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Amalgam and ART restorations in children: a controlled clinical trial

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Abstract

Objectives

The aims of this study were to compare 2-year cumulative survival rates of amalgam and atraumatic restorative treatment (ART) restorations in primary molars and to investigate the determinants of the survival rate of restorations.

Materials and methods

A controlled clinical trial using a parallel group design was carried out on 258 children aged 6–7 years old, allocated to two treatment groups: conventional restorative treatment using amalgam and ART using high-viscosity glass ionomer. A total of 364 amalgam restorations and 386 ART restorations were placed by three pedodontists in 126 and 158 children, respectively, and were evaluated after 0.5, 1, and 2 years. Restorations were placed in vital primary molars with neither pain nor signs of pulp involvement. The survival analysis was conducted using the proportional hazard rate regression model with frailty correction.

Results

The 2-year cumulative survival rates for all amalgam (77.3 %) and ART (73.5 %) restorations were not statistically significantly different, but there was an effect of “type of surface” (single/multiple) and “cavity filling time” on the survival rates. Both amalgam and ART single-surface restorations had higher survival rates than multiple-surface restorations of the same material. Secondary caries was responsible for 36 and 38 % of failures in amalgam and ART restorations, respectively. Mean time for restoring all type of cavities with amalgam and ART restorations was 13.6 and 13.7 min, respectively.

Conclusions

Amalgam and ART restorations presented similar survival rates over a 2-year period for all, single-surface, and multiple-surface restorations.

Clinical relevance

In the cause of finding alternatives to amalgam, ART restorations using high-viscosity glass ionomer might be a suitable option for managing cavitated dentine carious lesions in vital primary molars.

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Acknowledgments

The authors thank Danielle Abreu for providing the treatment, Luciana Oliveira and Gabriela Lopes for evaluating the restorations, and the dental assistants. We also convey acknowledgments to FAP-DF and Radboud University Nijmegen Medical Centre for the financial support and to ABCD-DF for the logistic support, and to 3M ESPE for providing Ketac Molar Easymix®.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Global Oral Health, College of Dental Sciences, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

    Rodrigo Guedes de Amorim

  2. Department of Pediatric Dentistry, School of Health Sciences, University of Brasília, Brasília, Brazil

    Soraya Coelho Leal

  3. Department of Global Oral Health, College of Dental Sciences, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

    Jan Mulder

  4. Department of Oral Rehabilitation, College of Dental Sciences, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

    Nico H. J. Creugers

  5. Department of Global Oral Health, College of Dental Sciences, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands

    Jo E. Frencken

Authors
  1. Rodrigo Guedes de Amorim
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  2. Soraya Coelho Leal
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  3. Jan Mulder
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  4. Nico H. J. Creugers
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  5. Jo E. Frencken
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Corresponding author

Correspondence to Jo E. Frencken.

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de Amorim, R.G., Leal, S.C., Mulder, J. et al. Amalgam and ART restorations in children: a controlled clinical trial. Clin Oral Invest 18, 117–124 (2014). https://doi.org/10.1007/s00784-013-0955-x

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  • DOI: https://doi.org/10.1007/s00784-013-0955-x

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