Atraumatic Restorative Treatment compared to the Hall Technique for occluso-proximal cavities in primary molars: study protocol for a randomized controlled trial The influence of restorative treatment approaches and the use of local analgesia, on the children's discomfort. Self-report of pain in children treated according to the atraumatic restorative treatment and the conventional restorative treatment--a pilot study. Restorative Outcomes of a Minimally Invasive Restorative Approach Based on Atraumatic Restorative Treatment to Manage Early Childhood Caries: A Randomised Controlled Trial The dilemma of selecting suitable proximal carious lesions in primary molars for restoration using ART technique. A clinical study of the "open sandwich" technique in pediatric dental practice. Effects of oral hygiene, residual caries and cervical Marginal-gaps on the survival of proximal atraumatic restorative treatment approach restorations The longevity of different restorations in primary teeth. Recommendations for conducting controlled clinical studies of dental restorative materials Efficacy of conventional treatment with composite resin and atraumatic restorative treatment in posterior primary teeth: study protocol for a randomised controlled trial A prospective randomized clinical trial of one bis-GMA-based and two ormocer-based composite restorative systems in class II cavities: Five-year results. Evidence-based clinical practice guideline on nonrestorative treatments for carious lesions: A report from the American Dental Association. Design and Validity of Randomized Controlled Dental Restorative Trials A prospective randomised clinical trial of one bis-GMA-based and two ormocer-based composite restorative systems in class II cavities: three-year results. Provision of Atraumatic Restorative Treatment (ART) restorations to Chinese pre-school children--a 30-month evaluation. Effectiveness of Three Minimal Intervention Approaches for Managing Dental Caries: Survival of Restorations after 2 Years A clinical evaluation of two glass ionomer cements in primary molars using atraumatic restorative treatment technique in India: 1 year follow up.
Background In many parts of the world , school-age children have high dental treatment needs ; however , there is often low , or no , dental care provision . Although Atraumatic Restorative Treatment ( ART ) was developed to address this , its survival rate in occluso-proximal lesions is low . An alternative , the Hall Technique ( HT ) has shown better relative outcomes for occluso-proximal lesions , but has not been directly compared to ART or tested in field setting s. This trial will compare ART and the HT for the most clinical ly- and cost-effective strategy for managing occluso-proximal lesions in primary molars , in a school setting , using low-technology and child-friendly dental techniques . Methods / Design This two-arm , parallel group , patient-r and omized controlled , superiority trial will have treatment provided in schools . Schoolchildren ( n = 124 , age 6–8 ) with at least one occluso-proximal carious primary molar lesion will have r and om allocation to treatment with ART or HT . Baseline measures and outcome data will be assessed through participant report , clinical examination and parent report/ question naires . The primary outcome is survival rate , a composite measure of absence of Minor Failures ( a defect in the restoration/crown , but not interfering with tooth health ) and Major Failures ( signs or symptoms of irreversible pulp damage , such as dental fistula/abscess , tooth fracture or failures that can not be repaired ) . Secondary outcomes are : ( 1 ) child-reported discomfort , ( 2 ) childrens ’ and ( 3 ) parents ’ concerns around dental appearance and ( 4 ) acceptability of treatments , ( 5 ) occlusal-vertical dimensions ( OVD ) changes , ( 6 ) plaque index , ( 7 ) gingival health , ( 8) decayed , missing , filled teeth in permanent teeth (DMFT)/decayed , missing , filled teeth in primary teeth ( dmft ) , ( 9 ) oral health-related- quality of life , reported by children and parents/caregivers , ( 10 ) the incremental cost-effectiveness , and ( 11 ) operator effect . A trained and calibrated examiner will evaluate the treated teeth after 1 week , then 1 , 6 , 12 , 24 and 36 months post treatment . Kaplan-Meier and Cox regression tests will be used to investigate the primary outcome . The Mann-Whitney or t test , Friedman test , paired t test or Wilcoxon test and Ordinal Logistic Regression Analysis will be used to analyze the secondary outcomes . Discussion The results of this trial will support decision-making by clinicians and policy-makers for managing occluso-proximal lesions in setting s