be modelled and compared with a Cox proportional hazard shared frailty model since there is an operator-cluster effect . The significance level for all analyses will be 5 % . Discussion Our hypothesis is that despite similar expected effectiveness between ART using high viscosity GIC and conventional treatment using bulk fill composite resin when treating single or multiple-surface in posterior primary and permanent teeth , ART will present superior cost-effectiveness . The results of this trial will support decision-making by clinicians and policy makers . Trial registration NCT02568917 . Registered on May 10th 2015 Aim : To compare 24-month pulp health outcomes of partial caries removal ( PCR ) and total caries removal ( TCR ) with  composite restoration in primary molars . Methods : 48 children aged 3 - 8 years with at least one molar with a deep carious lesion were included . 120 teeth were r and omized to control ( TCR ; n = 54 ; 69 % class II ) and test ( PCR ; n = 66 ; 63 % class II ) groups . Total absence of carious tissue was confirmed using a blunt-tipped probe in the TCR group . For PCR , excavation was stopped when hardened , dried dentin with a leathery consistency was achieved . Pulpotomy was performed in cases of pulp exposure . Results : Pulp exposure occurred in 2 and 27.5 % of teeth treated with PCR and TCR , respectively ( p < 0.01 ) . The operative time was significantly higher for TCR than PCR .  Success rates were 92 and 96 % in the PCR and TCR groups , respectively ( p = 0.34 ) . The success rate tended to be lower in occlusoproximal ( 92 % ) than in occlusal ( 100 % ) lesions ( p = 0.08 ) . Conclusion : The clinical and radiographic success rates of  PCR and TCR  in primary teeth with deep carious lesions were high and did not differ significantly , indicating that PCR is a reliable minimally invasive approach in primary teeth and that the retention of carious dentin does not interfere with pulp vitality . Moreover , PCR provided other clinical ly relevant advantages over TCR , especially lower incidence of pulp exposure and lower operative time Objective Good survival rates ( SR ) have been reported for occlusal-atraumatic restorative treatment ( ART ) restorations but not for approximal-ART restorations . The high-viscosity consistency of the glass ionomer cement ( GIC ) may lead to its incorrect adaptation into the cavity and thus to failure of the restoration . Because the use of a flowable GIC layer seemed to improve its adaptation in approximal restorations in vitro , we evaluated whether the use of an intermediate flowable GIC layer would improve the SR of approximal-ART restorations . Methods A total of 208 children ( 6–7 years old ) with at least one occluso-proximal carious lesion in a primary molar were selected and r and omly allocated to two groups : G1 , conventional technique , one-layer GIC ( powder/liquid ratio 1:1 ) ; and G2 , two-layer technique , consisting of a first layer of GIC with a flowable consistency ( powder/liquid ratio 1:2 ) and a second layer of a regular consistency . Restorations were made by final-year students and evaluated after 1 , 6 , 12 and 18 months . Restoration survival was evaluated using Kaplan – Meier survival and logrank test . Poisson regression analyses ( α = 5 ) were used to verify the influence of factors such as insertion technique , restoration surface and operators . Results The overall SR of the restorations after 18 months was 68 % . There was no difference in SR between the techniques , neither did the other factors influence the SR . Conclusions Over 18 months , the use of an intermediate flowable GIC layer in approximal-ART restorations does not improve the restoration survival . Clinical relevance This study suggests that the two-layer technique is not the answer for increasing approximal-ART restoration longevity The aim of this study was to compare the longevity and cariostatic effects of everyday  conventional glass-ionomer and amalgam restorations in primary teeth . The material s consisted of  515 Ketac-Fil glass-ionomer restorations and 543 Dispersalloy amalgam restorations prepared in 666 children , from 3 to 13 years of age , by 14 dentists within the Danish Public Dental Health Service in the municipalities of Vaerlose and Hillerød . The restorations , of which 79 % were of the Class II type , were in contact with 593 unrestored surfaces in adjacent primary and permanent teeth . After 3 years , 6 % of the patients had dropped out of the study , and 33 % of the teeth were exfoliated with the restoration in situ . A further 37 % of the glass-ionomer and 18 % of the amalgam restorations were recorded as failed ( p < 0.001 ) . The frequency of failures was highest for Class II glass-ionomer restorations , which showed a 50 % median survival time of only 34½ months , because of many fractures , while the 75 % survival time for Class II amalgam restorations just exceeded the actual 36 months ( p < 0.001 ) . Caries progression was most often recorded in surfaces