5-Year survival of ART restorations with and without cavity disinfection

Farag, A.; van der Sanden, W.J.M.; Abdelwahab, H.; Mulder, J.; Frencken, J.E.

doi:10.1016/j.jdent.2009.03.002

« Previous Next »Journal of Dentistry
Volume 37, Issue 6 , Pages 468-474, June 2009

5-Year survival of ART restorations with and without cavity disinfection

A. Farag
- Department of Conservative Dentistry, Faculty of Dentistry, Minia University, Minia City, Egypt
W.J.M. van der Sanden
- Department of Preventive and Restorative Dentistry, Radboud University Nijmegen Medical Centre, College of Dental Sciences, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
H. Abdelwahab
- Department of Conservative Dentistry, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
J. Mulder
- Department of Preventive and Restorative Dentistry, Radboud University Nijmegen Medical Centre, College of Dental Sciences, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
J.E. Frencken
- Nijmegen International Centre for Oral Health, Radboud University Nijmegen Medical Centre, College of Dental Sciences, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
- Corresponding author. Tel.: +31 24 361 4050; fax: +31 24 354 0265.

Received 12 January 2009; received in revised form 6 March 2009; accepted 6 March 2009.

Abstract

Objectives

The null-hypothesis tested was that there is no difference between the survival of ART restorations with, and without, cavity disinfection among adolescents after 5 years.

Methods

Eligible students were allocated to one of the treatment groups. One operator placed a total of 90 restorations, 45 each per treatment group, in ninety 14–15 year olds. Restorations were evaluated on replica models at baseline and after 1 and 5 years, by two calibrated and independent evaluators using the ART criteria. The independent variables were gender, mean DMFT score at baseline, cavity size (small/large), cavity type (single-/multiple surfaces) and disinfected cavity (yes/no). Statistical analyses were done using the Kaplan–Meier method and log-rank test.

Results

The cumulative survival percentage and standard error for the 61 ART restorations with and without disinfection at evaluation year 5 were 85% (S.E.=6.1%) and 80% (S.E.=7.1%), respectively: not significantly different (p=0.37) from each other. The cumulative survival percentage and standard error for all ART restorations was 97% (S.E.=2.0%) at evaluation year 1 and 82% (S.E.=4.7%) at year 5, and it was 85% (S.E.=5.4%) for single- and 77% (S.E.=9%) for multiple-surface ART restorations at year 5. The cumulative survival percentage of all ART restorations at evaluation year 5 was statistically significant higher for boys than for girls (p=0.03).

Conclusions

Disinfecting a cavity cleaned according to ART with a 2% chlorhexidine solution is unnecessary. It is useful to introduce the ART approach systematically into the healthcare system in Egypt.

Keywords: Atraumatic Restorative Treatment, Cavity disinfection, Glass-ionomer cement, Chlorhexidine solution, Survival, Egypt