Revista de Odontologia da UNESP
http://revodontolunesp.com.br/article/doi/10.1590/1807-2577.03318
Revista de Odontologia da UNESP
Original Article

Survival analysis of ART restorations in primary molars of preschool children: 1 year follow-up

Análise de sobrevivência de restaurações ART em molares decíduos de crianças com idade pré-escolar: acompanhamento de 1 ano

Marcia Falleiros Evangelista da ROCHA; Mitsue FUJIMAKI; Renata Corrêa PASCOTTO; Lucila Lemuch Castilho MENDES; Carla Martins LACERDA; Omar Cléo PEREIRA; Renata Iani WERNECK; Raquel Sano Suga TERADA

Abstract

Abstract: Among the minimally invasive approaches available today, the atraumatic restorative treatment (ART) has demonstrated promising results both in the primary and permanent dentition.

Objective: To evaluate the survival of Class I ART restorations in preschoolers with two Brazilian brands of glass ionomer cements (GIC) in comparison with a reference GIC.

Material and method: The cavities of 49 preschool children (three to five years) with carious lesions in the posterior teeth (N=81) were filled by two experienced pediatric dentists according to the ART technique. The Brazilian GICs Maxxion-R (MR) and Vitro-Fil LC (VF), and the reference GIC Ketac-Molar (KM) were placed in a randomly pre-established sequence. Restorations were evaluated after 6 and 12 months by another investigator. Scores 0 and 1 were considered successful, while scores 3-9 were classified as failures. Kaplan-Meier survival analysis and the log-rank test were performed (p<0.05).

Result: No statistically significant differences in survival rates of the tested GIC were observed after 12 months.

Conclusion: The clinical performance the low-cost Brazilian GICs MR and VF observed after 12 months suggests that they may be an alternative for Class I ART restorations to safeguard the natural exfoliation of primary teeth. However, until further studies involving a larger number of restorations and longer follow-up periods are conducted, reference GIC such as KM should continue to be the material of choice for ART restorations.

Keywords

Dental atraumatic restorative treatment, glass ionomer cements, clinical trial

Resumo

Resumo: Dentre as abordagens minimamente invasivas atualmente disponíveis, o tratamento restaurador atraumático (ART) demonstra resultados promissores tanto na dentadura decídua quanto permanente.

Objetivo: Avaliar a sobrevivência de restaurações ART Classe I, em pré-escolares, com duas marcas brasileiras de cimentos de ionômeros de vidro (CIV) em comparação com um CIV de referência.

Material e método: Cavidades de 49 crianças pré-escolares (três a cinco anos de idade) com lesões cariosas nos dentes posteriores (N = 81) foram preenchidas por dois odontopediatras experientes, de acordo com a técnica ART. Os CIV brasileiros Maxxion-R (MR) e Vitro-Fil LC (VF) e o CIV de referência, Ketac-Molar (KM), foram inseridos em uma sequência pré-estabelecida aleatoriamente. As restaurações foram avaliadas após 6 e 12 meses por outro pesquisador. As pontuações 0 e 1 foram consideradas bem-sucedidas, enquanto as pontuações 3-9 foram classificadas como falhas. Foram aplicadas a análise de sobrevivência de Kaplan-Meier e o teste log-rank (p <0,05).

Resultado: Não foram observadas diferenças estatisticamente significativas nas taxas de sobrevivência dos CIV testados após 12 meses.

Conclusão: O desempenho clínico dos CIV brasileiros MR e VF, observado após 12 meses, sugere que estes podem ser uma alternativa para restaurações ART Classe I para proteger a esfoliação natural dos dentes decíduos. No entanto, até que sejam realizados estudos adicionais envolvendo um maior número de restaurações e períodos de acompanhamento mais longos, os CIV de referência, como o KM, devem continuar sendo o material de escolha para as restaurações ART.
 

Palavras-chave

Tratamento restaurador dental sem trauma, cimentos de ionômeros de vidro, ensaio clínico

References

Sheiham A, James WP. Diet and dental caries: the pivotal role of free sugars reemphasized. J Dent Res. 2015 Oct;94(10):1341-7. http://dx.doi.org/10.1177/0022034515590377. PMid:26261186.

Brasil. Ministério da Saúde. Departamento de Atenção Básica. Coordenação Geral de Saúde Bucal. Projeto SBBrasil 2010 [Internet]. Brasília: Ministério da Saúde; 2011 [cited 2018 Mar 8]. Available from: dab.saude.gov.br/CNSB/sbbrasil/.../Projeto_SB2010_VersaoFinal.pdf

Petersen PE. Sociobehavioural risk factors in dental caries: international perspectives. Community Dent Oral Epidemiol. 2005 Aug;33(4):274-9. http://dx.doi.org/10.1111/j.1600-0528.2005.00235.x. PMid:16008634.

Deepa G, Shobha T. A clinical evaluation of two glass ionomer cements in primary molars using atraumatic restorative treatment technique in India: 1 year follow up. Int J Paediatr Dent. 2010 Nov;20(6):410-8. http://dx.doi.org/10.1111/j.1365-263X.2010.01067.x. PMid:20642467.

Roshan NM, Sakeenabi B. Survival of occlusal ART restorations in primary molars placed in school environment and hospital dental setup-one year follow-up study. Med Oral Patol Oral Cir Bucal. 2011 Nov;16(7):e973-7. PMid:21743396.

Ibiyemi O, Bankole OO, Oke GA. Assessment of atraumatic restorative treatment (ART) on the permanent dentition in a primary care setting in Nigeria. Int Dent J. 2011 Feb;61(1):2-6. http://dx.doi.org/10.1111/j.1875-595X.2011.00001.x. PMid:21382026.

