Survival of glass ionomer restorations placed in primary molars using atraumatic restorative treatment (ART) and conventional cavity preparations: 2-year results. The 3.5-year survival rates of primary molars treated according to three treatment protocols: a controlled clinical trial One-year survival of occlusal ART restorations in primary molars placed with and without cavity conditioner. Amalgam and ART restorations in children: a controlled clinical trial ART and Conventional Root Restorations in Elders after 12 Months Clinical evaluation of the ART approach and materials in peri-urban farm schools of the Johannesburg area. Atraumatic Restorative Treatment with Resin-Modified Glass Ionomer Material: Short-Term Results of a Pilot Study Clinical evaluation of multiple-surface ART restorations: 12 month follow-up. Effectiveness of Three Minimal Intervention Approaches for Managing Dental Caries: Survival of Restorations after 2 Years The atraumatic restorative treatment (ART) approach to restoring primary teeth in a standard dental clinic. Survival of Fuji IX ART fillings in permanent teeth of primary school children in Tanzania. A clinical evaluation of two glass ionomer cements in primary molars using atraumatic restorative treatment technique in India: 1 year follow up. The effects of two cavity preparation methods on the longevity of glass ionomer cement restorations: an evaluation after 12 months. Efficacy of conventional treatment with composite resin and atraumatic restorative treatment in posterior primary teeth: study protocol for a randomised controlled trial Influence of the cavity-size on the survival rate of proximal ART restorations in primary molars. Restoration of permanent teeth in young rural children in Cambodia using the atraumatic restorative treatment (ART) technique and Fuji II glass ionomer cement. The dilemma of selecting suitable proximal carious lesions in primary molars for restoration using ART technique. Bilayer technique and nano-filled coating increase success of approximal ART restorations: a randomized clinical trial. Survival of self-etch adhesive Class II composite restorations using ART and conventional cavity preparations in primary molars. Comparison of atraumatic restorative treatment and conventional cavity preparations for glass-ionomer restorations in primary molars: one-year results. Comparison of two tooth-saving preparation techniques for one-surface cavities. A clinical evaluation of resin-based composite and glass ionomer cement restorations placed in primary teeth using the ART approach: results at 24 months. Randomized controlled clinical trial of the 24-months survival of composite resin restorations after one-step incomplete and complete excavation on primary teeth.
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 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 PURPOSE The objectives of this clinical study were to : evaluate the survival of  occlusal atraumatic restorative treatment ( ART ) restorations  , on a longitudinal basis , in the primary molars of children in Mosul/Iraq ; and compare the success rate of ART restorations placed with and without cavity conditioning . METHODS One dentist placed 96 ART restorations in 48 6- to 7-year-olds who had bilateral matched pairs of carious primary molars . A split-mouth design was used to place restorations with and without cavity conditioning , which were assigned r and omly to contralateral sides . Restorations were evaluated after 6 and 12 months using the ART criteria . RESULTS The survival rate of ART restorations  placed with cavity conditioner was 89 % at the 6-month assessment and 74 % at the 12-month assessment . The success rates of ART restorations  placed without cavity conditioning in the 2 assessment s were 84 % and 67 % , respectively . There was no statistically significant difference between the ART restorations placed with and without cavity conditioner in both assessment s ( P>0.05 ) . The main cause of failure was the loss of restoration . CONCLUSIONS The 1-year success rate of occlusal ART restorations in primary molars was moderately successful . The ART technique 's cavity conditioning step was not proven to be better than not using it for Class I lesions 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 In this study , 1,325 school children from 7 farm schools were examined . Their mean age ( + /- SD ) was 10.5 + /- 3.0 ( range 6 - 11 ) years . At baseline , the mean DMFT score was 1.1 + /- 1.7 and 36.4 % of the children had caries . The prevalence of fluorosis among the children was 12.6 % . Curative treatment was offered to all the children . A total of 113 children ( 8.5 % ) with one-surface cavities on permanent teeth and without fluorosis were treated using the atraumatic restorative treatment ( ART ) approach . A total number of 163 cavities were included in the study , of which 82 were treated with Fuji IX glass-ionomer cement and 81 with Ketac-MOLAR ( h and mix ) . One year after treatment , restoration and sealant parts of ART fillings were examined . Caries status was also determined . The placing of the ART fillings and their evaluation were performed by different practitioners . A total number of 108 restorations  ( 58 with Fuji IX , 50 with Ketac-MOLAR ) were evaluated . Results of ART fillings showed a survival rate of 93.1 % with Fuji and 94.0 % with Ketac-MOLAR .  Retention of the sealant parts of ART fillings  was observed in 81 % of restorations with Fuji IX and 76 % with Ketac-MOLAR , not connected to the filled cavity . Caries was absent on all teeth restored with Fuji IX and noted in only one tooth restored with Ketac-MOLAR , not connected to the filled cavity . The retention rate after a 12-month period was acceptable and ART approach proved to be an appropriate technique for restoring teeth in this population group . There were no statistically significant differences between the survival rates of the two glass-ionomer restorative material s ( P > 0.05 ) 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 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 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 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 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 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 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 Introduction Despite the widespread acceptance of conventional treatment using composite resin in primary teeth , there is limited evidence that this approach is the best option in paediatric clinics .  