Long-term clinical evaluation of fracture and pulp injury following glass-ionomer cement or composite resin applied as a base filling in teeth restored with amalgam. The effects of two cavity preparation methods on the longevity of glass ionomer cement restorations: an evaluation after 12 months. Survival of glass ionomer restorations placed in primary molars using atraumatic restorative treatment (ART) and conventional cavity preparations: 2-year results. Restoration of permanent teeth in young rural children in Cambodia using the atraumatic restorative treatment (ART) technique and Fuji II glass ionomer cement. Comparison of atraumatic restorative treatment and conventional cavity preparations for glass-ionomer restorations in primary molars: one-year results. Clinical evaluation of three restorative materials applied in a minimal intervention caries treatment approach. The survival of resin modified glass ionomer and stainless steel crown restorations in primary molars, placed in a specialist paediatric dental practice Chemical exchange between glass-ionomer restorations and residual carious dentine in permanent molars: an in vivo study. The use of a reinforced glass-ionomer cermet for the restoration of primary molars: a clinical trial Comparison of atraumatic restorative treatment and conventional restorative procedures in a hospital clinic: evaluation after 30 months. A clinical evaluation of two glass ionomer cements in primary molars using atraumatic restorative treatment technique in India: 1 year follow up. Comparison of two tooth-saving preparation techniques for one-surface cavities. Clinical evaluation of multiple-surface ART restorations: 12 month follow-up. Two-year evaluation of Class II resin-modified glass ionomer cement/composite open sandwich and composite restorations Pulpal inflammatory responses following non-carious class V restorations. Atraumatic Restorative Treatment with Resin-Modified Glass Ionomer Material: Short-Term Results of a Pilot Study Effect of cavity form on the durability of glass ionomer cement restorations in primary teeth: a three-year clinical evaluation. Clinical Trial of a New Glass Ionomer for an Atraumatic Restorative Treatment Technique in Class I Restorations Placed in Latvian School Children Survival rate of approximal-ART restorations using a two-layer technique for glass ionomer insertion The effect of a chlorhexidine containing cavity disinfectant on the clinical performance of high-viscosity glass-ionomer cement following ART: 24-month results. Effect of glass-ionomer cement lining on postoperative sensitivity in occlusal cavities restored with resin composite--a randomized clinical trial. Influence of the cavity-size on the survival rate of proximal ART restorations in primary molars. Microleakage at gingival dentin margins of Class V composite restorations lined with light-cured glass ionomer cement.
The aim of this research was to analyse the long-term clinical behaviour of two dental material s applied as filling under  silver amalgam restorations  : glass-ionomer cement ( GIC ) and composite resin with adhesive system ( CR ) . In this study , 117 posterior teeth ( 29 premolars and 88 molars ) were selected with carious lesions which result ed in great loss of dentin and cusps with unsupported enamel . After caries removal , cavities were prepared and totally filled with GIC or with CR . In a following visit , new cavities were prepared , leaving the employed filling material as a base and support for the enamel , which were then restored with silver amalgam . Restorations were evaluated periodically after 6 months and up to 5 years . Both fracture and pulpal involvement rates were low . Although differences could be observed in the behaviour of the material s , statistical survival estimation showed that the performances of GIC and CR as filling material were similar . There was a significant association both between kind of tooth ( molar or premolar ) and long-term survival of the restorations ; and between degree of unsupported enamel and the same long-term survival . Our results confirmed that the technique in which GIC or CR are used as filling under  silver amalgam restorations is clinical ly acceptable BACKGROUND The authors undertook a study to evaluate the effect of two cavity preparation methods on the initial survival of two more-viscous glass ionomer cements , or GICs , placed in the occlusal surfaces of permanent molar teeth . METHODS Three dentists placed 149 restorations in 68 adult patients in a hospital clinic . They used either atraumatic restorative treatment , or ART , or conventional cavity preparation methods to place two encapsulated esthetic conventional GICs : Fuji IX GP ( GC International Corp. , Tokyo ) and Ketac-Molar Aplicap ( 3 M ESPE , Seefeld , Germany ) . For comparison , they used high-copper-content GK Amalgam Alloy ( Advanced Technology & Material s Co. Ltd. , Beijing ) in conventional preparations . They evaluated the restorations using both direct and indirect observation methods . RESULTS Cavity preparations