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

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.摘要 在当前临床可用的微创诊疗手段中，非创伤性修复治疗（atraumatic restorative treatment，ART）在乳牙列与恒牙列中均展现出良好的应用前景。 研究目的 评估两款巴西产玻璃离子水门汀（glass ionomer cements，GIC）用于学龄前儿童I类ART修复体的留存率，并与参比GIC进行对比。 材料与方法 由2名经验丰富的儿童牙科医师按照ART技术，对49名3~5岁学龄前儿童后牙的81处龋损病灶完成充填修复。受试材料包括巴西产的Maxxion-R（MR）、Vitro-Fil LC（VF）两款玻璃离子水门汀，以及参比材料Ketac-Molar（KM），所有材料按照预先随机设定的顺序进行充填。由另一名研究者分别在修复后6个月与12个月对修复体进行疗效评估。将评分0分与1分判定为修复成功，评分3~9分则归类为修复失败。采用Kaplan-Meier生存分析与对数秩检验进行统计学分析（p<0.05）。 结果 12个月随访时，受试各GIC的修复体留存率未出现统计学显著性差异。 结论 12个月随访观察显示，低成本巴西产GIC（MR与VF）的临床性能表明，其可作为I类ART修复体的替代材料，以保障乳牙的自然脱落。不过在开展更多涉及更大样本修复体量与更长随访周期的研究之前，Ketac-Molar（KM）这类参比GIC仍应作为ART修复的首选材料。