title: The influence of restorative material on the survival rate of restorations in primary molars. The longevity of different restorations in primary teeth. The dilemma of selecting suitable proximal carious lesions in primary molars for restoration using ART technique. One-year survival of occlusal ART restorations in primary molars placed with and without cavity conditioner. The effect of a chlorhexidine containing cavity disinfectant on the clinical performance of high-viscosity glass-ionomer cement following ART: 24-month results. Clinical evaluation of the ART technique using high density and resin-modified glass lonomer cements. The longevity of amalgam versus compomer/composite restorations in posterior primary and permanent teeth: findings From the New England Children's Amalgam Trial. A 2-year clinical study of two glass ionomer cements used in the atraumatic restorative treatment (ART) technique. Short communication: Influence of different isolation methods on the survival of proximal ART restorations in primary molars after two years. ART and Conventional Root Restorations in Elders after 12 Months Pain related to different ways of minimal intervention in the treatment of small caries lesions. Ketac Molar Versus Dyract Class II restorations in primary molars: twelve month clinical results. Effectiveness of Glass-Ionomer (ART) and Amalgam Restorations in the Deciduous Dentition: Results after 3 Years A clinical evaluation of resin-based composite and glass ionomer cement restorations placed in primary teeth using the ART approach: results at 24 months. The atraumatic restorative treatment (ART) approach to restoring primary teeth in a standard dental clinic. Atraumatic perspectives of ART: psychological and physiological aspects of treatment with and without rotary instruments. Clinical evaluation of atraumatic restorations in primary molars: a comparison between 2 glass ionomer cements. Clinical evaluation of Dyract AP restorative in permanent molars: 2-year results. A thirty months clinical evaluation of a posterior composite resin in primary molars. Shear bond strength of six restorative materials. Clinical Investigation of Two Glass–Ionomer Restoratives Used with the Atraumatic Restorative Treatment Approach in China: Two–Years Results Mineral loss on adjacent enamel glass ionomer cements restorations after cariogenic and erosive challenges.
abstract: The survival rates of  restorations in primary molars were calculated after a retrospective examination of patients ' dental records from a study population of 1,065 children . A r and om sample of 128 records showing information for 604 dental restorations  was examined , coded , and analyzed by the life table method of survival analysis . The order of the survival rate of restorations from higher to lower success was preformed crowns , amalgam , composite resin , and glass ionomer restorations . A highly statistically significant difference ( P = 0.0001 ) was found among the survival success rates of different material restorations . For preformed crowns and amalgam restorations , the median survival time was more than 5 years . The 5-year survival estimate for preformed crowns was 68 % and for amalgam restorations was 60 % . For composite resin the median survival time was 32 months and the 4-year survival estimate was 40 % . For glass ionomer restorations , the median survival time was 12 months and the 4-year survival estimate was 5 % 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 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 The objectives of this clinical study were to : evaluate the survival of  occlusal atraumatic restorative treatment ( ART ) restorations  , on a longitudinal basis , in the primary molars of children in Mosul/Iraq ; and compare the success rate of ART restorations placed with and without cavity conditioning . METHODS One dentist placed 96 ART restorations in 48 6- to 7-year-olds who had bilateral matched pairs of carious primary molars . A split-mouth design was used to place restorations with and without cavity conditioning , which were assigned r and omly to contralateral sides . Restorations were evaluated after 6 and 12 months using the ART criteria . RESULTS The survival rate of ART restorations  placed with cavity conditioner was 89 % at the 6-month assessment and 74 % at the 12-month assessment . The success rates of ART restorations  placed without cavity conditioning in the 2 assessment s were 84 % and 67 % , respectively . There was no statistically significant difference between the ART restorations placed with and without cavity conditioner in both assessment s ( P>0.05 ) . The main cause of failure was the loss of restoration . CONCLUSIONS The 1-year success rate of occlusal ART restorations in primary molars was moderately successful . The ART technique 's cavity conditioning step was not proven to be better than not using it for Class I lesions PURPOSE To evaluate the effect of a chlorhexidine-gluconate-based cavity disinfectant on the clinical performance of high viscosity