Failure rate of high-viscosity GIC based ART compared with that of conventional amalgam restorations--evidence from an update of a systematic review.
BACKGROUND
Atraumatic Restorative Treatment (ART) involves using only hand instruments for removing carious tooth tissue and then restoring the resulting cavity with an adhesive restorative material.


OBJECTIVE
To answer the question as to whether, in patients with carious cavities of any class in primary and permanent teeth, ART restorations with high-viscosity glass-ionomer cement (GIC) have a higher failure rate than amalgam restorations placed after drilling, in tooth cavities of the same size, dentition and follow-up period.


METHODS
Thirteen databases were searched for relevant trials up to January 2012. Hand-searching was performed for non indexed journals. References of included trials were checked. Prospective, clinical controlled trials with a followup period of at least one year were selected. The investi gated outcome was restoration failure. Meta-analysis was conducted and internal trial validity was assessed in-depth.


RESULTS
Twenty trials were accepted for review. The majority of the results show no differences between the types of intervention. The current evidence indicates that the failure rate of high-viscosity GIG/ART restorations is not higher than, but is similar to that of conventional amalgam fillings after periods longer than six years. There is a risk that these results are affected by bias and confirmation by further trials is recommended.
Department of Community Dentistry, Faculty of Health Sciences, University of the Witwatersrand, Parktown/Johannesburg, South Africa. neem@global.co.za
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Mickenautsch
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Yengopal
D015982:Bias; D003723:Dental Amalgam / Q000737:chemistry*; D057087:Dental Atraumatic Restorative Treatment; D019232:Dental Restoration Failure; D003793:Dental Restoration, Permanent; D005899:Glass Ionomer Cements / Q000737:chemistry*; D006801:Humans; D014783:Viscosity
D005899:Glass Ionomer Cements; D003723:Dental Amalgam