Atraumatic restorative treatment (ART): a three-year community field trial in Thailand--survival of one-surface restorations in the permanent dentition

Abstract

This study compares the Atraumatic Restorative Treatment (ART) technique to conventional amalgam restorations in the management of dental caries. The present report is limited to the results for one-surface restorations in the permanent dentition over a three-year period. A community field trial was carried out in rural villages in northeastern Thailand. Dental caries was treated using the ART technique in one village where 144 persons were treated with 241 restorations. In a second village, 205 conventional amalgam restorations were provided to 138 persons using mobile dental equipment. Both ART and amalgam restorations were performed by one dentist and two dental nurses without administering local anesthesia. Clinical evaluation was carried out one, two, and three years after placement. The longevity of the restorations was determined by computing the estimated cumulative survival rates according to the life table method. The survival rates of ART restorations (93%, 83%, 71% in years one, two, and three, respectively) were close to those for amalgam restorations (98%, 94%, 85%); however, differences were statistically significant. No statistically significant differences were observed between ART restorations in children and adults, or between those placed by the dentist and dental nurses. Survival rates were lower for occlusal surface restorations compared to those in other surfaces. ART is a feasible approach for the management of dental caries, especially for one-surface lesions in the permanent dentition. Because of its simplicity as a minimal intervention technique, ART can make the control of dental caries available to all people irrespective of their economic and living conditions.