glass-ionomer cement following the ART approach under field conditions after 24 months . METHODS 126 school children 6 - 8 years old who had bilateral matched pairs of carious Class I and II primary molars were included . A split mouth design was used in which Ketac Molar was r and omly placed with or without the use of chlorhexidine-gluconate-based cavity disinfectant on contralateral sides by three dentists . The restorations were evaluated after 6 , 12 and 24 months by two experienced examiners using USPHS-Ryge criteria . RESULTS The 24-month mean cumulative survival rates of Ketac Molar without the use of disinfectant were 97.7 % and 69.4 % while in the disinfectant group , the survival rates were 95.2 % and 63.9 % in Class I and II restorations , respectively with no significant difference between the groups in both class types . In the non-disinfected group , large Class II cavities had significantly better survival rates than did small Class II cavities ( P = 0.023 ) . In the disinfected group , the failure rates in mean cumulative survivals from 6 to 12 months and 12 to 24 months significantly increased with time ( P = 0.004 and P = 0.016 respectively ) PURPOSE The aim of this study was to evaluate the performance of two different glass ionomer cements using the Atraumatic Restorative Treatment ( ART ) technique in permanent teeth . MATERIAL S AND METHODS A total of 473 ART restorations were placed in 208 schoolchildren ( 7 - 12 years of age ) by two previously trained operators , using high density and resin-modified glass ionomer cements . All the restorations were photographed at baseline and the patients were asked about postoperative sensitivity . After a period of 8 months , 193 patients were present after recall and 428 restorations were evaluated and photographed . Two independent examiners carried out the evaluation . RESULTS The results showed a success rate of 86.2 % for occlusal restorations with Fuji IX and 88.4 % for those restored with Fuji Plus . A total of 86.7 % of the approximal restorations with Fuji Plus were also judged to be successful after 8 months . No association was found between the material s and the clinical performance of the ART restorations in class I cavities . CONCLUSION The type of restorative material did not influence the success or failure rates in class I cavities within this period . Fuji IX showed promising performance for occlusal ART restorations and Fuji Plus is also a promising material for occlusal and approximal ART restorations BACKGROUND Limited information is available from r and omized clinical trials comparing the longevity of  amalgam and resin-based compomer/composite restorations . The authors compared replacement rates of these types of restorations in posterior teeth during the five-year follow-up of the New Engl and Children 's Amalgam Trial . METHODS The authors r and omized children aged 6 to 10 years who had two or more posterior occlusal carious lesions into groups that received amalgam ( n=267 ) or compomer ( primary teeth)/composite ( permanent teeth ) ( n=267 ) restorations  and followed them up semiannually . They compared the longevity of restorations placed on all posterior surfaces using r and om effects survival analysis . RESULTS The average+/-st and ard deviation follow-up was 2.8+/-1.4 years for primary tooth restorations and 3.4+/-1.9 years for permanent tooth restorations . In primary teeth , the replacement rate was 5.8 percent of compomers versus 4.0 percent of amalgams ( P=.10 ) , with 3.0 percent versus 0.5 percent ( P=.002 ) , respectively , due to recurrent caries . In permanent teeth , the replacement rate was 14.9 percent of composites versus 10.8 percent of amalgams ( P=.45 ) , and the repair rate was 2.8 percent of composites versus 0.4 percent of amalgams ( P=.02 ) . CONCLUSION Although the overall difference in longevity was not statistically significant , compomer was replaced significantly more frequently owing to recurrent caries , and composite restorations required seven times as many repairs as did amalgam restorations . CLINICAL IMPLICATION S Compomer/composite restorations on posterior tooth surfaces in children may require replacement or repair at higher rates than amalgam restorations , even within five years of placement The purpose of the study was to evaluate , in a clinical study over 2 years , the deterioration of two glass ionomer cements used with the atraumatic restorative treatment ( ART ) technique or approach . Fifty-five Fuji IX and 45 ChemFil Superior restorations were placed r and omly in 23 adult patients , mainly in small occlusal preparations in molar teeth . The restorations were placed in a dental hospital by one dentist using the ART technique . Photographs , radiographs and replicas were obtained at baseline and subsequent recalls . Both cements were easy to mix and place , but the radiolucency of ChemFil Superior was a disadvantage . Both cements also showed early high losses of sealant and restorative material . After 2 years , 34.5 % of the sealants appeared to be completely