with constrained re sources and limited dental access . Trial registration www . clinical trials.gov , NCT02569047 , registered 5 October 2015 AIM The aim is to investigate possible differences in discomfort during treatment with the atraumatic restorative treatment ( ART ) or the Conventional restorative method with and without local analgesia ( LA ) . METHODS The study group consisted of 6 and 7 year old children with no dental experience ( mean age 6.98 , SD + /- 0.52 ) r and omly divided into four treatment groups : Conventional method with and without LA and ART with and without LA . One or two proximal lesions in primary molars were treated . The heart rate and the behaviour ( Venham ) were measured . STATISTICS Statistical analysis was performed in SPSS version 10.0 . RESULTS In a first session 300 children were treated and 109 children for a second time in the same way as at the first visit . During the first session ART without LA gave the least discomfort while the Conventional method without LA gave the most discomfort . During the second treatment the least discomfort was observed with ART without LA and the most discomfort in the Conventional way with LA . CONCLUSION There is a constant preference for h and instruments ; the bur is increasingly accepted . The experience with LA is the reverse OBJECTIVE To compare the level of pain among children treated according to the Atraumatic Restorative Treatment ( ART ) and the Conventional Restorative Treatment ( CRT ) .  STUDY DESIGN Forty children of both genders , 4- to 7-years old , presenting Class I cavitated dentin lesions in primary molars were r and omly allocated to 2 groups . One group ( CRT ) received conventional restorative treatment using rotary instruments , while in the other one ( ART ) h and instruments were used to perform the restorations . All children were treated by the same operator A high-viscosity glass-ionomer cement ( Fuji IX ) was used to restore the teeth in both groups . Children 's pain was measured at the end of the first restorative treatment session using the Wong-Baker FACES Pain Rating Scale ( dependent variable ) . Age , gender , treatment time and treatment group were independent variables . ANOVA and ANCOVA tests were used to analyze the data . RESULTS The CRT procedure took longer than the ART procedure ( p < 0.001 ) . Children from the ART group reported less pain than those from the CRT group ( p = 0.0037 ) . Four year olds reported more pain than 5- to 7-year olds ( p < 0.0001 ) in both groups . CONCLUSIONS Restorations placed using ART were less time consuming , children felt less pain when the ART approach was used , and younger children ( 4-years ) reported more pain than the older ones for both restorative treatments A pragmatic r and omised controlled trial comparing a minimally invasive approach based on atraumatic restorative treatment ( ART ) procedures ( test ) was tested against the st and ard-care approach ( control ) to treat early childhood caries ( ECC ) in a primary -care setting in Perth , W.A. , Australia . Parent/child dyads with ECC were allocated to the test or control group using stratified block r and omisation . Children were examined at baseline and follow-up by two calibrated examiners blinded to group allocation status . Dental therapists trained in ART provided treatment to the test group and dentists treated the control group . Restoration quality was evaluated at follow-up using the ART criteria . Data were analysed on an intention-to-treat basis ; test of proportions , Wilcoxon rank test and logistic regression , controlling for clustering of teeth , were used . Two hundred and fifty-four children were r and omised ( test = 127 and control = 127 ) . There was no statistically significant difference in age , sex and baseline caries experience between the test and control groups . At follow-up ( mean interval 11.4 months , SD 3.1 ) , 220 children were examined ( test = 115 and control = 105 ) and 597 teeth ( test = 417 and control = 180 ) were evaluated for restoration quality , of which 16.8 % ( test ) and 6.7 % ( control ) were judged to have failed ( required replacement ; p < 0.01 ) . Intention-to-treat , multiple logistic regression found multisurface restorations ( OR = 10.4 ) had significantly higher odds of failure , while referral for specialist paediatric care had significantly lower odds of restoration failure ( OR = 0.2 ) . The ART-based approach enabled more children and teeth to be treated , and multisurface restoration and treatment in a primary -care setting had higher odds of restoration failure OBJECTIVE To determine the examiner 's accuracy in selecting proximal carious lesions in primary molars for restoration