Survival of atraumatic restorative treatment (ART) sealants and restorations: a meta-analysis

Rodrigo G de Amorim, Soraya C Leal, Jo E Frencken, Rodrigo G de Amorim, Soraya C Leal, Jo E Frencken

Abstract

The purpose of this study is to perform a systematic investigation plus meta-analysis into survival of atraumatic restorative treatment (ART) sealants and restorations using high-viscosity glass ionomers and to compare the results with those from the 2005 ART meta-analysis. Until February 2010, four databases were searched. Two hundred four publications were found, and 66 reported on ART restorations or sealant survival. Based on five exclusion criteria, two independent reviewers selected the 29 publications that accounted for the meta-analysis. Confidence intervals (CI) and or standard errors were calculated and the heterogeneity variance of the survival rates was estimated. Location (school/clinic) was an independent variable. The survival rates of single-surface and multiple-surface ART restorations in primary teeth over the first 2 years were 93% (CI, 91-94%) and 62% (CI, 51-73%), respectively; for single-surface ART restorations in permanent teeth over the first 3 and 5 years it was 85% (CI, 77-91%) and 80% (CI, 76-83%), respectively and for multiple-surface ART restorations in permanent teeth over 1 year it was 86% (CI, 59-98%). The mean annual dentine lesion incidence rate, in pits and fissures previously sealed using ART, over the first 3 years was 1%. No location effect and no differences between the 2005 and 2010 survival rates of ART restorations and sealants were observed. The short-term survival rates of single-surface ART restorations in primary and permanent teeth, and the caries-preventive effect of ART sealants were high.

Clinical relevance: ART can safely be used in single-surface cavities in both primary and permanent teeth. ART sealants have a high caries preventive effect.

Figures

Fig. 1
Fig. 1
Flow chart of retrieved English publications from keywords to included publications reporting survival results of ART sealants or ART restorations
Fig. 2
Fig. 2
Flow chart of retrieved Portuguese/Spanish publications from keywords to included publications reporting survival results of ART sealants or ART restorations

References

    1. Van’t Hof MA, Frencken JE, Van Palenstein Helderman WH. The atraumatic restorative treatment (ART) approach for managing dental caries: a meta-analysis. Int Dent J. 2006;56:345–351. doi: 10.1111/j.1875-595X.2006.tb00339.x.
    1. Smith AJE, Chimimba PD, Kalf-Scholte S, Bouma J. Clinical pilot study on new dental filling materials and preparation procedures in developing countries. Community Dent Oral Epidemiol. 1990;18:309–312. doi: 10.1111/j.1600-0528.1990.tb00086.x.
    1. Loh KH. An ART technique in the mobile dental squad in Malaysia: a four-year review. Malaysian Dent J. 2003;24:95–101.
    1. Pan American Health Organization . Oral health of low income children. Procedures for atraumatic restorative treatment. Final report. Washington: PAHO; 2006.
    1. Farag A, van der Sanden WJM, Abdelwahab H, Mulder J, Frencken JE. 5-Year survival of ART restorations with and without cavity disinfection. J Dent. 2009;37:468–474. doi: 10.1016/j.jdent.2009.03.002.
    1. R Development Core Team (2009) R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. ISBN 3-900051-07-0, URL Accessed 4 April 2010
    1. Mulrow CD. Rational for systematic reviews. Br Med J. 1994;309:597–599. doi: 10.1136/bmj.309.6954.597.
    1. Holmgren CJ, Lo ECM, Hu DY, Wan HC. ART restorations and sealants placed in Chinese school children—results after 3 years. Community Dent Oral Epidemiol. 2000;28:314–320. doi: 10.1034/j.1600-0528.2000.280410.x.
    1. Frencken JE. The ART approach using glass-ionomers in relation to global oral health care. Dent Mat. 2010;26:1–6. doi: 10.1016/j.dental.2009.08.013.
    1. Mejàre I, Mjör IA. Glass ionomer and resin-based fissure sealants: a clinical study. Scand J Dent Res. 1990;98:345–350.