Atraumatic restorative treatment ( ART ) using high-viscosity glass ionomer cement has gradually become more popular because it performs well in clinical studies , is easy to h and le and is patient friendly . Therefore , the aim of this r and omised clinical trial study is to compare the restoration longevity of conventional treatment using composite resin with that of ART in posterior primary teeth . As secondary outcomes , cost-efficacy and patient self-reported discomfort will also be tested . Methods and analysis Children aged 3–6 years presenting with at least one occlusal and /or occlusal-proximal cavity will be r and omly assigned to one of two groups according to the dental treatment : ART ( experimental group ) or composite resin restoration ( control group ) . The dental treatment will be performed at a dental care trailer located in an educational complex in Barueri/SP , Brazil . The unit of r and omisation will be the child . A sample size of 240 teeth with occlusal cavities and 188 teeth with occlusal-proximal cavities has been calculated . The primary outcome will be restoration longevity , which will be clinical ly assessed after 6 , 12 , 18 and 24 months by two examiners . The duration of the dental treatment and the cost of all material s used will be considered when estimating the cost-efficacy of each treatment . Individual discomfort will be measured after each dental procedure using the Facial Scale of Wong-Baker . Ethics and dissemination This clinical trial was approved by the local ethics committee from the Faculty of Dentistry of the University of São Paulo ( registration no. 1.556.018 ) . Participants will be included after their legal guardians have signed an informed consent form containing detailed information about the research . Trial registration number www . clinical trials.gov , NCT02562456 ; Pre- results 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 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 To determine the examiner 's accuracy in selecting proximal carious lesions in primary molars for restoration using the atraumatic restorative treatment ( ART ) approach . BASIC RESEARCH DESIGN Intervention study . CLINICAL SETTING AND PARTICIPANTS : A total of 804 six to eight year-olds from 30 rural schools in Kenya participated in the study . INTERVENTION Three examiners selected a total of 1,280 suitable proximal carious lesions in primary molars after examining 6,002 children from 30 schools r and omly selected out of 142 schools in two divisions . Seven operators r and omly paired on a daily basis with eight assistants restored the lesions . An explanation was provided for any cavity that was not restored . Pre- and post-operative  radiographs of the cavities were also taken for evaluation . MAIN OUTCOME MEASURES The examiner 's choice of suitable proximal cavities restorable using the ART approach  was related to the decision made to either restore or not during the operative stage . The radiographic findings of the selected cavities were also compared to the decision made by the operator . The results obtained were used to determine the examiner 's accuracy in selecting suitable proximal cavities for restoration using the ART approach . RESULTS The majority of the children recruited in the study were excluded due to absenteeism , pulpal-exposure or anxiety during the operative stage . Only 804 children received one restoration in their primary molars . The examiner 's accuracy in selecting suitable ART-restorable cavities  clinical ly was 94.9 % and based on radiographic analysis was 91.7 % . CONCLUSIONS A trained and diligent examiner has a very good chance of selecting proximal carious lesions restorable with the use of ART approach , without the threat of dental pulpal-involvement during the excavation of caries 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 PURPOSE To test the null-hypothesis that there was no difference in the survival percentages of Class II composite restorations in primary teeth produced through either ART or conventional approaches after 2 years . METHODS 157 children with 325 Class II cavitated dentin lesions were included in a split-mouth study design . A computer program r and omly assigned cavitated dentin lesions to treatment groups stratified for gender , operator , upper/lower jaw and left/right side of the mouth . Three operators placed resin composite ( Pertac II ) restorations using a self-etch adhesive ( Prompt L-Pop ) . Two independent examiners evaluated the restorations after 0.5 , 1 and 2 years using the modified Ryge criteria . A modification of the actuarial survival method was applied to estimate survival percentages . RESULTS There was no statistically significant difference ( P > 0.05 ) observed between the cumulative survival percentages of Class II composite restorations in primary teeth produced by the two approaches after 2 years ( ART : 34.9 % + /- 4.7 % ; conventional : 35.1 % + /- 4.7 % ) . The cumulative survival percentages of ART and conventional Class II restorations  of one of the operators were lower than for ART restorations of the other two operators and for conventional restorations of one of the operators ( P < or = 0.001 ) . The main reason for Class II composite restorations to fail over the 2-year period was complete loss of retention ; ART : 75 % ; conventional : 77 % . The null-hypothesis was accepted as there was no difference in the cumulative survival percentages of ART and conventional Class II composite restorations  in primary teeth after 2 years . It appears that the low survival results obtained may have been caused by poor bonding of the self-etch adhesive 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 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 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 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
CONCLUSION ART restorations have similar survival rate compared to conventional treatment and can be considered an option to restore occlusoproximal cavities in primary molars
BACKGROUND A previous systematic review showed that atraumatic restorative treatment ( ART ) can be an option to restore the occlusoproximal cavities in primary teeth ; however , few studies fulfilled the criteria of inclusion to generate a high level of evidence .
AIM To up date the existing systematic review and address questions regarding survival rate of ART restorations compared to the conventional approach in occlusoproximal cavities in primary molars .