Direct Contra Naïve-Indirect Comparison of Clinical Failure Rates between High-Viscosity GIC and Conventional Amalgam Restorations: An Empirical Study Is high-viscosity glass-ionomer-cement a successor to amalgam for treating primary molars? 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. Survival of ART and Amalgam Restorations in Permanent Teeth of Children after 6.3 Years A comparative sealability study of different retrofilling materials. Clinical performance and caries inhibition of resin-modified glass ionomer cement and amalgam restorations. Comparison of atraumatic restorative treatment and conventional restorative procedures in a hospital clinic: evaluation after 30 months. A clinical comparison of glass ionomer (polyalkenoate) and silver amalgam restorations in the treatment of Class 5 caries in xerostomic head and neck cancer patients. In vitro evaluation of sealing pits and fissures with newer glass-ionomer cements developed for the ART technique. Six-Year Success Rates of Occlusal Amalgam and Glass-Ionomer Restorations Placed Using Three Minimal Intervention Approaches The use of a reinforced glass-ionomer cermet for the restoration of primary molars: a clinical trial Longevity and Cariostatic Effects of Everyday Conventional Glass-ionomer and Amalgam Restorations in Primary Teeth: Three-year Results Effectiveness of conventional treatment using bulk-fill composite resin versus Atraumatic Restorative Treatments in primary and permanent dentition: a pragmatic randomized clinical trial The effects of two cavity preparation methods on the longevity of glass ionomer cement restorations: an evaluation after 12 months. Apicectomy: a comparative clinical study of amalgam and glass ionomer cement as apical sealants. Clinical Investigation of Two Glass–Ionomer Restoratives Used with the Atraumatic Restorative Treatment Approach in China: Two–Years Results A clinical evaluation of resin-based composite and glass ionomer cement restorations placed in primary teeth using the ART approach: results at 24 months. Clinical evaluation of the ART technique using high density and resin-modified glass lonomer cements. Restoration of permanent teeth in young rural children in Cambodia using the atraumatic restorative treatment (ART) technique and Fuji II glass ionomer cement. The influence of luting cement on the probabilities of survival and modes of failure of cast full-coverage crowns. Effectiveness of Three Minimal Intervention Approaches for Managing Dental Caries: Survival of Restorations after 2 Years A 2-year clinical study of two glass ionomer cements used in the atraumatic restorative treatment (ART) technique. Clinical evaluation of three restorative materials applied in a minimal intervention caries treatment approach.
Background Naïve-indirect comparisons are comparisons between competing clinical interventions ’ evidence from separate ( uncontrolled ) trials . Direct comparisons are comparisons within r and omised control trials ( RCTs ) . The objective of this empirical study is to test the null-hypothesis that trends and performance differences inferred from naïve-indirect comparisons and from direct comparisons/ RCTs regarding the failure rates of  amalgam and direct high-viscosity glass-ionomer cement ( HVGIC ) restorations in permanent posterior teeth have similar direction and magnitude . Methods A total of 896 citations were identified through systematic literature search . From these , ten and two uncontrolled clinical longitudinal studies for HVGIC and amalgam , respectively , were included for naïve-indirect comparison and could be matched with three out twenty RCTs . Summary effects sizes were computed as Odds ratios ( OR ; 95 % Confidence intervals ) and compared with those from RCTs . Trend directions were inferred from 95 % Confidence interval overlaps and direction of point estimates ; magnitudes of performance differences were inferred from the median point estimates ( OR ) with 25 % and 75 % percentile range , for both types of comparison . Mann-Whitney U test was applied to test for statistically significant differences between point estimates of both comparison types . Results Trends and performance differences inferred from naïve-indirect comparison based on evidence from uncontrolled clinical longitudinal studies and from direct comparisons based on RCT evidence are not the same . The distributions of the point estimates differed significantly for both comparison types ( Mann – Whitney U = 25 , nindirect = 26 ; ndirect = 8 ; p = 0.0013 , two-tailed ) . Conclusion The null-hypothesis was rejected . Trends and performance differences inferred from either comparison between HVGIC and amalgam restorations failure rates in permanent posterior teeth are not the same . It is recommended that clinical practice guidance regarding HVGICs should rest on direct comparisons via RCTs and not on naïve-indirect comparisons based on uncontrolled longitudinal studies in order to avoid inflation of effect estimates 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 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 The null hypothesis tested was that there is no difference in the survival percentages of all restorations placed through the Atraumatic Restorative Treatment ( ART ) approach , with high-viscosity glass ionomer , and those produced through the traditional approach , with amalgam ( TA ) , in the permanent dentitions of children after 6.3 years . Using a parallel group design , we r and omly assigned a total of 370 children , aged 6 to 9 years , to the ART group and 311 children , also aged 6 to 9 years , to the TA group . Eight dentists placed a total of 1117 single- and multiple-surface restorations . The cumulative survival percentages  for ART glass-ionomer restorations were statistically significantly higher than those of amalgam restorations at all time intervals except the first ( p ≤ 0.044 ) . After 6.3 years , the cumulative survival percentages of ART and amalgam restorations were 66.1 % ( SE = 3.1 % ) and 57.0 % ( SE = 3.3 % ) , respectively . We concluded that the restorations produced with the ART approach , with high-viscosity glass ionomer , survived longer than those produced with the traditional approach , with amalgam , in the permanent teeth of young children The purpose of this study was to compare the sealing ability of high-copper amalgam , glass ionomer cement , and silver glass ionomer cement as retrofilling material s when used with and without varnish . Seventy extracted human single-rooted anterior teeth were instrumented and the root canals obturated with laterally condensed gutta-percha and sealer . The apical 3 mm of each root was resected and a 2 mm-deep apical Class I preparation cut . The roots were then r and omly allocated to six groups of 10 teeth and retrofilled with one of the experiment material s. Group I comprised high-copper amalgam ; group 2 , high-copper amalgam with cavity varnish ; group 3 , glass ionomer cement without varnish ; group 4 , glass ionomer cement with varnish ; group 5 , silver glass ionomer cement without varnish ; and group 6 , silver glass ionomer cement with varnish . Two groups of five roots each were used as positive and negative controls . The root surfaces were coated with nail polish and specimens immersed in 2 % methylene blue solution for 14 days . After vertical sectioning , dye penetration was examined under a stereomicroscope . The results of the study were analysed statistically . The sealing ability of the conventional glass ionomer cement with varnish was significantly better while dye penetration was higher in silver glass ionomer cement without varnish group than the other groups ( P < 0.01 ) BACKGROUND The authors clinical ly examined two restorative material s to evaluate their effectiveness in Class II restorations in primary molars and their ability to inhibit recurrent caries . METHODS Forty subjects , each in need of two Class II restorations in primary molars , took part in this study . Each patient received one  Class II restoration of resin-modified glass ionomer cement and one of amalgam . The authors evaluated the restorations at six-month , one-year , two-year and three-year recall appointments . On exfoliation , teeth with experimental restorations were retrieved and microscopically examined for inhibition of demineralization at restoration margins . RESULTS The results of the clinical evaluation demonstrated no significant differences between the resin-modified glass ionomer cement restorations and the amalgam restorations ( P < .05 ) . Polarized light microscopic examination of the returned teeth that were restored as a part of this study indicated that the resin-modified glass ionomer cement had significantly less enamel demineralization at restoration margins than did amalgam ( P < .0001 ) . CONCLUSIONS The resin-modified glass ionomer cement functioned clinical ly as well as amalgam for Class II restorations in primary molars . However , the resin-modified glass ionomer exhibited significantly less enamel demineralization at restoration margins than did amalgam . CLINICAL IMPLICATION S Resin-modified glass ionomer cement restorative material functions well for Class II restorations in primary molars and exhibits less recurrent caries at restoration margins than does amalgam 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 Fifty-four pairs of  restorations ( one glass ionomer and the other amalgam ) were placed in the mouths of 36 xerostomic head and neck cancer patients . Patients were either fluoride users or fluoride nonusers . In patients who used a daily application of a mildly acidic ( pH 5.8 ) sodium fluoride gel , glass-ionomer cements failed and amalgam restorations did not ( P < 0.0001 ) . In patients who neglected to use their topical fluoride as directed , glass-ionomer cement restorations  did not fail , but amalgam restorations did ( P < 0.001 ) . The mean time to restoration loss for both restorative material s was 8.5 months . In severely xerostomic patients these findings were exaggerated Four conventional glass-ionomer cements specifically developed for use with the atraumatic restorative treatment ( ART ) technique were compared with a resin-based sealant for marginal and surface dye penetration , material voids , and completeness of enamel fissure penetration .  Thirty sound permanent m and ibular molar teeth were r and omly divided into five groups . After delayed placement of the glass-ionomer cement sealants using st and ardized finger pressure , and conventional placement of the resin-based sealant using a dental probe , the teeth were first thermocycled then the crowns immersed in methylene blue dye before being sectioned . There were no statistically significant differences found between any of the five material s , apart from less marginal dye leakage being present for the resin-based sealant than for one of the glass-ionomer cements . The cements , however , showed better fissure penetration than did the sealant . Despite the delayed placement and higher viscosity , all of the glass-ionomer cements showed satisfactory penetration of the enamel fissures and minimal marginal and surface dye penetration , and material voids , when placed using firm finger pressure . The cements could prove to be useful in the dental treatment of apprehensive children 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 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 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 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 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 Healing capacity after apicectomy was investigated in a r and omized clinical study of 105 teeth apically sealed with either amalgam or glass ionomer cement .  