Effectiveness of three minimal intervention approaches for managing dental caries: survival of restorations after 2 years.
The present study was aimed at comparing the effectiveness of three minimally invasive restorative treatment approaches for dentinal lesions in occlusal surfaces. The approaches tested comprised a conventional and a modified-conventional treatment and a modified Atraumatic Restorative Treatment (ART). The conventional approach was performed in a university dental clinic whilst the modified-conventional, employing portable equipment, and the modified ART, using hand instruments and a caries removal solution (Caridex, were carried out in the field. Using the split-mouth design, 430 matched contralateral pairs of occlusal cavities were restored with amalgam or glass-ionomers in permanent molars of 152 school children by one dental therapist. The restorations were assessed using a modified USPHS-Ryge criteria. After 2 years, the cumulative survival percentages for occlusal amalgam and glass-ionomer restorations were 92 and 96%, respectively. The survival of all restorations in the conventional, modified-conventional and the modified ART group was 96, 96 and 91%, respectively. The survival of occlusal amalgam and glass-ionomer restorations per treatment group was as follows: 94 and 99%, respectively (conventional group); 95 and 97%, respectively (modified-conventional group), and 89 and 93%, respectively (modified ART group). The differences in survival percentage between restorations with amalgam and glass-ionomer, and between the three restorative treatment approaches were not statistically significant. In countries facing scarcity in resources for dental care, ART seems a promising restorative approach to occlusal caries in posterior teeth. However, a longer clinical observation period is required to substantiate this initial conclusion.
Mandari
G J
GJ
Department of Restorative Dentistry, University of Dar es Salaam, Tanzania. Gmandari@muchs.ac.tz
Truin
G J
GJ
van't Hof
M A
MA
Frencken
J E
JE
D000613:Aminobutyrates / Q000627:therapeutic use; D000704:Analysis of Variance; D002126:Calcium Hydroxide; D016022:Case-Control Studies; D002648:Child; D016001:Confidence Intervals; D003723:Dental Amalgam; D003731:Dental Caries / Q000628:therapy*; D003737:Dental Cavity Preparation; D003785:Dental Pulp Capping; D019232:Dental Restoration Failure; D003793:Dental Restoration, Permanent / Q000379:methods*; D003804:Dentin / Q000473:pathology; D016021:Epidemiologic Studies; D005500:Follow-Up Studies; D005899:Glass Ionomer Cements; D006801:Humans; D008963:Molar / Q000473:pathology; D015588:Observer Variation; D012008:Recurrence; D015203:Reproducibility of Results; D012423:Rural Health; D013223:Statistics as Topic; D016019:Survival Analysis; D013636:Tanzania; D016896:Treatment Outcome; D014504:Urban Health
D000613:Aminobutyrates; D005899:Glass Ionomer Cements; C018172:GK 101E; D003723:Dental Amalgam; D002126:Calcium Hydroxide