Conclusions ART single-surface restorations  presented high survival percentages in both primary and permanent posterior teeth , whilst ART multiple-surface restorations presented lower survival percentages .
ART sealants presented a high-caries-preventive effect .
Clinical relevance ART is an effective evidence -based option for treating and preventing carious lesions in primary and permanent posterior teeth
Objective The aim of the present study is to up date the results of two previous meta-analyses , published in 2006 and 2012 , on the survival percentages of  atraumatic restorative treatment ( ART ) restorations and ART sealants .
The current meta- analysis includes Chinese publications not investigated before .
Effectiveness of conventional treatment using bulk-fill composite resin versus Atraumatic Restorative Treatments in primary and permanent dentition: a pragmatic randomized clinical trial
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
Conclusions ART single-surface restorations  presented high survival percentages in both primary and permanent posterior teeth , whilst ART multiple-surface restorations presented lower survival percentages .
ART sealants presented a high-caries-preventive effect .
Clinical relevance ART is an effective evidence -based option for treating and preventing carious lesions in primary and permanent posterior teeth
Objective The aim of the present study is to up date the results of two previous meta-analyses , published in 2006 and 2012 , on the survival percentages of  atraumatic restorative treatment ( ART ) restorations and ART sealants .
The current meta- analysis includes Chinese publications not investigated before .