Clinical evaluation of multiple-surface ART restorations: 6-year follow-up

Objective: To evaluate the performance of multiple-surface restorations made with two different glass ionomer cements (GICs) using the Atraumatic Restorative Treatment (ART) in permanent teeth. Methods: A total of 60 restorations, 36 Class I involving two or more tooth surfaces and 24 Class II were placed in schoolchildren (9-16 years of age) by two dentists using standard ART procedures. The restorations were randomly divided into two groups in a parallel-group study design. Thirty cavities were filled with high strength GIC (Ketac Molar-3M ESPE, code K) and the other 30 cavities with resin-modified GIC (Fuji VIII-GC Corp., code F). Two calibrated independent examiners carried out the evaluation according to ART criteria. The inter examiner kappa was 0.92. A difference was considered statistically significant if p<0.05. Results: In the 6-year follow-up, 22 patients (47.8%) and 43 restorations (71.7%) were evaluated. The success rates of the restorations were 43.5% and 60.0% for K and F, respectively. Failures registered were: 9 restorations replaced by other restorations (6K, 3F), 7 restorations with marginal defect > 0.5 mm (repair is needed; 4K, 3F), 3 restorations partly or completely missing (2K, 1F), 1 restoration with wear > 0.5 mm (repair is needed; 1F,) and 1 tooth missing due to secondary caries (1K). There was no statistically significant difference between GICs, cavity types or operators. There was a statistically significant difference between baseline and 6-year results for both groups (p=0.001 and p=0.013, for Ketac Molar and Fuji VIII, respectively). Although the real reasons for replacement of restorations were unknown, secondary caries was observed in only one ART restoration. Conclusions: Both GICs performed similarly and ART approach provided approximately 50% of survival rate for multiple-surface restorations over a 6-year period. This study was supported by CNPq – grant 485476/2007-0.