Effectiveness of Three Minimal Intervention Approaches for Managing Dental Caries: Survival of Restorations after 2 Years

Abstract

The present study was aimed 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 hand 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 resources 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.

Clinical Investigation of Two Glass–Ionomer Restoratives Used with the Atraumatic Restorative Treatment Approach in China: Two–Years Results

“…period. This is in agreement with the results of other studies in Zimbabwe [Frencken et al, 1998a, b], in Tanzania [Mandari et al, 2001] and in China [Holmgren et al, 2000]. The 12-month success rates of the class I ART restorations placed in the primary teeth in this study were also very high, being over 90%.…”

Clinical Trial of a New Glass Ionomer for an Atraumatic Restorative Treatment Technique in Class I Restorations Placed in Latvian School Children

“…The early results of the ART studies have been promising, but improvements in performance and longevity of fillings are still being sought. In a later study, Mandari et al [10] not find a statistically significant difference between onesurface amalgam and glass ionomer fillings after 2 years.…”

“…However, many ART studies [4][5][6][7][8][9][10]17] have confirmed the advantages of this technique and successful performance of restorations in class I cavities. The test glass ionomer filling was manufactured as a universal glass ionomer filling material also indicated for use with the ART approach.…”

Microtensile Bond Strength of Glass Ionomer Cements to Artificially Created Carious Dentin

“…The clinical success rate of the ART approach is fairly high in initial, short-term studies. [9][10] However, no long-term studies are available yet, and few studies have been done on the bond strength and microscopic characteristics of the bonding interface between GICs and carious dentin.…”