Clinical Oral Investigations

, Volume 23, Issue 10, pp 3721–3729 | Cite as

Atraumatic restorative treatment—ART in early childhood caries in babies: 4 years of randomized clinical trial

  • Daniel Demétrio Faustino-SilvaEmail author
  • Márcia Cançado Figueiredo
Original Article



To assess the effectiveness of atraumatic restorative treatment (ART) performed 4 years ago in babies suffering from early childhood caries (ECC), and to compare the clinical performance of ART atraumatic restorations performed with two different high-viscosity glass ionomer cements (GIC).

Materials and methods

This was a longitudinal follow-up of a randomized, double-blind, split-mouth-type clinical trial. The initial sample was composed of 100 deciduous molars with occlusal lesions in 25 children with ages between 18 and 36 months who received ART with two different GICs: Ketac Molar Easymix® (3 M ESPE) and Vitro Molar® (DFL). The clinical assessments were performed by a trained, blind examiner gauged by the parameters assessed in 1, 2, and 4 years (ART and USPHS criteria).


For the analysis of the clinical performance of ARTs between the different GICs, the chi-square and Mann–Whitney tests were applied (p < 0.05). In the 4 years of evaluation, the sample was composed by 76 ARTs and 19 children, with 94.7% of the treatments having inactivated the cavity process. The total success percentage of the ARTs was 94%, 87.5%, and 82.9%, in 1, 2, and 4 years of follow-up, respectively. Moreover, among the GICs studied, this difference was not statistically significant (p > 0.05) ( NCT03756025).


ART was effective in handling ECC, with an excellent clinical performance of ART restorations, for both GICs, during the 4 years of follow-up.

Clinical relevance

ART, with both GIC studied, is an alternative therapy for ECC.


Early childhood caries Atraumatic restorative treatment Glass ionomer cement Deciduous tooth Odontopediatrics 



Mircelei Saldanha Sampaio and Cinthya Aline das Dores Guarienti are acknowledged for the help in the children’s care and the conduction of the clinical trial.


The study was supported by Federal University of Rio Grande do Sul (UFRGS) School of Dentistry, Rio Grande do Sul, Porto Alegre, Brazil.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in the study involving human participants were in accordance with the ethical standards of the institution and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Graduate Program of the Assessment and Production of Technologies for the Brazilian Unified Health System, Grupo Hospitalar Conceição (GHC)Porto AlegreBrazil
  2. 2.Hospital Nossa Senhora da Conceição, Gerência de Ensino e Pesquisa - Centro Administrativo, 1° andarPorto AlegreBrazil
  3. 3.Federal University of Rio Grande do Sul (UFRGS) School of DentistryPorto AlegreBrazil

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