One-year follow-up of Atraumatic Restorative Treatment(ART) for dental caries in children undergoing oncohematological treatment: a pragmatic trial

Abstract

BackgroundThe oral condition in children undergoing oncohematological treatment can have a negative impact on the course of disease. Little is known about survival of tooth restorations in these patients. The aim of this study was to evaluate the longevity of restorations and sealants performed by Atraumatic Restoration Treatment (ART) in patients undergoing oncohematological treatment.MethodsART single surface restorations and sealants were performed in the experimental group (E), which comprised children (2–13 years old) undergoing oncohematological treatment, and in the control group (C), in which patients did not undergo such treatment. The same examiner evaluated the ART at 1, 3, 6 and 12 months after preparation, using the same criteria for restorations and sealants. ART was successful if the sealant or restoration did not need a repair in the follow-up assessment. Descriptive, bivariate and Cox’s proportional hazard analyses were performed at a significance level of 5 %.ResultsThe two groups, one including 24 children (E) and the other 14 children (C), received 101 and 52 ART procedures, respectively. The success rates were 95.0 % (E) and 100 % (C) at 1 month (P = 0.233); 81.2 % (E) and 92.3 % (C) at 3 months (P = 0.009); 72.2 % (E) and 80.8 % (C) at 6 months (P = 0.050) and 48.5 % (E) and 73.1 % (C) at 12 months (P = 0.001). The final Cox’s regression model for occurrence of ART failure needing repair did not show differences between groups (E: OR = 1.6, 95 % CI 0.8–2.9); primary teeth had a shorter survival than permanent teeth (OR = 2.1, 95 % CI 1.2–3.7).ConclusionsOncohematological treatment did not interfere with the longevity of ART restorations and sealants, which suggests the potential use of this technique in children undergoing chemotherapy.Trial registrationBrazilian Clinical Trials Registry (REBEC) RBR-2c3c52. Registered 5 June 2014. http://www.ensaiosclinicos.gov.br/rg/RBR-2c3c52/Electronic supplementary materialThe online version of this article (doi:10.1186/s12903-015-0110-y) contains supplementary material, which is available to authorized users.

Management of dental caries lesions in patients with disabilities: Update of a systematic review

“…The quality of the included studies rated between level II and lV. Three RCT (one of them has two entrances for different types of outcomes) ( 21 – 24 ), one pragmatic controlled clinical trial ( 25 ), one prospective cohort study ( 26 ), one retrospective audit ( 27 ), and four retrospective cohort studies ( 28 – 31 ) reported the outcomes of different interventions that aimed to restore teeth affected by caries disease in patients with disability in time interval 2011–2022.…”

Poor Oral Health Increases the Physical Pain, Psychological Discomfort and Social Incapacity of Individuals with Oncohaematological Diseases

“…Dental ridges should be rounded, and infiltrated restorations and incipient caries should be restored. Gonçalves et al (2015) stated that restorations with glass ionomer cement present a great benefit because of the availability of fluoride in the buccal environment, since the chemotherapeutic treatment alters salivary defense mechanisms and increases the risk of caries. Severe caries and/or pulp involvement should be treated as long as there is a guarantee of elimination of infectious foci, because depending on the patient's adherence to the treatment and the time prior to the initiation of chemotherapy, the procedures will be less conservative and these teeth may have to be extracted (Zimmermann et al; Baungarten).…”

Oral health of adult patients undergoing hematopoietic cell transplantation. Pre-transplant assessment and care

“…No endodontic treatment unless patient has 7 days from the completion of endodontic therapy to onset of myelosuppression (<1000–2000 granulocytes/mm3, 3, 27] Insufficient time left for competing the procedure: the final dental procedure cannot be successfully terminated, or there are acute needs to be cured first. The risk of local/general complications of the treatment is taken into consideration Risk of dental treatment, concerning general health status of the pre-HCT patient: High risk patient: neutropenic and/or thrombocytopenic patient, Moderate risk patient: myelosuppression/ immunosuppression due to chemotherapy, Low risk patient: no evidence of malignancy and myelosuppression [ 9 , 20 ] ART (atraumatic restorative treatment): the approach that involves the use of hand instruments only to remove carious tooth substance and then restoring the cavity and sealing any adjacent enamel fissures with a glass ionomer restorative cement (GIC) [ 49 ] …”

“…Possible protocol for minimally invasive treatment of caries/non carious lesions in adult patients prior to HCT, based on the literature and the experience of the authors (considering the severity of lesion, time for completing the dental treatment, and the medical status of the patient) [ 3 , 15 , 22 , 26 , 36 , 46 , 47 , 49 , 50 ]. …”

“…ART (atraumatic restorative treatment): the approach that involves the use of hand instruments only to remove carious tooth substance and then restoring the cavity and sealing any adjacent enamel fissures with a glass ionomer restorative cement (GIC) [ 49 ]…”