Clinical evaluation of ART restorations using two different insertion techniques

Objectives: The aim of this study was to evaluate restorations made with two different insertion techniques of a glass ionomer cement (GIC) using the Atraumatic Restorative Treatment (ART) in permanent teeth. Methods: The study as conducted in nine schools of Anápolis/Brazil. A total of 182 restorations using Riva self-cure (SDI) were placed by two trained operators in 103 patients aged from 6 to 15 years old. The restorations were randomly divided into two groups one of which cavities were filled with hand-mixed GIC (N=95) and other group filled with encapsulated version of the same GIC (N=87). After 6-months, six patients, with ten restorations, have moved to other cities and 172 restorations within 97 patients were evaluated by two calibrated independent examiners according to ART criteria: 0- Present, good; 1- Present, slight marginal defect; 2- Present, marginal defect deeper than 0.5mm; 3- Present, gross defect of more than 1.0mm and 4- Not present. The Chi-square test (p<0.05) was used to perform the statistical analysis. Results: The observed scores after 6 months are presented in the following table:

Technique	Hand-Mixed GIC		Encapsulated GIC
Score	N	%	N	%
0	57	62.6	62	76.6
1	9	9.9	10	12.3
2	3	3.3	2	2.5
3	1	1.1	0	-
4	21	23.1	7	8.6

There was statistically significant difference between insertion approaches of GIC in ART within 6-months (p<0.05). Encapsulated GIC presented statistically significant better success rate than hand-mixed GIC. Conclusion: The restorations performed with encapsulated GIC survived longer than those produced with the hand-mixed GIC in the permanent teeth. Further evaluations are necessary for a better clinical performance analysis. Supported by SDI and FUNADESP.