    1. Smales RJ, Gao W, Ho FT. In vitro evaluation of sealing pits and fissures with newer glass-ionomer cements developed for the ART technique. J Clin Pediatr Dent. 1997;21:321–323.
    1. Weerheijm KL, Kreulen CM, Gruythuisen RJ. Comparison of retentative qualities of two glass-ionomer cements used as fissure sealants. ASDC J Dent Child. 1996;63:265–267.
    1. Frencken JE, Leal SC. The correct use of the ART approach. J Appl Oral Sci. 2010;18:1–4. doi: 10.1590/S1678-77572010000100002.
    1. Cefaly DFG, Bresciani E, Lauris JRP, Barata TJE, Fagundes TC, Navarro MFL. Clinical evaluation of multiple-surface ART restorations: 12 month follow-up. ASDC J Dent Child. 2007;74:203–208.
    1. Rutar J, McAllan L, Tyas MJ. Three-year clinical performance of glass ionomer cement in primary molars. Int J Paediat Dent. 2002;12:146–147. doi: 10.1046/j.1365-263X.2002.00339.x.
    1. Kemoli AM, van Amerongen WE, Opinya G. Influence of the experience of operator and assistant on the survival rate of proximal ART restorations: two-year results. Eur Arch Paediatr Dent. 2009;10:227–232.
    1. Van Gemert-Schriks MC, van Amerongen WE, ten Cate JM, Aartman IH. Three-year survival of single- and two-surface ART restorations in a high-caries child population. Clin Oral Invest. 2007;11:337–343. doi: 10.1007/s00784-007-0138-8.
    1. Frencken JE, Makoni F, Sithole WD. ART restorations and glass ionomer sealants in Zimbabwe: survival after 3 years. Community Dent Oral Epidemiol. 1998;26:372–381. doi: 10.1111/j.1600-0528.1998.tb01975.x.
    1. Rahimtoola S, Van Amerongen WE. Comparison of two tooth saving preparation techniques for one surface cavities. ASDC J Dent Child. 2002;69:16–26.
    1. Qvist V, Manscher E, Teglers PT. Resin-modified and conventional glass ionomer restorations in primary teeth: 8-years results. J Dent. 2004;32:285–294. doi: 10.1016/j.jdent.2004.01.001.
    1. Qvist V, Laurberg L, Poulsen A, Teglers PT. Class II restorations in primary teeth: 7-year study on three resin-modified glass ionomer cements and a compomer. Eur J Oral Sci. 2004;112:188–196. doi: 10.1111/j.1600-0722.2004.00117.x.
    1. Palma-Dibb RG, de Castro CG, Ramos RP, Chimello DT, Chinelatti MA. Bond strength of glass-ionomer cements to caries-affected dentin. J Adhes Dent. 2003;5:57–62.
    1. Qvist V, Poulsen A, Teglers PT, Mjör IA. The longevity of different restorations in primary teeth. Int J Paediatr Dent. 2010;20:1–7. doi: 10.1111/j.1365-263X.2009.01017.x.
    1. Eden E, Topaloglu-Ak A, Frencken JE, van’T Hof MA. Survival of self-etch adhesive Class II composite restorations using ART and conventional cavity preparations in deciduous teeth. Am J Dent. 2006;19:359–363.
    1. Topaloglu-Ak A, Eden E, Frencken JE, Oncag O. Two years survival rate of Class II composite resin restorations prepared by ART with and without a chemomechanical caries removal gel in primary molars. Clin Oral Invest. 2009;13:325–332. doi: 10.1007/s00784-008-0241-5.
    1. Ercan E, Dulgergil T, Soyman M, Dalli M, Yildirim I. A field-trial of two restorative materials used with atraumatic restorative treatment in rural Turkey: 24-month results. J Appl Oral Sci. 2009;17:307–314. doi: 10.1590/S1678-77572009000400008.
    1. Muller-Bolla M, Lupi-Pe’gurier L, Tardieu C, Velly AM, Antomarchi C. Retention of resin-based pit and fissure sealants: a systematic review. Community Dent Oral Epidemiol. 2006;34:321–336. doi: 10.1111/j.1600-0528.2006.00319.x.
