Class III atraumatic restorative treatment (ART) in adults living in West Africa--outcomes after 48 months

Twelve-month evaluation of the atraumatic restorative treatment approach for class III restorations: An interventional study

BACKGROUND

Atraumatic restorative treatment (ART) may be appropriate for populations without accessibility and affordability. More data are required regarding the success rate of ART in anterior teeth.

AIM

To evaluate the clinical performance of restoring class III cavities in anterior teeth of permanent dentition using the ART approach.

METHODS

A longitudinal interventional field study was carried out at two rural primary health centers, Tumkur district, India. A total of 54 teeth in 39 patients were evaluated for the survival rate of class III restorations in permanent anterior teeth using the ART approach in children and adult populations. Evaluation of ART restoration was carried out using Frencken J criteria, the mean procedure time, patient acceptance and reported pain severity during the ART approach were evaluated using a visual analog scale. Calculation of the cost of ART was also performed.

RESULTS

The mean time taken to perform the ART procedure was 14.79 ± 5.8 min with the majority of patients reporting only mild pain. At 6 mo follow-up, 72.2% remained in a good state, but this reduced to 27% at 12 mo. The cumulative survival rate of the restorations was 94.4% at 6 mo and 80.9% at 12 mo follow-up. Estimation of the direct cost for a single class III restoration was 186.50 INR (2.64 USD).

CONCLUSION

ART may be a good comprehensive option for basic oral health care for underserved or inaccessible populations, and preventive care for patients.

Survival percentages of atraumatic restorative treatment (ART) restorations and sealants in posterior teeth: an updated systematic review and meta-analysis

OBJECTIVE

The aim of the present study is to update the results of two previous meta-analyses, published in 2006 and 2012, on the survival percentages of atraumatic restorative treatment (ART) restorations and ART sealants. The current meta-analysis includes Chinese publications not investigated before.

MATERIALS AND METHODS

Until February 2017, six databases were interrogated (two English, one Portuguese, one Spanish and two Chinese). Using six exclusion criteria, a group of six independent reviewers selected 43 publications from a total of 1958 potentially relevant studies retrieved. Confidence intervals and/or standard errors were calculated and the heterogeneity variance of the survival rates was estimated.

RESULTS

The survival percentages and standard errors of single-surface and multiple-surface ART restorations in primary posterior teeth over the first 2 years were 94.3% (± 1.5) and 65.4% (± 3.9), respectively; for single-surface ART restorations in permanent posterior teeth over the first 3 years, they were 87.1% (± 3.2); and for multiple-surface ART restorations in permanent posterior teeth over the first 5 years, they were 77% (± 9.0). The mean annual dentine-carious-lesion-failure percentages in previously sealed pits and fissures using ART sealants in permanent posterior teeth over the first 3 and 5 years were 0.9 and 1.9%, respectively.

CONCLUSIONS

ART single-surface restorations presented high survival percentages in both primary and permanent posterior teeth, whilst ART multiple-surface restorations presented lower survival percentages. ART sealants presented a high-caries-preventive effect.

CLINICAL RELEVANCE

ART is an effective evidence-based option for treating and preventing carious lesions in primary and permanent posterior teeth.

Clinical effectiveness of basic root canal treatment after 24 months: a randomized controlled trial

INTRODUCTION

The purpose of this study was to investigate the effectiveness of basic root canal treatment (BRT) with tactile working length determination in terms of radiographic and clinical outcome parameters compared with endodontic treatment with standard radiographic working length control.

METHODS

This was a clinical, multicenter, controlled, open-label trial to evaluate BRT effectiveness after 24 months. The primary end point was the apical extension score of the radiographic quality parameter of root canal fillings. The secondary radiographic end point was the periapical index, and the secondary clinical end point was tooth tender to percussion. The safety end point was tooth loss as a consequence of endodontic failure. Statistical analyses of binary and categoric data were calculated using cross tables and the chi-square test.

RESULTS

BRT with tactile working length determination compared with standard radiographic working length control did not significantly differ in terms of radiographic and clinical outcomes after 24 months. The apical extension of the root canal fillings and the periapical anatomic structures showed no significant differences according to radiographic analyses (P = .5). Corresponding results were found in clinical aspects of tooth tender to percussion (P = .6) and tooth loss (P = .7).

CONCLUSIONS

Tactile working length determination in BRT resulted in comparable treatment outcomes compared with standard endodontic treatment with radiographic working length control and turned out to be an accurate method in BRT.