for which the authors used ART h and instruments took approximately twice as long to complete as did those for which they used conventional rotary instruments . After 12 months , no restorations had failed , but restorations comprising both GICs showed early losses of adjacent sealant material . Both GICs also showed relatively high restoration wear . At 12 months , the mean cumulative net occlusal wear for Fuji IX GP was 77 + /- 47 micrometers , and for Ketac-Molar 83 + /- 51 microm , without statistical significance ( P > .05 ) . Color matching improved significantly with time ( P < .001 ) , without significant differences in color between the two GICs by 12 months ( P = .09 ) . The amalgam alloy had minor surface tarnishing and marginal discrepancies increased with time ( P < .00 1 ) . CONCLUSIONS All of the occlusal restorations were rated as satisfactory after 12 months . The method of cavity preparation did not affect the restoration performance of the GICs . However , their deterioration requires long-term monitoring . Clinical Implication s. The more viscous GICs appear initially suitable for restricted use in clinical practice when placed using either of two cavity preparation methods in the occlusal surfaces of permanent molar teeth in adults OBJECTIVE To compare the survival of  glass ionomer cement ( GIC ) restorations placed in a dental clinic setting using both the atraumatic restorative treatment ( ART ) approach with h and instruments , and conventional cavity preparation with rotary instruments . METHOD AND MATERIAL S Two encapsulated high-strength conventional GICs ( Fuji IX GP , Ketac-Molar Aplicap ) were placed in 82 Class I and 53 Class II preparations and one encapsulated non-gamma 2 amalgam alloy ( GK-amalgam ) was placed in 32 Class I preparations , in the primary molars of 60 Chinese children with a mean age of 7.40 + /- 1.24 ( SD ) years . Thus , 9 treatment groups were formed . RESULTS After two years , there were no significant survival differences found among 7 of the 9 treatment groups ( p = 0.99 ) . However , two groups comprising Fuji IX GP and Ketac-Molar Aplicap placed in Class II cavities prepared using the ART approach showed significantly lower restoration survivals ( p < 0.001 ) . Only 3 of the 72 initially sealed fissures adjacent to the restorations appeared to retain any GIC material . CONCLUSIONS In a clinic setting , both the ART h and instrument and conventional rotary instrument methods were equally suitable for high Class I restoration survival , but not for Class II restoration survival where the conventional cavity preparation method was preferable 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 OBJECTIVE The purpose of this study was to compare the success rates of  glass-ionomer cement restorations placed with the atraumatic restorative treatment approach and conventional cavity preparation methods . METHOD AND MATERIAL S Two encapsulated , high-strength , esthetic conventional glass-ionomer cements were placed in 82 Class I and 53 Class II atraumatic restorative treatment and conventional cavity preparations  , and an encapsulated amalgam alloy was placed in 32 Class I conventional preparations , in vital primary molars of 60 Chinese children aged 7 to 9 years . RESULTS The atraumatic restorative treatment preparations , made with h and instruments only , took approximately 50 % longer to complete than did the preparations completed with conventional rotary instrumentation . After 1 year , there were no amalgam failures . For the glass-ionomer cement restorations , when the atraumatic restorative treatment method was used , significantly better survival rates were found for Class I ( 92.9 % ) than for Class II ( 64.7 % ) cavity preparations . There was also a strong trend for relatively better survival rates for the conventional cavity preparation method ( 86.7 % ) than for the atraumatic restorative treatment ( 64.7 % ) method for Class II cavity preparations . However , both the atraumatic restorative treatment and conventional methods appeared equally effective for Class I preparations . CONCLUSION In a clinic setting , the use of atraumatic restorative treatment h and instruments for cavity preparation is more time consuming , and the method may also provide less mechanical retention and /or bulk of glass-ionomer cement for some Class II preparations in primary molars than does the use of conventional rotary instruments OBJECTIVES This paper reports on a longitudinal evaluation of three material s ( glass ionomer , zinc oxide-eugenol cement , and composite ) employed in a minimal restorative intervention approach of 81 high caries-active pregnant women selected for a preventive oral health program in Brazil . The aim of the study was to evaluate the clinical behavior of the glass ionomer cement , currently indicated in programs for control of carious lesions . METHODS The patients were r and omly divided into two groups . Both groups were engaged in an oral health promotion approach . In Group 1 , 417 glass ionomer restorations were placed in 