using the atraumatic restorative treatment ( ART ) approach . BASIC RESEARCH DESIGN Intervention study . CLINICAL SETTING AND PARTICIPANTS : A total of 804 six to eight year-olds from 30 rural schools in Kenya participated in the study . INTERVENTION Three examiners selected a total of 1,280 suitable proximal carious lesions in primary molars after examining 6,002 children from 30 schools r and omly selected out of 142 schools in two divisions . Seven operators r and omly paired on a daily basis with eight assistants restored the lesions . An explanation was provided for any cavity that was not restored . Pre- and post-operative  radiographs of the cavities were also taken for evaluation . MAIN OUTCOME MEASURES The examiner 's choice of suitable proximal cavities restorable using the ART approach  was related to the decision made to either restore or not during the operative stage . The radiographic findings of the selected cavities were also compared to the decision made by the operator . The results obtained were used to determine the examiner 's accuracy in selecting suitable proximal cavities for restoration using the ART approach . RESULTS The majority of the children recruited in the study were excluded due to absenteeism , pulpal-exposure or anxiety during the operative stage . Only 804 children received one restoration in their primary molars . The examiner 's accuracy in selecting suitable ART-restorable cavities  clinical ly was 94.9 % and based on radiographic analysis was 91.7 % . CONCLUSIONS A trained and diligent examiner has a very good chance of selecting proximal carious lesions restorable with the use of ART approach , without the threat of dental pulpal-involvement during the excavation of caries PURPOSE This study evaluated the clinical efficacy of the " open s and wich " restoration for pediatric dental practice . METHODS Three pediatric dentists used a st and ardized preparation and restorative technique to place the restorations . The prepared tooth was etched with a phosphoric acid semigel and rinsed . A resin modified glass ionomer ( Fuji II LCor Photac-Fil ) was placed short of the margins and then light cured . The resin modified glass ionomer was covered with an occlusal layer of a microhybrid flowable composite ( Aeliteflo or Flow-it ) . The same preparation for the experimental restorations was used for the control conventional amalgam ( Tytin ) restorations . The restorations were evaluated at 6-month intervals and ranked with a modified United States Public Heath Survey ( USPHS ) scale as follows : Alfa : No discernible marginal opening or stain ; Beta : Slight opening of margin discernible with dental explorer , but without stain ; Charlie : Open margin and stain ; Delta : Recurrent caries or restoration failure . Restoration failures were categorized according to etiology , pulpal necrosis , bruxism , marginal leakage , isthmus fracture , or adhesive failure . RESULTS All recalled experimental restorations , except 8 , were rated as either Alpha or Beta . Six failed due to isthmus fracture and 2 due to pulpal necrosis . Fifteen restorations had delaminating of the flowable composite from the resin modified glass ionomer . The use of the " open s and wich " technique compared favorably with a similar study using adhesive amalgam restorations . CONCLUSIONS The " open s and wich " technique can be successfully used in a pediatric dental practice Background : Although Atraumatic restorative treatment ( ART ) approach has been in existence for a while , the reasons for the poor performance of multisurface ART restorations are not very clear . Aim : The aim of this study is to investigate the effects of oral hygiene , residual caries and cervical marginal-gaps on survival of proximal ART restorations . Setting s : Two rural divisions in Kenya were selected for the study . Design : A r and omized clinical trial . Material and Methods : The 804 children in the study had their baseline- and 2-year dental plaque levels documented . Each child received one proximal restoration in a primary molar using ART approach , together with trained and pre-tested operators/assistants , three glass ionomer cements (GIC)-br and s and two tooth-isolation methods . The restorations were clinical ly evaluated soon after placement and after 2 years . Post-restorative bite-wing radiographs taken soon after restoration were also evaluated . Statistical analysis : Statistical Package for Social Sciences ( SPSS ) version 14 computer programme was used and results tested using Pearson 's correlation , Cox Proportional Hazards regression analysis and Multiple Logistic regression models tests . Results : At baseline and after 2 years , the mean