One year survival of ART and conventional restorations in patients with disability

Abstract

BackgroundProviding restorative treatment for persons with disability may be challenging and has been related to the patient’s ability to cope with the anxiety engendered by treatment and to cooperate fully with the demands of the clinical situation. The aim of the present study was to assess the survival rate of ART restorations compared to conventional restorations in people with disability referred for special care dentistry.MethodsThree treatment protocols were distinguished: ART (hand instruments/high-viscosity glass-ionomer); conventional restorative treatment (rotary instrumentation/resin composite) in the clinic (CRT/clinic) and under general anaesthesia (CRT/GA). Patients were referred for restorative care to a special care centre and treated by one of two specialists. Patients and/or their caregivers were provided with written and verbal information regarding the proposed techniques, and selected the type of treatment they were to receive. Treatment was provided as selected but if this option proved clinically unfeasible one of the alternative techniques was subsequently proposed. Evaluation of restoration survival was performed by two independent trained and calibrated examiners using established ART restoration assessment codes at 6 months and 12 months. The Proportional Hazard model with frailty corrections was applied to calculate survival estimates over a one year period.Results66 patients (13.6 ± 7.8 years) with 16 different medical disorders participated. CRT/clinic proved feasible for 5 patients (7.5%), the ART approach for 47 patients (71.2%), and 14 patients received CRT/GA (21.2%). In all, 298 dentine carious lesions were restored in primary and permanent teeth, 182 (ART), 21 (CRT/clinic) and 95 (CRT/GA). The 1-year survival rates and jackknife standard error of ART and CRT restorations were 97.8 ± 1.0% and 90.5 ± 3.2%, respectively (p = 0.01).ConclusionsThese short-term results indicate that ART appears to be an effective treatment protocol for treating patients with disability restoratively, many of whom have difficulty coping with the conventional restorative treatment.Trial registration numberNetherlands Trial Registration: NTR 4400

The global burden of oral diseases in pediatric HIV‐infected populations: a workshop report

“…ART was presented to the World Health Organization in 1994 as a new approach to treat dental caries (Frencken et al , ). The technique consists of the excavation and removal of the softest portions of carious lesions using hand instruments only and restoration with fluoride containing glass ionomers (Molina et al , ). Previous studies in a high‐risk population showed that glass ionomer vs. amalgam restorations plus daily application of fluoride in xerostomic patients did not present recurrent caries but the patients treated with amalgam without fluoride developed recurrent caries (Haveman et al , ).…”

“…Oral diseases in HIV-infected children E Arrive et al restoration with fluoride containing glass ionomers (Molina et al, 2014). Previous studies in a high-risk population showed that glass ionomer vs. amalgam restorations plus daily application of fluoride in xerostomic patients did not present recurrent caries but the patients treated with amalgam without fluoride developed recurrent caries (Haveman et al, 2003).…”

Acceptability, feasibility and perceived satisfaction of the use of the Atraumatic Restorative Treatment approach for people with disability

“…Ethical approval was obtained from the local Ethical Committee, CIEIS Facultad de Odontología, Universidad Nacional de Córdoba with the reference number 38/2012 and the trial was registered at Netherlands Trial Register with number 4400. As a detailed report about the methodology used is presented elsewhere, 21 a shortened version is presented underneath.…”

“…The survival rates have been recently published and showed a 98% survival of all ART high-viscosity glass-ionomer restorations and a 91% survival of all conventional composite restorations after one year. 21 The present study, the first in its kind, is aimed to compare ART with conventional restorative treatment in terms of acceptability and feasibility of the approach and respondent satisfaction in a population of patients referred for special care restorative dentistry.…”

Microinvasive dental treatment in pre-school children

“…Так, при использовании методики для лечения лиц с задержкой интеллектуального развития она оказалась более эффективной, чем стандартное лечение с применением композитных материалов (соответственно 97,8±1,0% против 90,5±3,2% успешных результатов через 1 год наблюдения), именно благодаря лучшему сотрудничеству больных, а также большей толерантности стеклоиономерных цементов к погрешностям в изоляции рабочего поля от влаги. Полноценного высушивания полости у этой группы больных добиться сложно из-за непроизвольных движений языка и обильного слюнотечения [9].…”