Survival of atraumatic restorative treatment restorations in the elderly patients: a systematic review

Abstract

This study aimed to assess the survival of glass ionomer cement (GIC) restorations performed using the atraumatic restorative treatment (ART) in elderly patients. The systematic review protocol was registered in the PROSPERO database. The records were searched until August 2020 in eight electronic bibliographic databases, and included randomized and non-randomized clinical trials and observational studies, with no restrictions on the language or year of publication. Study selection and data extraction were performed independently by two reviewers. Data were extracted, summarized, collected for qualitative analysis, and evaluated for individual risk of bias using the Joanna Briggs Institute's Critical Appraisal Tool. The literature search retrieved 5,186 records; however, only seven studies fulfilled the eligibility criteria and were included. The studies were published between 2002 and 2019. A total of 1,239 restorations were investigated at intervals of 6, 12, 24, and 60 months of follow-up. Some studies had a low risk of bias, while others had moderate and high risk of bias. In general, GIC restorations placed using ART were considered satisfactory. The 6-month, 12-month, and 24-month survival rates ranged from 81.3% to 97.2%, 72.2% to 94%, and 63% to 87%, respectively; additionally, the survival rate for the longest follow-up period (60 months) was 85%. Given the best evidence-based information regarding caries removal, we highlight the need to provide a conservative and effective technique for use in elderly patients. ART is a promising and viable alternative that guarantees the survival of restorations in elderly patients.

Use of Glass-ionomer cement as a restorative material: a systematic review

“…RMGICs seems to be a very good option in restoring Class I and II cavities and performed better than HVGIC and composite resins in some studies in terms of survival rates, uoride release and biologic considerations (43,46,48). Other studies could not nd signi cant differences between RMGICs compared to conventional GICs, composite resins, compomers and amalgam (45,46,47,48,54) or there's con icting evidence on which performs better between RMGICs and composite resins. Silver-reinforced glass ionomer cement seems to have the lower survival rates and higher recurrences of secondaries caries (46).…”

“…In primary dentition the ART technique can be effective because it helps in reducing the anxiety of the patients (44,45,53). Despite is wide application in primary dentition, two studies found that the annual failure rates (AFRs) of ART were higher in primary dentition compared to permanent in both single and multi-surface restorations (44,48).…”

“…Despite is wide application in primary dentition, two studies found that the annual failure rates (AFRs) of ART were higher in primary dentition compared to permanent in both single and multi-surface restorations (44,48). The main reasons of failure were marginal defects, loss of the restoration, excessive wear and retention loss in both dentitions (45,48,49). There is con icting evidence regarding the conventional-GIC compared to ART-GIC restoration techniques, since different studies showed different results: better results with conventional techniques and no signi cant differences, respectively (48,53,54).…”

“…Glass ionomer cements have evolved during the years and several modi cations have been experimented, but there is not enough scienti c evidence on their effective-ness to be used in clinical situations. One modi cation that is being actively used in patients is RMGIC, which is being used in both primary and permanent dentitions (45,48).…”

Evaluating Glass Ionomer Cement Longevity in the Primary and Permanent Teeth—An Umbrella Review

“…In this step, 11 studies were excluded for the following reasons: (1) not being a systematic review of clinical trials and (2) not evaluating clinical performance/longevity of GICs. Finally, 13 studies [48][49][50][51][52][53][54][55][56][57][58][59][60] were included in the following review. The study selection process is shown in Figure 1.…”