title: Effectiveness of ART and traditional amalgam approach in restoring single-surface cavities in posterior teeth of permanent dentitions in school children after 6.3 years.
abstract: OBJECTIVE
  The Atraumatic Restorative Treatment (ART) approach was compared with the traditional amalgam (TA) approach in order to test their appropriateness to complement a preventive and educational school oral health programme in Syria.
  
  
  METHODS
  Using a parallel group design, 370 and 311 grade 2 children were randomly assigned to the ART and the TA group respectively. Eight dentists placed 1117 single- and multiple-surface restorations. A modified actuarial method was used to estimate survival curves. The jackknife method was applied to calculate the standard error in the cumulative survival percentages.
  
  
  RESULTS
  A statistically significant difference in cumulative survival percentages between single-surface non-occlusal ART and comparable amalgam restorations was observed after 4.3, 5.3 and 6.3 years. The survival of single-surface non-occlusal ART posterior restorations (80.2 +/- 4.9%) was statistically significantly higher than that of occlusal posterior ART restorations (64.8 +/- 3.9%) at evaluation year 6.3. There was no statistically significant difference observed between survival percentages of large (55.8 +/- 10%) and that of small (69.2 +/- 4.6%) single-surface posterior ART restorations after 6.3 years. There was an operator effect observed for single-surface ART and comparable amalgam restorations. Secondary caries was observed in 2.3% of single-surface ART restorations and in 3.7% of single-surface amalgam restorations during the 6.3 year observation period.
  
  
  CONCLUSIONS
  The ART approach provided higher survival percentages for single-surface restorations than the TA approach over 6.3 years and is therefore appropriate for use in school oral health programmes. Secondary caries was only a minor reason for ART restorations to fail. An operator effect was observed for both treatment approaches.
authors.affiliation: WHO Collaborating Centre for Oral Health Care Planning and Future Scenarios, Radboud University Medical Centre, College of Dental Sciences, Nijmegen, The Netherlands. j.frencken@dent.umcn.nl
authors.forename: J E
authors.initials: JE
authors.lastname: Frencken
authors.forename: M A
authors.initials: MA
authors.lastname: van't Hof
authors.forename: D
authors.initials: D
authors.lastname: Taifour
authors.forename: I
authors.initials: I
authors.lastname: Al-Zaher
mesh_terms: D001641:Bicuspid; D002648:Child; D004245:DMF Index; D003723:Dental Amalgam; D003731:Dental Caries / Q000517:prevention & control / Q000628:therapy*; D003737:Dental Cavity Preparation / Q000145:classification / Q000379:methods; D003774:Dental Plaque Index; D003793:Dental Restoration, Permanent / Q000379:methods* / Q000706:statistics & numerical data; D005500:Follow-Up Studies; D005899:Glass Ionomer Cements; D006267:Health Education, Dental; D006801:Humans; D008963:Molar; D012008:Recurrence; D016019:Survival Analysis; D013593:Syria
chemical_list: D005899:Glass Ionomer Cements; C110713:fuji IX; C110712:ketac-molar; D003723:Dental Amalgam