cumulative survival and plaque index changed from 94.4 % to 30.8 % and 2.34 ( St and ard Deviation , or SD of 0.46 ) to 1.92 ( SD 2.1 ) respectively , with higher plaque indices associated with higher restoration failures . Of the 507 radiographs evaluated , 48 ( 9.5 % ) , 63 ( 12.4 % ) and 9 ( 1.8 % ) restorations had residual caries ( RC ) , cervical marginal-gaps ( CMG ) and both RC/CMG respectively . Survival of the restorations with RC/CMG was significantly lower ( p = 0.003 ) compared to those with RC or without RC . Conclusion : Low survival of proximal restorations in the study was associated with the presence of cervical marginal-gaps BACKGROUND AND AIM This paper review s three published papers and adds results from a fourth study which aim ed to determine which restorative material would be the best alternative(s ) to amalgam ( AM )  in primary teeth . DESIGN All studies had a practice -based design and were part of the routine treatment of children and adolescents . The clinicians were assigned which material s to use in a r and omised matter in the first three studies which lasted for 7 - 8 years . In the fourth study conducted 4 years after the initial studies , the clinicians were free to select the restorative material s. RESULTS AND CONCLUSIONS Resin modified glass ionomer ( RMGI ) and compomer ( COM ) restorations showed similar longevity compared with AM , whereas conventional GI restorations showed significantly shorter longevity . The studies indicated that the ' new and improved ' material s based on in vitro tests did not always show enhanced clinical properties . In the last study , where clinicians freely selected the restorative material s they used in their practice s , seven used COM , one used conventional GI material s and one used a combination of the two types of material About 35 years ago , Ryge provided a practical approach to evaluation of clinical performance of restorative material s. This systematic approach was soon universally accepted . While that methodology has served us well , a large number of scientific method ologies and more detailed questions have arisen that require more rigor . Current restorative material s have vastly improved clinical performance and any changes over time are not easily detected by the limited sensitivity of the Ryge criteria in short term clinical investigations . However , the clinical evaluation of restorations not only involves the restorative material per se but also different operative techniques . For instance , a composite resin may show good longevity data when applied in conventional cavities but not in modified operative approaches . Insensitivity , combined with the continually evolving and non-st and ard investigator modifications of the categories , scales , and reporting methods , has created a body of literature that is extremely difficult to meaningfully interpret . In many cases , the insensitivity of the original Ryge methods is misinterpreted as good clinical performance . While there are many good features of the original system , it is now time to move to a more contemporary one . The current review approaches this challenge in two ways : ( 1 ) a proposal for a modern clinical testing protocol for controlled clinical trials , and ( 2 ) an in-depth discussion of relevant clinical evaluation parameters , providing 84 references that are primarily related to issues or problems for clinical research trials . Together , these two parts offer a st and ard for the clinical testing of restorative material s/ procedures and provide significant guidance for research teams in the design and conduct of contemporary clinical trials . Part 1 of the review considers the recruitment of subjects , restorations per subject , clinical events , validity versus bias , legal and regulatory aspects , rationale s for clinical trial design s , guidelines for design , r and omization , number of subjects , characteristics of participants , clinical assessment , st and ards and calibration , categories for assessment , criteria for evaluation , and supplemental documentation . Part 2 of the review considers categories of assessment for esthetic evaluation , functional assessment , biological responses to restorative material s , and statistical analysis of results . The overall review represents a considerable effort to include a range of clinical research interests over the past years . As part of the recognition of the importance of these suggestions , the review is being published simultaneously in identical form in both the “ Journal of Adhesive Dentistry ” and the “ Clinical Oral Investigations . ” Additionally an extended abstract will be published in the “ International Dental Journal ” giving a link to the web full version . This should help to introduce these considerations more quickly to the scientific community Introduction Despite the widespread acceptance of conventional treatment using composite resin in primary teeth , there is limited evidence that this approach is the best option in paediatric clinics .  