adjacent to amalgam restorations , and 21 % of these surfaces needed restorative treatment vs. 12 % of the surfaces adjacent to glass-ionomer restorations ( p < 0.01 ) . The three-year results indicated that conventional glass ionomer is not an appropriate alternative to amalgam for all types of restorations in primary teeth . In particular , the short longevity of Class II glass-ionomer restorations could not be compensated for by the reduced caries progression and need for restorative therapy of adjacent surfaces OBJECTIVES To assess and compare the cumulative survival rate of amalgam and atraumatic restorative treatment ( ART ) restorations in primary molars over 3 years . METHODS 280 children aged 6 - 7 years old were enrolled in a cluster r and omized controlled clinical trial using a parallel group design covering two treatment groups : conventional restorative treatment with amalgam ( CRT ) and atraumatic restorative treatment ( ART ) using a high-viscosity glass-ionomer ( HVGIC ) Ketac Molar Easymix . Three pedodontists placed 750 restorations ( 364 amalgam and 386 ART in 126 and 154 children , respectively ) which were evaluated at 0.5 , 1 , 2 and 3 years . The proportional hazard rate regression model with frailty correction , ANOVA and Wald tests , and the Jackknife procedure were applied in analysing the data . RESULTS The cumulative survival rates over 3 years for all , single- and multiple-surface CRT/amalgam restorations ( 72.6 % , 93.4 % , 64.7 % , respectively ) were no different from those of comparable ART/HVGIC restorations ( 66.8 % ; 90.1 % and 56.4 % , respectively ) ( p=0.10 ) . Single-surface restorations had higher survival rates than multiple-surface restorations for the both treatment procedures ( p<0.0001 ) . A higher proportion of restorations failed because of mechanical reasons ( 94.8 % ) than of secondary caries ( 5.2 % ) . No difference in reasons for restoration failures between all types of amalgam and ART/HVGIC restorations were observed ( p=0.24 ) . SIGNIFICANCE The high-viscosity glass-ionomer used in this study in conjunction with the ART is a viable option for restoring carious dentin lesions in single surfaces in vital primary molars BACKGROUND Limited information is available from r and omized clinical trials comparing the longevity of  amalgam and resin-based compomer/composite restorations . The authors compared replacement rates of these types of restorations in posterior teeth during the five-year follow-up of the New Engl and Children 's Amalgam Trial . METHODS The authors r and omized children aged 6 to 10 years who had two or more posterior occlusal carious lesions into groups that received amalgam ( n=267 ) or compomer ( primary teeth)/composite ( permanent teeth ) ( n=267 ) restorations  and followed them up semiannually . They compared the longevity of restorations placed on all posterior surfaces using r and om effects survival analysis . RESULTS The average+/-st and ard deviation follow-up was 2.8+/-1.4 years for primary tooth restorations and 3.4+/-1.9 years for permanent tooth restorations . In primary teeth , the replacement rate was 5.8 percent of compomers versus 4.0 percent of amalgams ( P=.10 ) , with 3.0 percent versus 0.5 percent ( P=.002 ) , respectively , due to recurrent caries . In permanent teeth , the replacement rate was 14.9 percent of composites versus 10.8 percent of amalgams ( P=.45 ) , and the repair rate was 2.8 percent of composites versus 0.4 percent of amalgams ( P=.02 ) . CONCLUSION Although the overall difference in longevity was not statistically significant , compomer was replaced significantly more frequently owing to recurrent caries , and composite restorations required seven times as many repairs as did amalgam restorations . CLINICAL IMPLICATION S Compomer/composite restorations on posterior tooth surfaces in children may require replacement or repair at higher rates than amalgam restorations , even within five years of placement OBJECTIVE To evaluate the clinical performance of atraumatic restorative treatment ( ART ) fillings using Fuji IX as a filling material in field conditions . DESIGN Longitudinal study of the ART fillings in permanent teeth of primary school children aged eight to fifteen years . SETTING Primary schools in Morogoro municipality , Tanzania . SUBJECTS AND METHODS St and ard 3 and 4 children in five primary schools r and omly selected from a list of 36 primary schools of Morogoro municipality were examined for dental caries and periodontal conditions . All 296 carious lesions that were indicated for restoration were treated using ART approach according to the instructions given in the manual for ART approach for the control of dental caries . Essential measurements for treated teeth and cavity were taken . The cavities were filled with Fuji IX glass ionomer cement as per manufacturer 's instructions . After one year , 238 restorations were evaluated using the criteria for evaluating ART restorations . MAIN OUTCOME MEASURE Clinical