43 individuals , involving all types and sizes of cavities . In the second group , 213 posterior zinc oxide-eugenol ( ZOE ) restorations and 127 anterior composite restorations were placed in 38 patients . Minimal cavity preparations were made , in which only soft or infected dentin was removed , on the basis of clinical judgment . RESULTS After two years , the restorations were clinical ly evaluated by two examiners for marginal integrity , amount of wear , presence of fracture , carious lesions , and lost restorations . Statistical analysis ( chi-square test ) identified statistically significant difference between glass ionomer and ZOE ( 90.6 % vs 9.2 % ) . Comparing glass ionomer and composite , similar survival rates were observed . The success rate observed for the glass ionomer cement ranged from 77.1 percent to 92.5 percent , depending on the type and size of cavity in which it was applied . Four teeth restored with glass ionomer cement and one tooth restored with composite showed caries signs . Regarding the ZOE restorations , caries was always associated with other causes of failure such as excessive wear , restoration loss , or marginal defects , with no possibility of separate evaluation . Despite the preventive and therapeutic measurements employed , a mean increase of 2.15 new surfaces with cavities was observed in Group 1 , as well as 2.83 surfaces presenting the same status in Group 2 . CONCLUSIONS This study demonstrated that highly viscous glass ionomer cement applied in a minimal intervention approach provided high- quality preventive and restorative care after two years to a population at high risk for caries . The composite was employed in cavities exposed to lower stress , such as in the anterior teeth , and its behavior was comparable to that of the glass ionomer cement . The reinforced ZOE presented a high failure rate , thus contraindicating its use for such purpose Aims To prospect ively report on the survival of resin-modified glass ionomer cement ( RMGIC ) , photac-fil and pre-formed stainless steel crown ( SSC ) restorations in primary molar teeth placed over a seven-year period in a specialist paediatric dental practice under private contract of remuneration . Method All primary molar restorations placed by a specialist paediatric dentist over a seven-year period were review ed and the outcome results recorded . Data were recorded at review visits until June 30 , 2003 . Data recorded included Class I restorations , Class II restorations and SSC . The Class II cavities were either mesial or distal , with or without buccal/palatal extensions . If both proximal surfaces were decayed or if after cavity preparation the result ant outline form was significantly larger than the minimal classical form , RMGIC was not used ; an SSC was placed instead . Stainless steel crown preparation followed conventional guidelines . The crowns were cemented with reinforced zinc oxide and eugenol ( Kalzinol ) . The status was recorded as satisfactory restoration , tooth exfoliated , tooth extracted for orthodontic reasons with the date of extraction , or needing replacement . If replaced then the reason for replacement was also recorded . Results A total of 544 Class I RMGICs , 962 Class II RMGICs , and 1,010 SSCs  were placed . At the last review of each restoration , 98.3 % of Class I , 97.3 % of Class II RMGICs and 97.0 % of SSCs were either satisfactory or withdrawn intact . Conclusion Under the conditions of private specialist practice -based study SSCs continued to prove very successful for the restoration of larger cavities and for pulp-treated primary molar teeth . For the smaller cavities RMGIC were also very successful OBJECTIVE To evaluate the remineralization of carious dentine following the restoration of an extensive lesion in a permanent molar with a high strength glass-ionomer cement ( GIC ) .  MATERIAL S AND METHODS Thirteen first permanent molars , which were scheduled for extraction because of the presence of extensive caries lesions , were selected for this study . They were first restored , according to the ART technique , using encapsulated Fuji IX(GP ) , which contains a strontium glass rather than the traditional calcium glass . The cavities were prepared with a clean enamel margin and minimal removal of the carious dentine around the walls . After a period of 1 - 3 months they were harvested and subsequently sectioned and examined using an electron probe micro analysis ( EPMA ) and scanning electron microscopy ( SEM ) . RESULTS EPMA demonstrated that both fluorine and strontium ions had penetrated deep into the underlying demineralized dentine . The only possible source of these ions was the GIC restoration . CONCLUSION The pattern of penetration of the fluorine and strontium ions into the dentine was consistent with a remineralization process The development of adhesive restorative material s has led to more conservative cavity design with greater reliance being placed upon the bond of a material with tooth tissue for retention of the restoration . Glass-ionomer cements