The results were evaluated clinical ly and radiographically after 1 year . The success rate was high for both material s : 91 % for amalgam and 89 % for glass ionomer cement .  Contamination with moisture and blood adversely affected the outcome for both material s and was significantly more frequent in unsuccessful cases Objective : To compare the clinical performance of two glass – ionomer cements , ChemFlex ( Dentsply DeTrey ) and Fuji IX GP ( GC ) , when used with the atraumatic restorative treatment ( ART ) approach in China . Methods : Eighty – nine school children aged between 6 and 14 years who had bilateral matched pairs of carious posterior teeth were included . A split – mouth design was used in which the two material s were r and omly placed on contralateral sides . The performance of the restorations was assessed directly and also indirectly from die – stone replicas at baseline and after 6 , 12 , and 24 months . Results : The 24–month cumulative survival rates of ART restorations  in the primary teeth were 93 and 90 % for the ChemFlex and Fuji IX GP class I restorations , respectively , while 40 and 46 % of class II restorations placed with the respective material s were satisfactory . In the permanent dentition , only class I restorations were involved and the cumulative survival rates were 95 and 96 % for ChemFlex and Fuji IX GP . For the primary teeth after 24 months , net mean occlusal wear was 87 µm for ChemFlex and 85 µm for Fuji IX GP . The occlusal wear in the permanent teeth was 75 µm for ChemFlex and 79 µm for Fuji IX GP . Conclusion : The clinical performance of both material s over a 24–month period was similar and the survival rates of class I ART restorations  in both primary and permanent teeth were high BACKGROUND The authors evaluated the 24-month performance of a packable resin-based composite/dentin bonding system and a high-viscosity glass ionomer cement ( GIC ) in restorations placed in primary molars with the atraumatic restorative treatment ( ART )  approach . METHODS Three dentists placed 419 restorations in 219 children aged 6 through 10 years who had bilateral matched pairs of carious posterior Class I and II primary teeth . They used a split-mouth design to place the two material s , which were assigned r and omly to contralateral sides . The authors evaluated the restorations according to U.S. Public Health Service Ryge criteria . RESULTS After 24 months , 96.7 percent of the Class I GIC restorations and 91 percent of the resin-based composite restorations survived , while the success rates for the Class II restorations were 76.1 percent and 82 percent for the GIC and resin-based composite restorations , respectively . The survival rate of the Class II resin-based composite restorations was 5.9 percent higher than that of the GIC restorations at the 24-month evaluation , but this difference was not statistically significant . However , the study results showed a statistically significant difference in survival rates between Class I and II restorations for both material s. CONCLUSION AND CLINICAL IMPLICATION S The two-year clinical performance of both material s was satisfactory for the restoration of Class I and II primary molars using the ART approach PURPOSE The aim of this study was to evaluate the performance of two different glass ionomer cements using the Atraumatic Restorative Treatment ( ART ) technique in permanent teeth . MATERIAL S AND METHODS A total of 473 ART restorations were placed in 208 schoolchildren ( 7 - 12 years of age ) by two previously trained operators , using high density and resin-modified glass ionomer cements . All the restorations were photographed at baseline and the patients were asked about postoperative sensitivity . After a period of 8 months , 193 patients were present after recall and 428 restorations were evaluated and photographed . Two independent examiners carried out the evaluation . RESULTS The results showed a success rate of 86.2 % for occlusal restorations with Fuji IX and 88.4 % for those restored with Fuji Plus . A total of 86.7 % of the approximal restorations with Fuji Plus were also judged to be successful after 8 months . No association was found between the material s and the clinical performance of the ART restorations in class I cavities . CONCLUSION The type of restorative material did not influence the success or failure rates in class I cavities within this period . Fuji IX showed promising performance for occlusal ART restorations and Fuji Plus is also a promising material for occlusal and 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 This study compares the probabilities of survival and modes of failure of cast full-coverage crowns bonded with five cements when subjected to tensile pull-off testing . METHODS Five groups of 25 sound human premolar teeth were prepared for full-coverage crowns , impressions recorded and customized castings fabricated in Ni-Cr-Mb bonding alloy . The cements tested were zinc phosphate , a h and -mixed and capsulated conventional glass-ionomer cement , a resin-modified glass-ionomer cement and a resin composite luting cement . The cemented crowns were stored in water at 37 degrees C for 24 h prior to application of a tensile pull-off force at a strain rate of 10 mm/min . The loads at failure were ranked and modelled by derived Weibull functions each describing the probability of a given specimen failing under a given load . Non-parametric statistical analysis was also applied to the results . RESULTS There were no significant differences between the loads at failure of zinc phosphate cement , the h and -mixed or the capsulated glass-ionomer cements . The resin-modified glass-ionomer cement and the resin composite cement  failed at significantly higher loads than the other three cements , but were not significantly different from each other . The Weibull modulus ranking for each cement from highest to lowest was resin composite = zinc phosphate , resin-modified glass-ionomer , h and -mixed conventional glass-ionomer and capsulated conventional glass-ionomer cement . SIGNIFICANCE Weibull analysis allows dentists to compare the probability of survival of a crown bonded with different cements at a chosen load giving an indication of cement reliability The present study was aim ed at comparing the effectiveness of three minimally invasive restorative treatment approaches for dentinal lesions in occlusal surfaces . The approaches tested comprised a conventional and a modified – conventional treatment and a modified Atraumatic Restorative Treatment ( ART ) . The conventional approach was performed in a university dental clinic whilst the modified – conventional , employing portable equipment , and the modified ART , using h and instruments and a caries removal solution ( Caridex ® ) , were carried out in the field . Using the split – mouth design , 430 matched contralateral pairs of occlusal cavities were restored with amalgam or glass – ionomers in permanent molars of 152 school children by one dental therapist . The restorations were assessed using a modified USPHS – Ryge criteria . After 2 years , the cumulative survival percentages for occlusal amalgam and glass – ionomer restorations were 92 and 96 % , respectively . The survival of all restorations in the conventional , modified – conventional and the modified ART group was 96 , 96 and 91 % , respectively . The survival of occlusal amalgam and glass – ionomer restorations per treatment group was as follows : 94 and 99 % , respectively ( conventional group ) ; 95 and 97 % , respectively ( modified – conventional group ) , and 89 and 93 % , respectively ( modified ART group ) . The differences in survival percentage between restorations with amalgam and glass – ionomer , and between the three restorative treatment approaches were not statistically significant . In countries facing scarcity in re sources for dental care , ART seems a promising restorative approach to occlusal caries in posterior teeth . However , a longer clinical observation period is required to substantiate this initial conclusion The purpose of the study was to evaluate , in a clinical study over 2 years , the deterioration of two glass ionomer cements used with the atraumatic restorative treatment ( ART ) technique or approach . Fifty-five Fuji IX and 45 ChemFil Superior restorations were placed r and omly in 23 adult patients , mainly in small occlusal preparations in molar teeth . The restorations were placed in a dental hospital by one dentist using the ART technique . Photographs , radiographs and replicas were obtained at baseline and subsequent recalls . Both cements were easy to mix and place , but the radiolucency of ChemFil Superior was a disadvantage . Both cements also showed early high losses of sealant and restorative material . After 2 years , 34.5 % of the sealants appeared to be completely lost , with caries recorded in 5.3 % of the exposed fissures . In some instances , these small lesions may have been present , but not detected clinical ly , at the time of sealing . Restoration failures of 7.0 % were from wear and fracture of the cements and recurrent caries . Mean cumulative wear was 83.1 microm for Fuji IX and 104.0 microm for ChemFil Superior , which was not statistically significant . The cements became darker after their placement to more closely match the restored teeth , but there were few exact matches . There was no surface staining and only minor marginal discrepancies and staining associated with the restorations . Although the short-term clinical performance of the two glass ionomer cements was reasonable , the material s require further improvements in their mechanical properties , to reduce sealant losses and wear . The cements evaluated appear suitable for restricted use only , in posterior teeth 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
Conclusion The current evidence suggests lack of support for the hypothesis that high-viscosity glass-ionomer cements are inferior to silver amalgam as restorative material s for permanent posterior teeth .
Background To develop a synthesis within a Bayesian probability framework of previously established evidence , in order to derive an overall conclusion about the hypothesis ( H1 ) : ‘ High-viscosity glass-ionomer cements ( HVGIC ) are inferior to silver amalgam as ( load bearing ) restorative material s for permanent posterior teeth ’ .