appearance of the surface of the restorations . RESULTS Ninety four per cent of the restorations evaluated were rated as good and intact , while 1.7 % were rated as having slight defects that needed no repair , giving a one year survival rate of 96.1 % . Mean working time was 14.5 minutes . CONCLUSIONS AND RECOMMENDATIONS The one-year survival rate of 96.1 % is high enough to recommend wide use of ART in Tanzania . Town and municipal councils should be encouraged to adopt ART in their school oral health programmes PURPOSE The purpose of this study was to evaluate the performance of multiple-surface restorations employing 2 different glass ionomer cements ( GICs ) and the Atraumatic Restorative Treatment ( ART ) approach in permanent molar teeth . METHODS This study examined 60 restorations--36 Class I restorations involving 2 or more tooth surfaces and 24 Class II restorations -- that were placed in 46 schoolchildren ( 9 - 16 years of age ) by 2 dentists using the ART approach . The restorations were r and omly divided into 2 groups : ( a ) 30 cavities were filled with high strength GIC ( Ketac Molar-3 M ESPE ) , and ( b ) 30 cavities were filled with resin-modified GIC ( Fuji VIII-GC Corp ) . Two independent calibrated examiners carried out the evaluations according to ART criteria . The interexaminer kappa was 0.92 . Data were su bmi tted to chi-square , McNemar , and Fisher 's tests . A difference was statistically significant if P<.05 . RESULTS In a 12-month follow-up , 59 restorations were evaluated . The success rates of the restorations were 100 % and 93 % for Fuji VIII and Ketac Molar , respectively . There was no statistically significant difference between GICs , cavity types , or operators . CONCLUSIONS Based on a 12-month follow-up evaluation , the clinical performance of the multiple-surface atraumatic restorative treatment restorations of both glass ionomer cements ( high-strength and resin-modified ) was considered satisfactory with a high success rate Dental caries continues to be a highly prevalent disease among Brazilian preschoolers , especially those with low socioeconomic status . The purpose of this r and omized , controlled trial was to evaluate in vivo 245 simplified  restorations  in deciduous molars using glass ionomer cements ( Vidrion R and Ketac-Molar ) . Dental restorations were evaluated at 6- and 12-month follow-ups . The teeth restored with Vidrion R ( SS White ) on a single tooth surface were successful in 87 % of the cases evaluated at 6 months and in 63 % at 12 months . The teeth restored with Ketac-Molar on one surface achieved a success rate of 95 % at 6 months and 82 % at 12 months . No recurrent caries or pulpal infection was evident . Logistic regression analysis demonstrated that teeth with cavities restricted to the occlusal surface on sclerotic dentin showed the best adhesion to the restorative material . The restorations with Ketac-Molar had a better clinical performance than those with Vidrion OBJECTIVES The Atraumatic Restorative Treatment ( ART ) approach was compared with the traditional amalgam ( TA ) approach in order to test their appropriateness to complement a preventive and educational school oral health programme in Syria . METHODS Using a parallel group design , 370 and 311 grade 2 children were r and omly assigned to the ART and the TA group respectively . Eight dentists placed 1117  single- and multiple-surface restorations .  A modified actuarial method was used to estimate survival curves . The jackknife method was applied to calculate the st and ard error in the cumulative survival percentages . RESULTS A statistically significant difference in cumulative survival percentages between single-surface non-occlusal ART and comparable amalgam restorations was observed after 4.3 , 5.3 and 6.3 years . The survival of single-surface non-occlusal  ART  posterior restorations ( 80.2 + /- 4.9 % ) was statistically significantly higher than that of occlusal posterior ART restorations ( 64.8 + /- 3.9 % ) at evaluation year 6.3 . There was no statistically significant difference observed between survival percentages of large ( 55.8 + /- 10 % ) and that of small ( 69.2 + /- 4.6 % ) single-surface posterior ART restorations after 6.3 years . There was an operator effect observed for single-surface ART and comparable amalgam restorations . Secondary caries was observed in 2.3 % of single-surface ART restorations and in 3.7 % of single-surface amalgam restorations during the 6.3 year observation period . CONCLUSIONS The ART approach provided higher survival percentages for single-surface restorations than the TA approach over 6.3 years and is therefore appropriate for use in school oral health programmes . Secondary caries was only a minor reason for ART restorations to fail . An operator effect was observed for both treatment approaches OBJECTIVES The aims of this study are to assess the feasibility of the  Atraumatic Restorative Treatment ( ART ) approach in primary teeth and to compare the ART approach