may offer particular advantages but have yet to achieve the durability reported for amalgam . This study reports on the results of a 2.5-year prospect i ve clinical trial comparing the durability of two glass-ionomer cements , a conventional material ( Ketac Fil ) and a metal reinforced cermet ( Ketac Silver ) in the restoration of Class II lesions in primary molars . Forty-six pairs of restorations were assessed in 37 children . The failure rate of Ketac Fil , 23 % , was significantly lower than that of Ketac Silver , 41 % ( P < 0.05 ) . The median survival time of the Ketac Fil restorations was significantly greater , 25.3 months , than that of the Ketac Silver restorations , 20.3 months ( P < 0.05 ) . These values may be an underestimate of the true longevity of both restoration types as many of the restorations survived intact at the censor date . Neither the age of the child nor the tooth restored influenced the durability of the restoration . The deterioration in both marginal integrity and anatomic form of the Ketac Silver restorations  was significantly greater than the Ketac Fil restorations ( P < 0.05 ) . The durability of Ketac Silver was such that it can not be recommended for use in restoring carious primary OBJECTIVE The purpose of this study was to evaluate two glass-ionomer cements placed in the occlusal surfaces of permanent molar teeth , using two cavity preparation methods . METHOD AND MATERIAL S Three dentists placed 149 restorations for 68 patients in a hospital clinic .  Atraumatic restorative treatment or conventional cavity preparation methods were used for two encapsulated , high-strength conventional glass-ionomer cements : Fuji IX GP and Ketac-Molar . Non-gamma 2 amalgam alloy was used in conventional preparations for comparison . RESULTS The restorative procedures were uneventful , but cavity preparations made with atraumatic restorative treatment h and instruments took approximately twice as long as did conventional rotary instrumentation . After 30 months , only one glass-ionomer cement restoration had failed . Both glass-ionomer cements showed high early losses of sealant material , but caries was not detected in the exposed fissures . Both glass-ionomer cements also showed relatively high restoration wear . At 30 months , the mean cumulative net occlusal wear was 119 + /- 12 mm for Fuji IX GP and 96 + /- 13 mm for Ketac-Molar ; the difference was not statistically significant . Color matching improved significantly by 6 months ; there was no significant difference in color match between the two glass-ionomer cements by 12 months . Minor surface tarnishing and marginal discrepancies were present in the amalgam restorations and increased with time . CONCLUSION The occlusal restorations performed satisfactorily over periods of up to 30 months . However , the continued deterioration of the cements requires longer-term studies to be undertaken AIM To compare the clinical performance of two glass ionomer cements , Amalgomer CR and Fuji IX in small and medium cavities prepared using Atraumatic restorative treatment approach in India . STUDY DESIGN One hundred school children in the age group of 4 - 9 years who had bilateral matched pair of carious lesions in primary posterior teeth were included . A split mouth design was used in which two material s were r and omly placed in contralateral sides . The performance of the restorations was assessed after 1 year using Frenken 's criteria ( 1996 ) . Survival analysis of restoration was done using chi-square test . RESULTS The survival rate of Amalgomer CR and Fuji IX class I restorations were 97.4 % and 94.9 % , respectively . In class II cavities 95.1 % and 88.5 % of Amalgomer CR and Fuji IX restorations were successful . Amalgomer CR and Fuji IX showed a success of 94.2 % and 92.3 % in small sized class II cavities . Amalgomer CR showed a 100 % success for medium sized class I and II restorations . Whereas Fuji IX showed a 100 % and 66.7 % success in medium sized class I and II cavities . CONCLUSION The clinical performances of both material s were satisfactory at the end of 1 year and ART is suitable procedure to be done in a dental clinic for children 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 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 Abstract Restorations made of a combination of resin modified glass ionomer cement ( RMGIC ) and composite resin ( CR ) – open s and wich fillings – have been recommended for use in proximal boxes of molar cavities . The aim of this study was to compare the clinical behaviour over time of RMGIC/CR s and wich restorations versus CR restorations in Class II molar cavities . During a period of 2 years , a total of 220 restorations were placed in 118 patients by one operator ( VV ) . A r and om block allocation was used to allocate cavities to one of the two restorative techniques . Bitewing radiographs and photographs were taken at baseline and at annual recall appointments . At present , a total of 210 restorations have been evaluated after 1 year and 141 restorations after 2 years . All restorations were evaluated using a modification of USPHS criteria . A total of three RMGIC/CR and two CR restorations ( 2.8 % ) were rated as failures caused by endodontic complications or major fractures . Twenty-eight teeth were reported to have postoperative sensitivity at the baseline evaluation 1 week following placement . Nine RMGIC/CR ( 8.5 % ) and four CR ( 4.9 % ) restorations with minor fractures were rated Charlie but were still acceptable . Bitewing radiographs revealed progression of carious lesions in proximal surfaces of originally intact or restored teeth adjacent to five ( 5.9 % ) RMGIC/CR restorations and eight ( 10.9 % ) CR restorations . No statistically significant differences between the two types of restoration were observed with respect to marginal adaptation , discoloration and caries progression . However , a higher number of large CR fillings exhibited postoperative sensitivity at baseline compared to moderate CR or extensive and moderate RMGIC/CR restorations The effects of inflammatory activity following surgical intervention can injure pulp tissues ; in severe cases it can lead to pulpal complications . With this article , the authors report on the effects of cavity preparation and restoration events and how they can interact together to reduce or increase the severity of pulpal inflammatory activity in 202 restored Class V cavities . Although some inflammatory activity was observed in the absence of bacteria , the severity of pulpal inflammatory activity was increased when cavity restorations became infected . Zinc oxide eugenol and resin-modified glass ionomer cement prevented bacterial microleakage in cavity restorations , with no severe inflammatory activity observed with these material s. Bacteria were observed in cavities restored with enamel bonding resin and adhesive bonded composites and were associated with severe grade s of inflammatory activity . The cavity remaining dentin thickness influenced the grade of inflammatory activity . In the absence of infection , the grade of inflammatory activity decreased after 20 weeks post-operatively . In the presence of infection , the grade of pulpal inflammation remained stable until a minimum of 30 weeks had elapsed 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 The effect of cavity form on the durability of  glass ionomer cement restorations in primary molars was studied in a clinical , intraindividual , three-year longitudinal study . Proximal restorations were placed in either a microcavity or a modified Black 's Class II cavity with rounded internal and external angles . A total of twenty-eight pairs were assessed . After two years the cumulative failure rate was 16 percent for each of the cavity types and after three years 25 percent for the microcavity and 32 percent for the modified Black 's Class II cavity . No statistical difference was found in the longevity of the restorations placed in the two different types of cavities Objective : The aim of this study was to evaluate the performance of a new glass ionomer filling material ( ChemFlex ™ ) using the atraumatic restorative treatment ( ART ) approach in class I cavities in the permanent dentition of Latvian schoolchildren . Methods : A total of 63 fillings ( 40 test and 23 control ) were placed using the ART technique in 41 schoolchildren in Riga at the Stomatology Institute of the Medical Academy of Latvia . These fillings were then blindly assessed after 2 years . Results : The complete success rate for both the test and the control material fillings were 92.5 and 94.9 % , respectively . Conclusion : The new glass ionomer filling has shown a good performance in terms of retention , marginal failure and fractures in class I cavities 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 PURPOSE To evaluate the effect of a chlorhexidine-gluconate-based cavity disinfectant on the clinical performance of high viscosity glass-ionomer cement following the ART approach under field conditions after 24 months . METHODS 126 school children 6 - 8 years old who had bilateral matched pairs of carious Class I and II primary molars were included . A split mouth design was used in which Ketac Molar was r and omly placed with or without the use of chlorhexidine-gluconate-based cavity disinfectant on contralateral sides by three dentists . The restorations were evaluated after 6 , 12 and 24 months by two experienced examiners using USPHS-Ryge criteria . RESULTS The 24-month mean cumulative survival rates of Ketac Molar without the use of disinfectant were 97.7 % and 69.4 % while in the disinfectant group , the survival rates were 95.2 % and 63.9 % in Class I and II restorations , respectively with no significant difference between the groups in both class types . In the non-disinfected group , large Class II cavities had significantly better survival rates than did small Class II cavities ( P = 0.023 ) . In the disinfected group , the failure rates in mean cumulative survivals from 6 to 12 months and 12 to 24 months significantly increased with time ( P = 0.004 and