lost , with caries recorded in 5.3 % of the exposed fissures . In some instances , these small lesions may have been present , but not detected clinical ly , at the time of sealing . Restoration failures of 7.0 % were from wear and fracture of the cements and recurrent caries . Mean cumulative wear was 83.1 microm for Fuji IX and 104.0 microm for ChemFil Superior , which was not statistically significant . The cements became darker after their placement to more closely match the restored teeth , but there were few exact matches . There was no surface staining and only minor marginal discrepancies and staining associated with the restorations . Although the short-term clinical performance of the two glass ionomer cements was reasonable , the material s require further improvements in their mechanical properties , to reduce sealant losses and wear . The cements evaluated appear suitable for restricted use only , in posterior teeth AIM This was to evaluate the influence of two methods of tooth-isolation on the survival rate of proximal ART restorations in the primary molars . METHODS The study was conducted in two rural divisions in Kenya , with 7 operators r and omly paired to a group of 8 assistants . A total of 804 children each had one proximal cavity in a primary molar restored using the ART approach .  During restorations 2 isolation methods , rubber dam or cotton wool rolls , and 3 br and s of glass ionomer cements were used by the operators . The restorations were then followed for a period of 2 years . STATISTICS SPSS 14.0 was used to analyse and relate the data obtained to the method of isolation used . RESULTS After 2 years 30.8 % of the ART restorations had survived . Higher survival rates of the restorations were obtained when using rubber dam irrespective of the GIC material or the operator . CONCLUSION Generally the survival rate of the proximal restorations in the present study was very low , but the use of rubber dam result ed in a higher survival rate of the restorations Successful use of atraumatic restorative treatment ( ART ) in children has been reported , but little information is available regarding its use in older adults . The hypothesis of this study was that survival rates of root restorations placed by both ART and the conventional technique were similar . Root-surface caries lesions in 103 institutionalized elders in Hong Kong were treated r and omly by either : ( 1 ) the conventional approach — caries removed by dental burs , and the cavity filled with light-cured resin-modified glass ionomer ; or ( 2 ) the ART approach — caries removed by h and instruments , and the cavity filled with chemically cured high-strength glass ionomer . In total , 84 conventional and 78 ART restorations were placed . After 12 months , 63 conventional and 59 ART restorations were review ed , and the respective 12-month survival rates were 91.7 % and 87.0 % ( p > 0.05 ) . It is concluded that the survival rates of both types of root restorations were high and similar Pain during invasive treatment of dental caries is a common phenomenon , if no local analgesia has been used before cavity preparation . Atraumatic restorative technique ( ART ) is a suggested procedure which is at least less traumatic for the patient . Although the ART approach has been received well by both children and adults who belong to population groups hardly ever exposed to regular oral health care , it has not yet been proven that this particular procedure really causes less pain , compared to more conventional techniques with rotating instruments . In the present study , pain was reported in connection with tooth restoration in 19.3 percent of the cases , when the ART technique was used , which is significantly less than with a conventional restorative technique ( 35.7 percent ) . Finally the results show a clear relationship in the pain reports between the first and the following treatments in both ART and the conventional technique groups The aim of the present clinical study was an in vivo evaluation of an improved conventional glass ionomer cement Ketac Molar ( ESPE ) , compared to a polyacid modified composite resin , Dyract ( Dentsply/De Trey ) , used in primary molars . Fifty-three Ketac Molar and fifty-two Dyract restorations were placed in box-only preparations in primary molars . The application time for the chemically cured Ketac Molar , was longer compared to the light-cured Dyract . In comparing the material s , no differences were found , comparing both material s regarding secondary caries , marginal adaptation , wear and fracture toughness . One case of recurrent caries adjacent to a Ketac Molar restoration and two cases in the Dyract group were reported . Two Ketac Molar restorations and one Dyract showed bulk fracture at the time of evaluation . At the twelve-month evaluation , no difference between the investigated material s was registered , which indicates that Ketac Molar can be used as a proximal restoration in the primary dentition . It should be emphasized , however , that one-year data should not be extrapolated to indicate the long-term success of restorations This study compared the survival of restorations produced through the atraumatic restorative treatment ( ART ) approach using glass-ionomer with those produced through the traditional approach using amalgam ( MTA ) in deciduous dentitions over a period of 3 years . Using a parallel group design , 835 grade 1 children , aged 6–7 years , participated . A total of 482 children were treated through the ART and 353 children through the MTA approach .  