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 .
Survival rate of approximal-ART restorations using a two-layer technique for glass ionomer insertion
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
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 .