Atraumatic restorative treatment ( ART ) using high-viscosity glass ionomer cement has gradually become more popular because it performs well in clinical studies , is easy to h and le and is patient friendly . Therefore , the aim of this r and omised clinical trial study is to compare the restoration longevity of conventional treatment using composite resin with that of ART in posterior primary teeth . As secondary outcomes , cost-efficacy and patient self-reported discomfort will also be tested . Methods and analysis Children aged 3–6 years presenting with at least one occlusal and /or occlusal-proximal cavity will be r and omly assigned to one of two groups according to the dental treatment : ART ( experimental group ) or composite resin restoration ( control group ) . The dental treatment will be performed at a dental care trailer located in an educational complex in Barueri/SP , Brazil . The unit of r and omisation will be the child . A sample size of 240 teeth with occlusal cavities and 188 teeth with occlusal-proximal cavities has been calculated . The primary outcome will be restoration longevity , which will be clinical ly assessed after 6 , 12 , 18 and 24 months by two examiners . The duration of the dental treatment and the cost of all material s used will be considered when estimating the cost-efficacy of each treatment . Individual discomfort will be measured after each dental procedure using the Facial Scale of Wong-Baker . Ethics and dissemination This clinical trial was approved by the local ethics committee from the Faculty of Dentistry of the University of São Paulo ( registration no. 1.556.018 ) . Participants will be included after their legal guardians have signed an informed consent form containing detailed information about the research . Trial registration number www . clinical trials.gov , NCT02562456 ; Pre- results OBJECTIVES Ormocer composites , consisting of a silicon-based polymer , have been developed recently as a tooth-colored restorative material . The purpose of this prospect i ve r and omized clinical trial was to evaluate the performance of two small-particle hybrid ormocer-based restorative systems ( AD , Admira/Admira Bond , VOCO ; DE , Definite/Etch & Prime 3.0 , Dentsply ) and one small-particle hybrid bis-GMA-based composite restorative system ( TC , Tetric-Ceram/Syntac , Ivoclar-Vivadent ) in class II cavities . METHODS From 128 occlusal-proximal restorations ( 44 AD , 43 DE and 41 TC ) placed in 32 adult patients , eventually 77 ( 22 AD , 29 DE and 26 TC ) remained available for evaluation after 5 years . Their clinical performance was scored according to the USPHS criteria and evaluation of bite-wing radiographs . RESULTS After 5 years , eight AD , six DE and seven TC restorations had failed ( p=0.10 , log-rank test ) . The main reason was fracture or marginal gap formation , while secondary caries accounted for four failures . In all restorations the quality of surface , margins and contact point decreased significantly compared to baseline . DE had a significant poorer color match ( p<0.01 ) . Statistical evaluation using the KW test showed that failures were concentrated on specific patients . CONCLUSIONS In a group of class II restorations , there was no significant difference in failures after 5 years between ormocer-based and bis-GMA-based restorative systems BACKGROUND An expert panel convened by the American Dental Association Council on Scientific Affairs and the Center for Evidence -Based Dentistry conducted a systematic review and formulated evidence -based clinical recommendations for the arrest or reversal of  noncavitated and cavitated dental caries  using nonrestorative treatments  in children and adults . TYPES OF STUDIES REVIEW ED The authors conducted a systematic search of the literature in MEDLINE and Embase via Ovid , Cochrane CENTRAL , and Cochrane data base of systematic review s to identify r and omized controlled trials reporting on nonrestorative treatments  for noncavitated and cavitated carious lesions . The authors used the Grading of Recommendations Assessment , Development and Evaluation approach to assess the certainty in the evidence and move from the evidence to the decisions . RESULTS The expert panel formulated 11 clinical recommendations , each specific to lesion type , tooth surface , and dentition . Of the most effective interventions , the panel provided recommendations for the use of 38 % silver diamine fluoride , sealants , 5 % sodium fluoride varnish , 1.23 % acidulated phosphate fluoride gel , and 5,000 parts per million fluoride ( 1.1 % sodium fluoride ) toothpaste or gel , among others . The panel also provided a recommendation against the use of 10 % casein phosphopeptide-amorphous calcium phosphate . CONCLUSIONS AND PRACTICAL IMPLICATION S Although the recommended interventions are often used for caries prevention , or in conjunction with restorative treatment options , these approaches have shown to be effective in arresting or reversing carious lesions . Clinicians are encouraged to prioritize use of these interventions based on effectiveness , safety , and feasibility Background : The evidence stemming from trials on restorative material s is shaped not only by trial findings , but also trial design and validity . We aim ed to evaluate both aspects in r and omized controlled dental restorative trials published from 2005–2015 . Methods : Using systematic review methodology , we retrieved trials comparing  restorative or adhesive dental material s. Two authors independently assessed design , risk of bias , registration status , and findings of trials . Descriptive and regression analyses were performed . Results : 114 studies on 15,321 restorations placed mainly in permanent teeth of 5232 patients were included . Per trial , the median number of patients was 37 ( 25th/75th percentiles : 30/51 ) . Follow-up was 24 ( 20/48 ) months . Seventeen percent of trials reported on sample size calculations , 2 % had been registered . Most trials ( 90 % ) used US Public Health Service ( USPHS ) criteria , and had a high risk of bias . More recent trials were more likely to have been registered , to have reported on sample size calculations , to be of low risk of bias , and to use other than USPHS- criteria . Twenty-three percent of trials yielded significant differences between groups . The likelihood of such differences was significantly increased in older studies , studies with potential reporting bias , published in journals with high impact factor ( > 2 ) , longer follow-up periods , and not using USPHS- criteria . Conclusions : The majority of dental restorative trials published from 2005–2015 had limited validity . Risk of bias decreased in more recent trials . Future trials should aim for high validity , be registered , and use defined and appropriate sample sizes , follow-up periods , and outcome measures OBJECTIVES Ormocer composites , consisting of a silicon-based polymer , have been developed recently as a tooth-coloured restorative material . The purpose of this prospect i ve r and omised clinical trial was to evaluate the performance of two small-particle hybrid ormocer-based restorative systems ( AD , Admira/Admira Bond , VOCO ; DE , Definite/Etch & Prime 3.0 , Dentsply ) and one small-particle hybrid bis-GMA-based composite restorative system ( TC , Tetric-Ceram/Syntac , Ivoclar-Vivadent ) in occlusal stress-bearing restorations . METHODS One hundred and twenty-eight occlusal-proximal restorations ( 44 AD , 43 DE and 41 TC ) were placed according to the manufacturer 's instructions in thirty-two adult patients . Their clinical performance was scored according to the USPHS criteria and evaluation of bite-wing radiographs . RESULTS After 3 years , four AD , five DE and four TC restorations had failed due to fracture or marginal gap formation . Surface roughness improved significantly when compared to the baseline in AD and TC ( Friedman test , p<0.05 ) during the first year but returned to baseline values after 3 years . DE had a significant tendency towards discolouration ( p<0.05 ) . Bite-wing radiographs showed two AD and one TC restorations with internal porosities . ANOVA showed that larger restorations ( > or = 3 surfaces ) showed significantly more degradation than smaller ones . CONCLUSIONS In a group of class II restorations , there was no significant difference in failures after 3 years between ormocer-based and bis-GMA-based restorative systems OBJECTIVES The objectives of this study were : to provide restorations using the ART approach to pre-school children in Southern China in a kindergarten environment , using a high-strength glass-ionomer restorative material ; to assess the acceptability of this approach and to evaluate on a longitudinal basis the restorations placed . SAMPLE AND METHODS A total of 170 ART restorations were placed in 95 children , aged 5.1 + /- 0.7 years , by seven final-year dental students using st and ard ART procedures and h and instruments . The restorations were evaluated every six months thereafter by two calibrated independent