Eight dentists produced a total of 1,891 single- and multiple-surface restorations . After 3 years , 22.1 % of the restorations were lost for evaluation . There was a statistically significant difference in the combined survival of all single- and multiple-surface restorations between the two approaches in favour of the ART approach ( p = 0.04 ) . The study revealed a 3-year cumulative survival percentage of single-surface ART and MTA restorations of 86.1 and 79.6 % , respectively . The difference was statistically significant ( p = 0.03 ) . The main reasons for both single-surface ART and MTA restorations to fail was ‘ restoration missing ’ followed by ‘ gross marginal defect ’ . The 3-year cumulative survival percentages of multiple-surface ART and MTA restorations were 48.7 and 42.9 % , respectively . The difference was not statistically significant ( p > 0.05 ) . The 3-year survival percentages of single- and multiple- surface ART and MTA restorations varied widely amongst the 8 operators with an operator effect ( p = 0.001 ) for multiple-surface MTA restorations . It can be concluded that the ART approach using glass-ionomer yielded better results in treating dentinal lesions in deciduous teeth than did the traditional approach using amalgam after 3 years . It is recommended to select the ART approach to complement the other activities of the school oral health programme BACKGROUND The authors evaluated the 24-month performance of a packable resin-based composite/dentin bonding system and a high-viscosity glass ionomer cement ( GIC ) in restorations placed in primary molars with the atraumatic restorative treatment ( ART )  approach . METHODS Three dentists placed 419 restorations in 219 children aged 6 through 10 years who had bilateral matched pairs of carious posterior Class I and II primary teeth . They used a split-mouth design to place the two material s , which were assigned r and omly to contralateral sides . The authors evaluated the restorations according to U.S. Public Health Service Ryge criteria . RESULTS After 24 months , 96.7 percent of the Class I GIC restorations and 91 percent of the resin-based composite restorations survived , while the success rates for the Class II restorations were 76.1 percent and 82 percent for the GIC and resin-based composite restorations , respectively . The survival rate of the Class II resin-based composite restorations was 5.9 percent higher than that of the GIC restorations at the 24-month evaluation , but this difference was not statistically significant . However , the study results showed a statistically significant difference in survival rates between Class I and II restorations for both material s. CONCLUSION AND CLINICAL IMPLICATION S The two-year clinical performance of both material s was satisfactory for the restoration of Class I and II primary molars using the ART approach OBJECTIVES The aims of this study are to assess the feasibility of the  Atraumatic Restorative Treatment ( ART ) approach in primary teeth and to compare the ART approach with traditional amalgam restorations in primary molars . METHODS This study was conducted in a paediatric dentistry clinic in Kuwait between April 1999 and December 2001 . The ART and amalgam restorations were placed r and omly on comparable pairs of primary molars , if available . In addition , the ART approach was used for other primary teeth that had no pulpal involvement and no perceived pain before treatment . The restorations were assessed by both the ART evaluation criteria and USPHS criteria in August-September 2000 and in August-December 2001 . The mean follow-up period for the restorations was 8.3 months in the first assessment ( 2000 ) and 22 months in the second assessment ( 2001 ) . The assessment was possible for 35 children ( mean age = 5.7 years ) , 18 of whom had comparable pairs ( n = 35 pairs ) of restorations in their primary molars . In addition , 48 other ART restorations  were assessed in 2000 and 42 in 2001 . RESULTS In a 2-year follow-up , 89.6 % of all ART restorations were considered successful . The failure rate of the comparable pairs of ART and amalgam restorations was 5.7 % . There was no significant difference in success rate between ART and amalgam techniques . CONCLUSIONS Based on a 2-year follow-up evaluation , the class I ART restorations seemed to have a high success rate , indicating the appropriateness of the ART approach in primary teeth Atraumatic Restorative Treatment , ART , is a method of minimal caries intervention that uses only h and instruments . The aim of the present study was to explore a possible difference between the extent of discomfort experienced during dental treatment according to the ART approach and a method using rotary instruments .  