title: One year survival of ART and conventional restorations in patients with disability.
abstract: BACKGROUND
  Providing restorative treatment for persons with disability may be challenging and has been related to the patient's ability to cope with the anxiety engendered by treatment and to cooperate fully with the demands of the clinical situation. The aim of the present study was to assess the survival rate of ART restorations compared to conventional restorations in people with disability referred for special care dentistry.
  
  
  METHODS
  Three treatment protocols were distinguished: ART (hand instruments/high-viscosity glass-ionomer); conventional restorative treatment (rotary instrumentation/resin composite) in the clinic (CRT/clinic) and under general anaesthesia (CRT/GA). Patients were referred for restorative care to a special care centre and treated by one of two specialists. Patients and/or their caregivers were provided with written and verbal information regarding the proposed techniques, and selected the type of treatment they were to receive. Treatment was provided as selected but if this option proved clinically unfeasible one of the alternative techniques was subsequently proposed. Evaluation of restoration survival was performed by two independent trained and calibrated examiners using established ART restoration assessment codes at 6 months and 12 months. The Proportional Hazard model with frailty corrections was applied to calculate survival estimates over a one year period.
  
  
  RESULTS
  66 patients (13.6 ± 7.8 years) with 16 different medical disorders participated. CRT/clinic proved feasible for 5 patients (7.5%), the ART approach for 47 patients (71.2%), and 14 patients received CRT/GA (21.2%). In all, 298 dentine carious lesions were restored in primary and permanent teeth, 182 (ART), 21 (CRT/clinic) and 95 (CRT/GA). The 1-year survival rates and jackknife standard error of ART and CRT restorations were 97.8 ± 1.0% and 90.5 ± 3.2%, respectively (p = 0.01).
  
  
  CONCLUSIONS
  These short-term results indicate that ART appears to be an effective treatment protocol for treating patients with disability restoratively, many of whom have difficulty coping with the conventional restorative treatment.
  
  
  BACKGROUND
  Netherlands Trial Registration: NTR 4400.
authors.affiliation: Cátedra de Materiales Dentales, Facultad de Odontología, Universidad Nacional de Córdoba, Av, Maipú 177 4, B - 5000 Córdoba, Argentina. gfmolina@hotmail.com.
authors.forename: Gustavo F
authors.initials: GF
authors.lastname: Molina
authors.forename: Denise
authors.initials: D
authors.lastname: Faulks
authors.forename: Ignacio
authors.initials: I
authors.lastname: Mazzola
authors.forename: Jan
authors.initials: J
authors.lastname: Mulder
authors.forename: Jo E
authors.initials: JE
authors.lastname: Frencken
mesh_terms: D000293:Adolescent; D000328:Adult; D000766:Anesthesia, Dental / Q000706:statistics & numerical data; D000768:Anesthesia, General / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D003188:Composite Resins / Q000737:chemistry; D004245:DMF Index; D057087:Dental Atraumatic Restorative Treatment / Q000295:instrumentation / Q000706:statistics & numerical data*; D003730:Dental Care for Persons with Disabilities / Q000706:statistics & numerical data*; D003764:Dental Materials / Q000737:chemistry; D003774:Dental Plaque Index; D019232:Dental Restoration Failure / Q000706:statistics & numerical data; D003793:Dental Restoration, Permanent / Q000295:instrumentation / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D005899:Glass Ionomer Cements / Q000737:chemistry; D006801:Humans; D008297:Male; D009911:Oral Hygiene Index; D010512:Periodontal Index; D016016:Proportional Hazards Models; D016019:Survival Analysis; D014094:Tooth, Deciduous / Q000473:pathology; D055815:Young Adult
chemical_list: D003188:Composite Resins; D003764:Dental Materials; D005899:Glass Ionomer Cements