    1. Williams B, Laxton L, Holt RD, Winter GB. Fissure sealants: a 4-year clinical trial comparing an experimental glass polyalkenoate cement with a bis glycidyl methacrylate resin used as fissure sealants. Br Dent J. 1996;180:104–108. doi: 10.1038/sj.bdj.4808989.
    1. Frencken JE, Wolke J. Clinical and SEM assessment of ART high-viscosity glass-ionomer sealants after 8–13 years in 4 teeth. J Dent. 2010;38:59–64. doi: 10.1016/j.jdent.2009.09.004.
    1. Papacchini F, Goracci C, Sadek FT, Monticelli F, Garcia-Godoy F, Ferrari M. Microtensile bond strength to ground enamel by glass-ionomers, resin-modified glass-ionomers, and resin composites used as pit and fissure sealants. J Dent. 2005;33:459–467. doi: 10.1016/j.jdent.2004.11.007.
    1. Beiruti N, Frencken JE, Van’T Hof MA, van Palenstein Helderman WH. Caries preventive effect of resin-based and glass ionomer sealants over time: a systematic review. Community Dent Oral Epidemiol. 2006;34:403–409. doi: 10.1111/j.1600-0528.2006.00321.x.
    1. Yengopal V, Mickenautsch S, Bezerra AC, Leal SC. Caries-preventive effect of glass ionomer and resin-based fissure sealants on permanent teeth: a meta analysis. J Oral Sci. 2009;51:373–382. doi: 10.2334/josnusd.51.373.
    1. Beiruti N, Frencken JE, van’t Hof MA, Taifour D, van Palenstein Helderman WH. Caries-preventive effect of a one-time application of composite resin and glass ionomer sealants after 5 years. Caries Res. 2006;40:52–59. doi: 10.1159/000088907.
    1. Menezes JPL, Rosenblatt A, Medeiros E. Clinical evaluation of atraumatic restorations in primary molars: a comparison between 2 glass ionomer cements. ASDC J Dent Child. 2006;73:91–97.
    1. Hickel R, Roulet JF, Bayne S, Heintze SD, Mjör IA, Peters M, Rousson V, Randall R, Schmalz G, Tyas M, Vanherle G. Recommendations for conducting controlled clinical studies of dental restorative materials. Clin Oral Invest. 2007;11:5–33. doi: 10.1007/s00784-006-0095-7.
    1. Farag A, van der Sanden WJM, Abdelwahab H, Frencken JE (2010) Survival of ART restorations, assessed using selected FDI and the modified ART restoration criteria. Clin Oral Invest (in press)
    1. Zanata RL, Fagundes TC, Freitas MCCA, Lauris JRP, Navarro MFL (2010) Ten-year survival of ART restorations in permanent posterior teeth. Clin Oral Invest (in press)
    1. Oba AA, Dulgergil T, Sonmez IS, Dogan S. Comparison of caries prevention with glass ionomer and composite resin fissure sealants. J Form Med Assoc. 2009;108:844–848. doi: 10.1016/S0929-6646(09)60415-0.
    1. Faccin ES, Ferreira SH, Kramer PF, Ardenghi TM, Feldens CA. Clinical performance of ART restorations in primary teeth: a survival analysis. J Clin Pediatr Dent. 2009;33:295–298.
    1. Roeleveld AC, van Amerongen WE, Mandari GJ. Influence of residual caries and cervical gaps on the survival rate of class II glass ionomer restorations. Eur Arch Paediatr Dent. 2006;7:85–91.
    1. Barata TJ, Bresciani E, Mattos MC, Lauris JR, Ericson D, Navarro MFL. Comparison of two minimally invasive methods on the longevity of glass ionomer cements restorations: short-term results of a pilot study. J Appl Oral Sci. 2008;16:155–160. doi: 10.1590/S1678-77572008000200014.
    1. Dulgergil CT, Soyman M, Civelek A. Atraumatic restorative treatment with resin-modified glass ionomer material: short term results of a pilot study. Med Princ Pract. 2005;14:277–280. doi: 10.1159/000085750.