The study was performed in Indonesia . A total of 403 children were r and omly divided in two groups . In each child , one class II restoration in a deciduous molar was made . One group received treatment using rotary instruments ( 750 r.p.m . ) . The other group was treated according to the ART approach . Glass ionomer cement was used for restoration in both groups . Discomfort scores were determined using both physiological measurements ( heart rate ) and behavioral observations ( Venham ) on specific moments during the treatment . Venham scores showed a marked difference between the two groups at most time points . Heart rate measurements were different at deep excavation . Also , a clear relation between Venham scores and heart rate measurements could be found at all time points . Confounding could be shown for operating dentist , gender of the patient and initial anxiety , not for age . No effect modification could be shown . It can be concluded that children treated according to the ART approach using h and instruments alone experience less discomfort than those treated using rotary instruments Dental caries continues to be a highly prevalent disease among Brazilian preschoolers , especially those with low socioeconomic status . The purpose of this r and omized , controlled trial was to evaluate in vivo 245 simplified  restorations  in deciduous molars using glass ionomer cements ( Vidrion R and Ketac-Molar ) . Dental restorations were evaluated at 6- and 12-month follow-ups . The teeth restored with Vidrion R ( SS White ) on a single tooth surface were successful in 87 % of the cases evaluated at 6 months and in 63 % at 12 months . The teeth restored with Ketac-Molar on one surface achieved a success rate of 95 % at 6 months and 82 % at 12 months . No recurrent caries or pulpal infection was evident . Logistic regression analysis demonstrated that teeth with cavities restricted to the occlusal surface on sclerotic dentin showed the best adhesion to the restorative material . The restorations with Ketac-Molar had a better clinical performance than those with Vidrion PURPOSE To evaluate the clinical behavior of a compomer restorative system , Dyract AP , placed in combination with Non-Rinse Conditioner and Prime&Bond NT in permanent posterior teeth . MATERIAL S AND METHODS Fifty Class II and 41 Class I restorations were placed in 39 patients in a dental teaching hospital . The restorations were evaluated directly at baseline and after 6 , 12 and 24 months using the modified USPHS-Ryge criteria . Clinical photographs , polyvinylsiloxane impressions and bitewing radiographs of each restoration were taken for indirect assessment . RESULTS After 2 years , all 76 restorations were evaluated in situ . Color matching ability and surface characteristics were excellent . A gradual deterioration in marginal discoloration and marginal integrity was noted . The percentages of Alfa scores for each criterion at the 24-month evaluation were : color match 96 % , marginal discoloration 50 % , marginal integrity 26 % , anatomic form 97 % and surface texture 95 % . Five of the restorations ( 6 % ) had experienced partial fracture or recurrent caries . After 6 , 12 and 24 months , the net mean occlusal wear values were 18.5 microm , 35.7 microm and 55.9 microm , respectively . There was no statistically significant difference between Class I and II restorations for each criterion ( Fisher 's exact test , P > 0.05 ) The purpose of this in vivo study was to evaluate the clinical performance of a posterior composite resin TP.H ( Caulk Dentisply ) in class I restorations in primary molars . A total of 30 children aged 5 to 8 years old with 49 class I dental lesions in primary molars participated in the study . The cavity preparations involved removal of carious lesion only and the enamel margins were beveled . The results showed after 30 months that , 82 % ( 32/39 ) of Alfa ratings and 18 % ( 7/39 ) of Bravo ratings . We concluded that the composite resin TP-H could be used in conservative restorations in primary molars , particularly in the late mixed dentition The purpose of this study was to determine and compare the shear bond strength of a conventional glass-ionomer cement , a resin modified glass-ionomer , a composite resin and three compomer restorative material s. Dentin of the occlusal surfaces from sixty extracted human permanent molars were prepared for shear bond strength testing . The specimens were r and omly divided into six groups of 10 each . Dentinal surfaces were treated according to the instructions of manufacturers for each material . Each restorative material was placed inside nylon cylinders 2 mm high with an internal diameter of 3 mm , which were placed perpendicular to dentin surfaces . Shear bond strengths were determined using an Universal Testing Machine at crosshead speed of 