examiners using explorers and mouth-mirrors . RESULTS 93 % of the children reported that they did not feel pain during treatment and 86 % were willing to receive ART restorations again . The cumulative 12- and 30-month survival rates of Class I restorations were 91 % and 79 % , respectively . The corresponding figures for Class V restorations were 79 % and 70 % , while those for Class II restorations were 75 % and 51 % . The failure rates of Class III and IV restorations were high with more than half of them scored as missing within the first year . CONCLUSIONS The ART approach was shown to be acceptable to Chinese pre-school children for providing restorative dental care outside the traditional clinical setting . The success rates were high for Class I and V restorations in primary teeth , modest for Class II , and low for Class III and IV restorations The present study was aim ed at comparing the effectiveness of three minimally invasive restorative treatment approaches for dentinal lesions in occlusal surfaces . The approaches tested comprised a conventional and a modified – conventional treatment and a modified Atraumatic Restorative Treatment ( ART ) . The conventional approach was performed in a university dental clinic whilst the modified – conventional , employing portable equipment , and the modified ART , using h and instruments and a caries removal solution ( Caridex ® ) , were carried out in the field . Using the split – mouth design , 430 matched contralateral pairs of occlusal cavities were restored with amalgam or glass – ionomers in permanent molars of 152 school children by one dental therapist . The restorations were assessed using a modified USPHS – Ryge criteria . After 2 years , the cumulative survival percentages for occlusal amalgam and glass – ionomer restorations were 92 and 96 % , respectively . The survival of all restorations in the conventional , modified – conventional and the modified ART group was 96 , 96 and 91 % , respectively . The survival of occlusal amalgam and glass – ionomer restorations per treatment group was as follows : 94 and 99 % , respectively ( conventional group ) ; 95 and 97 % , respectively ( modified – conventional group ) , and 89 and 93 % , respectively ( modified ART group ) . The differences in survival percentage between restorations with amalgam and glass – ionomer , and between the three restorative treatment approaches were not statistically significant . In countries facing scarcity in re sources for dental care , ART seems a promising restorative approach to occlusal caries in posterior teeth . However , a longer clinical observation period is required to substantiate this initial conclusion AIM To compare the clinical performance of two glass ionomer cements , Amalgomer CR and Fuji IX in small and medium cavities prepared using Atraumatic restorative treatment approach in India . STUDY DESIGN One hundred school children in the age group of 4 - 9 years who had bilateral matched pair of carious lesions in primary posterior teeth were included . A split mouth design was used in which two material s were r and omly placed in contralateral sides . The performance of the restorations was assessed after 1 year using Frenken 's criteria ( 1996 ) . Survival analysis of restoration was done using chi-square test . RESULTS The survival rate of Amalgomer CR and Fuji IX class I restorations were 97.4 % and 94.9 % , respectively . In class II cavities 95.1 % and 88.5 % of Amalgomer CR and Fuji IX restorations were successful . Amalgomer CR and Fuji IX showed a success of 94.2 % and 92.3 % in small sized class II cavities . Amalgomer CR showed a 100 % success for medium sized class I and II restorations . Whereas Fuji IX showed a 100 % and 66.7 % success in medium sized class I and II cavities . CONCLUSION The clinical performances of both material s were satisfactory at the end of 1 year and ART is suitable procedure to be done in a dental clinic for children
Regarding pain , there was a trend for treatments without rotary instruments and local anesthesia to be less frequently reported as painful .
No statistical difference was found intragroup nor among treatments for OHRQoL. CONCLUSIONS Anxiety and pain are directly related with more invasive restorative treatments .
On the other h and , quality of life is not improved regardless of the restorative technique used .
BACKGROUND Despite the increasing number of studies evaluating patient reported outcome measures ( PROs ) , there is no clearness regarding which restorative treatment offers major benefits based on the pediatric patient perspective .
AIM To compare different restorative techniques in pediatric dentistry regarding patient-reported outcomes .