    1. Lopez N, Simpser-Rafalin S, Berthold P. Atraumatic restorative treatment for prevention and treatment of caries in a underserved community. Am J Public Health. 2005;95:1338–1339. doi: 10.2105/AJPH.2004.056945.
    1. Cefaly DFG, Barata TJE, Tapety CMC, Bresciani E, Navarro MFL. Clinical evaluation of multisurface ART restorations. J Appl Oral Sci. 2005;13:15–19. doi: 10.1590/S1678-77572005000100004.
    1. Bresciani E, Carvalho WL, Pereira LCG, Barata TJE, Garcia-Godoy F, Navarro MFL. Six-month evaluation of ART one-surface restorations in a community with high caries experience in Brazil. J Appl Oral Sci. 2005;13:180–186. doi: 10.1590/S1678-77572005000200017.
    1. Mallow PK, Durward CS, Klaipo M. Restoration of permanent teeth in young rural children in Cambodia using the atraumatic restorative treatment (ART) technique and Fuji II glass ionomer cement. Int J Paediat Dent. 1998;8:35–40. doi: 10.1046/j.1365-263X.1998.00058.x.
    1. Abid A, Chkir F, Ben Salem K, Argoubi K, Sfar-Gandoura M. Atraumatic restorative treatment and glass ionomer sealants in Tunesian children: survival after 3 years. East Med Health J. 2002;8:315–23.
    1. Motsei SM, Kroon J, Holtshousen WS. Implementation of the ART approach in South Africa: an activity report. S Afr Dent J. 2001;56:327–329.
    1. Kalf-Scholte SM, Van Amerongen WE, Smith AJE, Van Haastrecht HJA. Atraumatic restorative treatment (ART): a three-year clinical study in Malawi—comparison of conventional amalgam and ART restorations. J Public Health Dent. 2003;63:99–103. doi: 10.1111/j.1752-7325.2003.tb03482.x.
    1. Phantumvanit P, Songpaisan Y, Pilot T, Frencken JE. Atraumatic restorative treatment (ART). Survival of one-surface restorations in the permanent dentition. J Public Health Dent. 1996;56:141–145. doi: 10.1111/j.1752-7325.1996.tb02424.x.
    1. Mandari GJ, Truin GJ, Van’T Hof MA, Frencken JE. Effectiveness of three minimal intervention approaches for managing dental caries: survival of restorations after 2 years. Caries Res. 2001;35:90–94. doi: 10.1159/000047438.
    1. Mandari GJ, Frencken JE, Van’T Hof MA. Six-year success rates of occlusal amalgam and glass-ionomer restorations placed using three minimal intervention approaches. Caries Res. 2003;37:246–253. doi: 10.1159/000070866.
    1. Frencken JE, Makoni F, Sithole WD, Hackenitz E. Three-year survival of one-surface ART restorations and glass-ionomer sealants in a school oral health programme in Zimbabwe. Caries Res. 1998;32:119–126. doi: 10.1159/000016441.
    1. De Souza EM, Cefaly DF, Terada RS, Rodrigues CC, De Lima Navarro MF. Clinical evaluation of the ART technique using high density and resin-modified glass ionomer cements. Oral Health Prev Dent. 2003;1:201–207.
    1. Frencken JE, Songpaisan Y, Phantumvanit P, Pilot T. Atraumatic restorative treatment (ART) technique: evaluation after 1 year. Int Dent J. 1994;44:460–464.
    1. Wang L, Lopes LG, Bresciani E, Lauris JR, Mondelli RF, De Lima Navarro MF. Evaluation of class I ART restorations in Brazilian schoolchildren; three-year results. Spec Care Dent. 2004;24:28–33. doi: 10.1111/j.1754-4505.2004.tb01676.x.
    1. Lo ECM, Holmgren CJ. Provision of atraumatic restorative treatment (ART) restorations to Chinese pre-school children—a 30 month evaluation. Int J Paediat Dent. 2001;11:3–10. doi: 10.1046/j.1365-263x.2001.00232.x.