P = 0.016 respectively ) This study investigated the ability of a glass-ionomer cement ( GIC ) lining to reduce postoperative sensitivity in occlusal cavities restored with resin composite . In addition , the effects of a total-etch and self-etch adhesive on postoperative sensitivity were also compared . Patients who had moderate to deep occlusal caries of at least one molar were recruited . Overall , 103 restorations were placed in 70 participants , with an average age of 22.8 + /- 3.8 years . Preoperatively , each tooth was evaluated for cold-stimulated tooth sensitivity using a visual analog scale . If present , tooth sensitivity induced by cold/hot drinks or occlusal function was also noted . Caries was stained with a caries detector dye , then removed using slow-speed burs and h and excavators . The cavity was restored with one of four r and omly allocated restorative procedures : 1 ) bonded with a two-step , total-etch adhesive ( Single Bond 2 ) ; 2 ) lined with a resin-modified GIC liner ( Fuji Lining LC ) , then bonded with total-etch adhesive ; 3 ) bonded with a two-step , self-etch adhesive ( Clearfil SE Bond ) and 4 ) lined with the GIC liner , then bonded with self-etch adhesive . The cavities were incrementally filled with a nanofilled hybrid resin composite . At recall , postoperative sensitivity was evaluated at one week and one month . Overall , postoperative sensitivity in daily function was rare . No significant difference in postoperative sensitivity , either in daily function or in response to a cold stimulus , was observed between the restorative procedures with or without the GIC liner , regardless of the adhesive used ( p > 0.05 ) . In addition , no difference in postoperative sensitivity was noted between use of the self-etch and total-etch adhesive AIM To evaluate the influence of the size of proximal cavities on the survival rate of the  atraumatic restorative treatment ( ART ) restorations . DESIGN A total of 804 children , aged 6 - 8 years , from a low socio-economic community , with an ART restorable proximal carious lesion in their primary molars , participated . Over a 3-week period , three ' experienced ' and four ' inexperienced ' operators r and omly paired with four ' experienced ' and four ' inexperienced ' assistants , made the restorations at site using h and instruments . They r and omly used Fuji IX , Ketac Molar Easymix and Ketac Molar Aplicap glass ionomer cements to restore the cavities , under r and omly selected rubber dam and cotton roll isolation methods . The fillings were independently evaluated by nine trained and calibrated evaluators . RESULTS After 1 year , the survival rate of the fillings evaluated in the study was 44.8 % . Irrespective of the other factors involved , restorations with the highest survival rate were of size between 2 and 3 mm ( mesio-distal , bucco-lingual , and depth ) or volumes 10.0 - 19.9 mm(3 ) ( Chi-square , P = 0.002 , KM mean survival of 345 days ) . CONCLUSIONS While the survival rates for class II ART restorations were still low , the choice of medium-sized proximal cavities gave better survival rates for this technique This study compared the microleakage of  light-cured and auto-set glass ionomer liners used in Class V composite laminated glass ionomer restorations by determining the amount of microleakage at the gingival cementum/dentin margins . St and ardized nonundercut V-shaped Class V cavities with gingival margins below the cementoenamel junction were prepared on the mesial and distal surfaces of 40 molars , establishing a total of 80 cavities , which were r and omly divided into four groups . Each was lined with glass ionomers : group 1 , Ketac-Bond ( ESPE-Premier ) , which served as the control ; group 2 , XR-Ionomer ( Kerr ) ; group 3 , XR-Ionomer with polyacrylic acid ( PAA ) pretreatment ( Kerr ) ; and group 4 , Vitrabond ( 3 M ) . Specimens were thermocycled for 300 cycles in 0.5 % aqueous solution of basic fuchsin between 4 and 55 C with a 1-minute dwell time , and individually embedded in an epoxy resin . Statistical analysis indicated no differences among groups using the light-cured glass ionomer ( groups 2 to 4 ) , and they showed significantly less leakage than the control ( group 1 ) at P less than 0.00001 ) . Removal of the smear layer using 10 % polyacrylic acid solution did not influence microleakage in restorations with light-cured glass ionomer liners
The overall results of the computed data sets suggest that GIC has a higher caries-preventive effect than amalgam for restorations in permanent teeth .
No difference was found for restorations in the primary dentition .
Background This article aims to up date the existing systematic review evidence elicited by Mickenautsch et al. up to 18 January 2008 ( published in the European Journal of Paediatric Dentistry in 2009 ) and addressing the review question of whether , in the same dentition and same cavity class ,  glass-ionomer cement ( GIC ) restored cavities show less recurrent carious lesions on cavity margins than cavities restored with amalgam .