with traditional amalgam restorations in primary molars . METHODS This study was conducted in a paediatric dentistry clinic in Kuwait between April 1999 and December 2001 . The ART and amalgam restorations were placed r and omly on comparable pairs of primary molars , if available . In addition , the ART approach was used for other primary teeth that had no pulpal involvement and no perceived pain before treatment . The restorations were assessed by both the ART evaluation criteria and USPHS criteria in August-September 2000 and in August-December 2001 . The mean follow-up period for the restorations was 8.3 months in the first assessment ( 2000 ) and 22 months in the second assessment ( 2001 ) . The assessment was possible for 35 children ( mean age = 5.7 years ) , 18 of whom had comparable pairs ( n = 35 pairs ) of restorations in their primary molars . In addition , 48 other ART restorations  were assessed in 2000 and 42 in 2001 . RESULTS In a 2-year follow-up , 89.6 % of all ART restorations were considered successful . The failure rate of the comparable pairs of ART and amalgam restorations was 5.7 % . There was no significant difference in success rate between ART and amalgam techniques . CONCLUSIONS Based on a 2-year follow-up evaluation , the class I ART restorations seemed to have a high success rate , indicating the appropriateness of the ART approach in primary teeth The atraumatic restorative treatment technique ( ART ) is based on removing infected tooth material using only h and instruments and filling the subsequently cleaned cavity with adhesive material such as glass ionomer . As its name suggests , the ART technique should be atraumatic during treatment , as well as for the tooth itself as for the patient . It was primarily developed for treating people living in underserved areas of the world where re sources and facilities such as electricity and trained manpower are limited . Many studies have evaluated the ART technique and the results have supported its application . However , a very limited number of studies have compared ART with more conventional techniques . For that reason , a study was conducted in Pakistan , to compare the ART technique with another more conventional treatment technique . The results of this study show that the preparations with h and instruments result ed in smaller sized cavities and therefore may be less traumatic to the tooth . It was also associated with less pain reactions compared to the more conventional technique . Although preparations with h and instruments required more time , this did not seem to affect the survival of restorations . The survival of glass ionomer cement restorations  made with h and instruments was comparable with single surface amalgam restorations made with a more conventional technique . Recurrent caries was not associated with any glass ionomer cement restorations made with h and instruments . The retention rate of glass ionomer sealants was low , however one dentist had a sealant retention rate of 81.5 percent that suggests that this procedure can be performed satisfactorily in conjunction with a glass ionomer cement restoration . Operator variances did seem to affect the restorations . Survival of glass ionomer restorations  made with both h and and rotary instruments varied for different operators . Similarly , the retention of fissure sealant also varied amongst operators . Operator differences also influenced the extent of tooth substance lost due to cavity preparation . The ART technique is a feasible approach towards the treatment of dental caries especially of one-surface lesions for underserved population BACKGROUND As the world population ages , the requirement for cost-effective methods of treating chronic disease conditions increases . In terms of oral health , there is a rapidly increasing number of dentate elderly with a high burden of maintenance . Population surveys indicate that older individuals are keeping their teeth for longer and are a higher caries risk group . Atraumatic Restorative Treatment ( ART ) could be suitable for patients in nursing homes or house-bound elderly , but very little research has been done on its use in adults . OBJECTIVES To compare the cost-effectiveness of ART  and a conventional technique ( CT )  for restoring carious lesions as part of a preventive and restorative programme for older adults . METHODS In this r and omized clinical trial , 82 patients with carious lesions were r and omly allocated to receive either ART or conventional restorations .  Treatment costs were measured based on treatment time , material s and labour . For the ART group , the cost of care provided by a dentist was also compared to the cost of having a hygienist to provide treatment . Effectiveness was measured using percentage of restorations that survived after a year . RESULTS Eighty-two patients received 260 restorations , that is , 128 ART and 132 conventional restorations . 91.1 % of the restorations were on one surface only . After a year , 252 restorations were assessed in 80 patients .  