    1. Yee R. An ART field study in western Nepal. Int Dent J. 2001;51:103–108. doi: 10.1002/j.1875-595X.2001.tb00830.x.
    1. van Den Dungen GM, Huddleston Slater AE, van Amerongen WE. ART of conventioneel? Onderzoeksresultaten van proximale restauraties in tijdelijke molaren. Ned Tijdschr Tandheelk. 2004;111:345–349.
    1. Zanata RL, Navarro MFL, Barbosa SH, Lauris JRP, Franco EB. Clinical evaluation of three restorative materials applied in a minimal intervention caries treatment approach. J Public Health Dent. 2003;63:221–226. doi: 10.1111/j.1752-7325.2003.tb03503.x.
    1. Falbo S, Grisoski M, Vivone G, Zac L. Dos años de atención comunitária con tecnica atraumática en ninõs escolares. Rev Asoc Odontol Argent. 2002;90:171–174.
    1. Moraes NM, Knupp R, Cabral I. Avaliação de dezoito meses de um programa de saúde bucal em alunos de uma escola municipal do Rio de Janeiro. Rev Bras Odontol. 2004;61:227–228.
    1. Oliveira MT, Bittencourt ST, Oliveira MDS, Roberta H, Pereira JR. Avaliação clínica do desempenho de TRA (tratamento restaurador atraumático) associado a um agente químico de remoção de cárie. Rev Odontol Ciênc. 2009;24:190–193.
    1. Silva JJS, Carvalho RB, Batittucci MHG, Silva KRS. Tratamento restaurador atraumático (TRA) em escolares do Morro São Benedito, município de Vitória, ES. J Bras Clín Odontol Integr. 2005;9:24–30.
    1. Bresciani E, Nogueira DA, Henostroza Quintans N, Barata TJE, Lauris JRP, Navarro MFL. Influência do isolamento absoluto sobre o sucesso do tratamento restaurador atraumático (ART) em cavidades classe II, em dentes decíduos. Rev Fac Odontol Bauru. 2002;10:231–237.
    1. Peres SHCS, Hussne R, Peres AS. Tratamento restaurador atraumático (ART) em crianças de 4 a 7 anos: avaliação clínica após 6 meses. Rev Inst Ciênc Saúde. 2005;23:275–280.
    1. Coelho FSM, Ribeiro CCC. Restaurações atraumáticas em odontopediatria (ART) Rev Gaú Odontol. 2002;50:105–110.
    1. Ewoldsen N, Cacho Z, Callahan S, Froeschle ML, Goel Brackett M. Tratamiento restaurador no traumático usando uma mezcla de cementos de ionómero de vidrio. Rev Asoc Dent Mex. 1999;56:8–11.
    1. Oliveira LMC (2000) Avaliação de um programa de tratamento restaurador atraumático em crianças institucionalizadas. PhD Thesis, Rio de Janeiro, p 168
    1. Bustamante C, Edelberg MH. Tratamiento restaurador atraumático (TRA) em dientes permanentes jóvenes. Resultados de 3 años: un procedimiento válido para la prevención e inactivación de caries en el marco de un programa comunitario de atención primaria. Rev Asoc Odontol Argent. 2004;92:155–159.
    1. Edelberg MH, Basso ML. Tratamiento restaurador atraumático. Rev Asoc Odontol Argent. 2000;88:43–47.
    1. Figueiredo MC, Froner AM, Rosito DB, Gallarreta FWM, Sampaio MS. A utilização da técnica de Tratamento Restaurador Atraumático (ART) em bebês: avaliação clínica de um ano. J Bras Odontopediatr Odontol Bebê. 1999;2:362–368.
    1. Honkala E, Behbehani J, Ibricevic H, Kerosuo E, Al-Jame G. The atraumatic restorative treatment (ART) approach to restoring primary teeth in a standard dental clinic. Int J Paediat Dent. 2003;13:172–179. doi: 10.1046/j.1365-263X.2003.00455.x.
    1. Taifour D, Frencken JE, Beiruti N, Hof MA, Truin GJ. Effectiveness of glass-ionomer (ART) and amalgam restorations in the deciduous dentition—results after 3 years. Caries Res. 2002;36:437–444. doi: 10.1159/000066531.