0.5 mm/min in a compression mode . Conventional glass-ionomer , Ketac-Molar aplicap showed the lowest mean shear bond strength 3.77+/-1.76 ( X + /- SD MPa ) and the composite resin , Heliomolar showed the highest mean shear bond strength 16.54+/-1.65 while the mean bond strength of Fuji II LC was 9.55+/-1.06 . The shear bond strengths of compomer restorative material s were 12.83+/-1.42 , 10.64+/-1.42 and 11.19+/-1.19 for Compoglass , Hytac and Dyract respectively . ANOVA revealed statistically significant differences in the mean shear bond strengths of all groups ( P<0.001 ) . No statistically significant difference was found between the three compomer material s ( P>0.5 ) . Ketac-Molar and composite resin showed statistically significant difference ( P<0.0005 ) . The mode of fracture varied between material s. It is concluded that the compomer restorative material s show higher shear bond strength than conventional glass-ionomer and resin modified glass-ionomer , but less than composite resin . The fracture mode is not related to the shear bond strengths values Objective : To compare the clinical performance of two glass – ionomer cements , ChemFlex ( Dentsply DeTrey ) and Fuji IX GP ( GC ) , when used with the atraumatic restorative treatment ( ART ) approach in China . Methods : Eighty – nine school children aged between 6 and 14 years who had bilateral matched pairs of carious posterior teeth were included . A split – mouth design was used in which the two material s were r and omly placed on contralateral sides . The performance of the restorations was assessed directly and also indirectly from die – stone replicas at baseline and after 6 , 12 , and 24 months . Results : The 24–month cumulative survival rates of ART restorations  in the primary teeth were 93 and 90 % for the ChemFlex and Fuji IX GP class I restorations , respectively , while 40 and 46 % of class II restorations placed with the respective material s were satisfactory . In the permanent dentition , only class I restorations were involved and the cumulative survival rates were 95 and 96 % for ChemFlex and Fuji IX GP . For the primary teeth after 24 months , net mean occlusal wear was 87 µm for ChemFlex and 85 µm for Fuji IX GP . The occlusal wear in the permanent teeth was 75 µm for ChemFlex and 79 µm for Fuji IX GP . Conclusion : The clinical performance of both material s over a 24–month period was similar and the survival rates of class I ART restorations  in both primary and permanent teeth were high OBJECTIVES the purpose of this study was to determine the mineral loss on surrounding enamel restored with glass ionomer cements ( GIC ) after erosive and cariogenic challenges . METHODS Bovine enamel specimens were r and omly assigned into six groups according to the restorative material : G1 - composite resin ; G2 - high viscous GIC ; G3 - resin-modified glass ionomer with nanoparticles ; G4 - encapsulated resin-modified GIC ; G5 - encapsulated high viscous GIC ; G6 - resin-modified GIC . After restorative procedures , half of specimens in each group were su bmi tted to caries challenge using a pH cycling model for 5 days , and the other half were su bmi tted to erosive challenge in citric acid for 10 min . Before and after the challenges , surface Knoop microhardness assessment s were performed and mineral changes were calculated for adjacent enamel at different distances from restorative margin . RESULTS Data were compared for significant differences using two-way ANOVA and Student-Newman-Keuls tests ( p<0.05 ) . Erosive challenge significantly reduced enamel surface hardness , but no significant difference was observed irrespectively restorative material s ( p>0.05 ) . The cariogenic challenge promoted a higher surface hardness loss for the resin-modified GIC ( G4 ) and only for the High viscous GIC ( G2 ) an increase in surface hardness was observed . For enamel analyses , significant differences were observed with respect to the different material s ( p<0.001 ) and distances ( p=0.023 ) . Specimens restored with the composite resin presented higher mineral loss and specimens restored with the conventional high viscous GIC and the encapsulated resin-modified GIC presented the lowest values for mineral loss . CONCLUSION The GICs exerts protective effect only for cariogenic challenge
target: Atraumatic restorative treatment restorations performed with high-viscous GIC present similar survival/success rates to conventional approach using composite resin or amalgam for occlusoproximal restorations in primary teeth and can be suggested as a good option for occlusoproximal cavities in primary molars .
background: BACKGROUND Atraumatic restorative treatment ( ART ) has demonstrated good longevity when used for single-surface restorations , but lower success rates are reported for occlusoproximal surfaces .
  AIM This systematic review and meta- analysis aim ed to verify the pooled success rate of  occlusoproximal ART restorations in primary teeth considering the outcomes : longevity , pulp damage , or caries lesion progression .