Zanata RL, Fagundes TC, Freitas MC, Lauris JR, Navarro MF. Ten-year survival of ART restorations in permanent posterior teeth. Clin Oral Investig. 2011 Apr;15(2):265-71. http://dx.doi.org/10.1007/s00784-009-0378-x. PMid:20140470.

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 Jul-Aug;37(4):246-53. http://dx.doi.org/10.1159/000070866. PMid:12771499.

Frencken JE. Survival of single surface ART-restorations in Zimbabwe after 3 years. Ned Tijdschr Tandheelkd. 1999 Jun;106(6):214-8. PMid:11930476.

Amorim RG, Leal SC, Mulder J, Creugers NH, Frencken JE. Amalgam and ART restorations in children: a controlled clinical trial. Clin Oral Investig. 2014 Jan;18(1):117-24. http://dx.doi.org/10.1007/s00784-013-0955-x. PMid:23455576.

Frencken JE, Pilot T, Songpaisan Y, Phantumvanit P. Atraumatic restorative treatment (ART): rationale, technique, and development. J Public Health Dent. 1996;56(3):135-40. http://dx.doi.org/10.1111/j.1752-7325.1996.tb02423.x. PMid:8915958.

Van’t Hof M, Frencken JE, Van Palenstein Helderman WH, Holmgren CJ. The atraumatic restorative treatment (ART) approach to managing dental caries: a meta-analisys. Int Dent J. 2006 Dec;56(6):345-51. http://dx.doi.org/10.1111/j.1875-595X.2006.tb00339.x. PMid:17243467.

Frencken JE, Leal SC, Navarro MF. Twenty-five-year atraumatic restorative treatment (ART) approach: a comprehensive overview. Clin Oral Investig. 2012 Oct;16(5):1337-46. http://dx.doi.org/10.1007/s00784-012-0783-4. PMid:22824915.

Mickenautsch S, Yengopal V, Banerjee A. Atraumatic restorative treatment versus amalgam restoration longevity: a systematic review. Clin Oral Investig. 2010 Jun;14(3):233-40. http://dx.doi.org/10.1007/s00784-009-0335-8. PMid:19688227.

Amorim RG, Leal SC, Frencken JE. Survival of atraumatic restorative treatment (ART) sealants and restorations: a meta-analysis. Clin Oral Investig. 2012 Apr;16(2):429-41. http://dx.doi.org/10.1007/s00784-011-0513-3. PMid:21274581.

Molina GF, Cabral RJ, Frencken JE. The ART approach: clinical aspects reviewed. J Appl Oral Sci. 2009;17(spe Suppl):89-98. http://dx.doi.org/10.1590/S1678-77572009000700016. PMid:21499662.

Ismail AI, Sohn W, Tellez M, Amaya A, Sen A, Hasson H, et al. The International Caries Detection and Assessment System (ICDAS): an integrated system for measuring dental caries. Community Dent Oral Epidemiol. 2007 Jun;35(3):170-8. http://dx.doi.org/10.1111/j.1600-0528.2007.00347.x. PMid:17518963.

Kishore J, Goel MK, Khanna P. Understanding survival anaysis: Kaplan-Meier estimate. Int J Ayurveda Res. 2010 Oct;1(4):274-8. http://dx.doi.org/10.4103/0974-7788.76794. PMid:21455458.

R Foundation for Statistical Computing. R: a language and environment for statistical computing. Vienna: R Foundation for Statistical Computing.

Bonifácio CC, Hesse D, Raggio DP, Bönecker M, Van Loveren C, Van Amerongen WE. The effect of GIC-brand on the survival rate of proximal-ART restorations. Int J Paediatr Dent. 2013 Jul;23(4):251-8. http://dx.doi.org/10.1111/j.1365-263X.2012.01259.x. PMid:22891625.

Shintome LK, Nagayassu MP, Di Nicoló R, Myaki SI. Microhardness of glass ionomer cements indicated for the ART technique according to surface protection treatment and storage time. Braz Oral Res. 2009 Oct-Dec;23(4):439-45. http://dx.doi.org/10.1590/S1806-83242009000400014. PMid:20027452.

Bonifácio CC, Kleverlaan CJ, Raggio DP, Werner A, Carvalho RC, Van Amerongen WE. Physical-mechanical properties of glass ionomer cements indicated for atraumatic restorative treatment. Aust Dent J. 2009 Sep;54(3):233-7. http://dx.doi.org/10.1111/j.1834-7819.2009.01125.x. PMid:19709111.

Carvalho TS, Van Amerongen WE, Gee A, Bönecker M, Sampaio FC. Shear bond strengths of three glass ionomer cements to enamel and dentine. Med Oral Patol Oral Cir Bucal. 2011 May;16(3):e406-10. http://dx.doi.org/10.4317/medoral.16.e406. PMid:20526266.

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(4):295-8. http://dx.doi.org/10.17796/jcpd.33.4.001283522r230h70. PMid:19725234.

Anusavice KJ. Does ART have a place in preservative dentistry? Community Dent Oral Epidemiol. 1999 Dec;27(6):442-8. http://dx.doi.org/10.1111/j.1600-0528.1999.tb02046.x. PMid:10600079.

Kemoli AM, Opinya GN, Van Amerongen WE, Mwalili SM. Two-year survival rates of proximal atraumatic restorative treatment restorations in relation to glass ionomer cements and postrestoration meals consumed. Pediatr Dent. 2011 May-Jun;33(3):246-51. PMid:21703078.
 

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