    1. Yip HK, Smales RJ, Yu C, Deng DM. Comparison of atraumatic restorative treatment and conventional cavity preparations for glass-ionomer restorations in primary molars: 1-year results. Quintessence Int. 2002;33:17–21.
    1. Yu C, Gao X-J, Deng D-M, Yip H-K, Smales RJ. Survival of glass ionomer restorations placed in primary molars using atraumatic restorative treatment (ART) and conventional cavity preparations: 2-year results. Int Dent J. 2004;54:42–46. doi: 10.1111/j.1875-595X.2004.tb00251.x.
    1. Louw AJ, Sarvan I, Chikte UME, Honkala E. One-year evaluation of atraumatic restorative treatment and minimal intervention techniques on primary teeth. S Afr Dent J. 2002;57:366–371.
    1. Luo Y, Wei SHY, Fan MW, Lo ECM. Clinical investigation of a high-strength glass ionomer restorative used with the ART technique in Wuhan, China: 1-year results. Chin J Dent Res. 1999;2:73–78.
    1. Lo ECM, Luo Y, Fan MW, Wei SHY. Clinical investigation of two glass-ionomer restoratives used with the atraumatic restorative treatment approach in China: 2-years results. Caries Res. 2001;35:458–463. doi: 10.1159/000047490.
    1. Ersin NK, Candan U, Aykut A, Onçag O, Eronat C, Kose T. A clinical evaluation of resin-based composite and glass ionomer cement restorations placed in primary teeth using the ART approach: results at 24 months. J Am Dent Assoc. 2006;137:1529–1536.
    1. Yassen G. One-year survival of ART occlusal restorations in primary molars placed with and without cavity conditioner. ASDC J Dent Child. 2009;76:136–141.
    1. Ziraps A, Honkala E. Clinical trial of a new glass ionomer for an atraumatic restorative treatment technique in class I restorations placed in Latvian school children. Med Princ Pract. 2002;11:44–47. doi: 10.1159/000057778.
    1. Lo EC, Holmgren CJ, Hu D, van Palenstein HW. Six-year follow up of atraumatic restorative treatment restorations placed in Chinese school children. Community Dent Oral Epidemiol. 2007;35:387–392. doi: 10.1111/j.1600-0528.2006.00342.x.
    1. Ho TFT, Smales RJ, Fang DKS. A 2-year clinical study of two glass ionomer cements used in the atraumatic restorative treatment (ART) technique. Community Dent Oral Epidemiol. 1999;27:195–201. doi: 10.1111/j.1600-0528.1999.tb02010.x.
    1. Kikwilu EN, Mandari GJ, Honkala E. Survival of Fuji IX fillings in permanent teeth of primary school children in Tanzania. East Afr Med J. 2001;78:19–21.
    1. Frencken JE, Taifour D, Van’t Hof MA. Survival of ART and amalgam restorations in permanent teeth of children after 6.3 years. J Dent Res. 2006;85:622–626. doi: 10.1177/154405910608500708.
    1. Yip KH-K, Smales RJ, Gao W, Peng D. The effects of two cavity preparation methods on longevity of glass ionomer cement restorations. An evaluation after 12 months. J Am Dent Assoc. 2002;133:744–751.
    1. Gao W, Peng D, Smales R, Yip KHK. Comparison of atraumatic restorative treatment and conventional restorative procedures in a hospital clinic: Evaluation after 30 months. Quintessence Int. 2003;34:31–37.
    1. Mickenautsch S, Rudolph MJ, Ogunbodede EO, Frencken JE. The impact of the ART approach on the treatment profile in a mobile dental system (MDS) in South Africa. Int Dent J. 1999;49:132–138. doi: 10.1002/j.1875-595X.1999.tb00897.x.
    1. Vieira ALF, Zanella NLM, Bresciani E, Barata TJE, Silva SMB, Machado MAAM, Navarro MFL. Evaluation of glass ionomer sealants placed according to the ART approach in a community with high-caries experience: 1-year follow-up. J Appl Oral Sci. 2006;14:270–275. doi: 10.1590/S1678-77572006000400011.

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