The average cost for ART and conventional restorations  was € 16.86 and € 28.71 respectively ; the restoration survival percentages were 91.1 % and 97.7 % , respectively . This result ed in a cost-effectiveness ratio of 0.18 ( ART ) and 0.29 ( CT ) . When the cost of a hygienist to provide ART was inserted in the analysis , the result ing ratio was 0.14 . CONCLUSIONS Atraumatic restorative treatment was found to be a more cost-effective alternative to treat older adults after 1 year , compared to conventional restorations , especially in out of surgery facilities and using alternative workforce such as hygienists . Atraumatic restorative treatment can be a useful tool to provide dental care for frail and fearful individuals who might not access dental treatment routinely Objectives : The aim of this study was to assess the feasibility of the resin-modified glass ionomer ( RMGI ) material in atraumatic restorative treatment ( ART ) approach and compare RMGI with the high-strength traditional glass ionomer cement ( GIC ) in permanent teeth with one or more surface-carious cavities . Material s and Methods : This study was conducted in a village school in rural southeastern Anatolia , Turkey . The RMGI and GIC restorations with the ART technique were placed r and omly employing a split mouth design . In addition , the ART approach was used when necessary for both primary and /or permanent teeth with no pulpal involvement and no perceived pain before treatment . Ninety-one fillings were placed on contralateral molar pairs of 37 children . Baseline and 6-month evaluation of the fillings were made with the classic ART , modified Ryge and USPHS criteria . Results : Based on the ART criteria , 100 % of RMGI and 92.4 % of GIC restorations were classified as successful after 6 months , and the difference between the 2 groups was statistically significant ( p = 0.009 ) . While marginal discoloration was the commonest failure in the RMGI group according to both the modified Ryge and USPHS criteria , unsatisfactory surface texture and low anatomic form were the commonly seen failures in the ART technique . Conclusion : Generally , for each rating system , RMGI exhibited better clinical performance than GIC in all categories , except for marginal discoloration . Results based on the 6-month evaluation show that RMGI can be an alternative material to the GIC Objectives This study aim ed to test the hypothesis that there is no difference in the survival rates of molars treated according to the conventional restorative treatment ( CRT ) using amalgam , atraumatic restorative treatment ( ART ) using high-viscosity glass ionomer , and ultraconservative treatment ( UCT ) protocol after 3.5 years . Material s and methods Cavitated primary molars were treated according to CRT , ART , and UCT ( small cavities were restored with ART and medium/large cavities were daily cleaned with toothpaste/toothbrush under supervision ) . Molar extraction s result ing from toothache , sepsis , or pulp exposure were failures . The Kaplan – Meier method was used to estimate the survival curves . Results The numbers of treated teeth , among the 302 6–7-year-old children , were 341 ( CRT ) , 244 ( ART ) , and 281 ( for UCT group : 109 small ART , 166 open cavities , and 6 combinations ) . Protocol groups were similar at baseline regarding gender and mean decayed missing filled tooth score , but not regarding age and type of surface . The numbers of molars extracted were 22 ( CRT ) , 16 ( ART ) , and 26 ( UCT ) . Fistulae were most often recorded . After 3.5 years , the cumulative survival rate ± st and ard error for all molars treated was 90.9 ± 2.0 % with CRT , 90.4 ± 2.4 % with ART , and 88.6 ± 1.9 % with UCT ( p = 0.13 ) . Only a type of surface effect was observed over the 3.5-year period : survival rates for molars were higher for single- than for multiple-surface cavities . Conclusion There was no difference in the cumulative survival rates of primary molars treated according to the CRT , ART , and UCT protocol s over a 3.5-year period . Clinical relevance Keeping cavities in primary molars biofilm-free might be another treatment option alongside restoring such cavities through conventional and ART protocol
Atraumatic restorative treatment restorations performed with high-viscous GIC present similar survival/success rates to conventional approach using composite resin or amalgam for occlusoproximal restorations in primary teeth and can be suggested as a good option for occlusoproximal cavities in primary molars .
BACKGROUND Atraumatic restorative treatment ( ART ) has demonstrated good longevity when used for single-surface restorations , but lower success rates are reported for occlusoproximal surfaces .
AIM This systematic review and meta- analysis aim ed to verify the pooled success rate of  occlusoproximal ART restorations in primary teeth considering the outcomes : longevity , pulp damage , or caries lesion progression .