Evaluation of Class I ART restorations in Brazilian schoolchildren: three‐year results

Abstract

Atraumatic Restorative Treatment (ART) has been adopted around the world to avoid unnecessary extractions, especially in non-industrialized countries. The development of specific glass ionomer cements marketed for the ART technique has contributed to the technical success rate. In this study, Ketac-Molar (3M ESPE, Dental Medzin, Germany) was used to restore 150 Class I cavities in 118 Brazilian public school children, aged from 7-12 years. At baseline and at subsequent recalls, CPI probes with a ball-end of 0.5 millimeters (mm) were used to assess loss of restorative material, and photographic color transparencies of restorations were made. After six months, 83 patients returned for follow-up examinations, with 71.8% of their restorations designated as acceptable. After three years, 49 patients with 57 ART-restorations were evaluated, with 21.0% of these restorations graded as acceptable. Another 29.8% of their restorations had been replaced by more permanent materials. The main objective of the ART technique is tooth retention; this was achieved for 94.7% of the restored teeth in a high caries risk population who returned for recalls.

Clinical Evaluation of Multiple-surface ART Restorations: Three-Year Follow-up

“…These criteria are appropriate for clinical evaluations carried out in a field setting and are defined by a description of the reason for success or failures of the restorations [4,8,16,17,19]. In this study, similarly as others reporting ART restoration replacement by another treatment, these scenarios were classified as failure [12,16,17,20]. As a result of this divergence, the present study might have reported higher failure rate compared to other ART studies that excluded these cases [7].…”

“…The drop-out-rate in this study was very low (5%) compared to previous ART studies, which were usually more than 30% [7,11,12]. In these studies the reason was , in general, attributed to the children's irregular attendance at school.…”

“…The high success rates of the restorations in this study in both groups after 3 years may be also result of the meticulous care with removing carious dentine from enamel-dentine junction (EDJ), as well as the preparation of retentive grooves in the EDJ that could have enhanced bonding. Wang et al (2004) [12] reported that the failure of the restorations was probably due to the lack of retention in prepared teeth.…”

“…The ART approach have been carried out in different countries around the world [1,2,3,5] The survival of single-surface ART restorations in the primary and permanent dentition shows good results, on average 86.1% and 91.7% after 3 years, respectively [7,8,9,12], while the success rate of multiple-surface ART restorations in the same period is about 77% in the permanent dentition [8] and 48.7% in the primary dentition [9]. It has been observed that the main circumstances for failed multiple-surface ART restoration were: restorations missing, restoration fractures, and unacceptable occlusal wear [4,10,11,12]. These facts may be attributed to: inadequate mechanical properties of the GIC's to resist occlusal forces, inadequate GIC's placement with inclusion voids, large cavity sizes, operators inexperience and inadequate cavity preparation with hand instruments, lack of chairside assistance, blood and salivary contamination [4,7,13].…”

Evaluation of Compressive Strength for a Combination of Glass Ionomer Cement and Antibiotics

“…16 A 3 years study conducted in Brazilian school children showed that the teeth affected by caries can be retained without extraction in 94.7% of the restored teeth in high cries risk population. 17 Survival rates of single-surface ART restorations in permanent posterior teeth, using high-viscosity glassionomers, do not differ significantly from comparable traditional restorations using amalgam. 18,19 ART restorations using high-viscosity glass-ionomers were more cost-effective after 2 years than comparable amalgam restorations.…”