Survival percentages of atraumatic restorative treatment (ART) restorations and sealants in posterior teeth: an updated systematic review and meta-analysis

• Published in: Clinical oral investigations 2018-11, Vol.22 (8), p.2703-2725
• Main Authors: de Amorim, R. G., Frencken, J. E., Raggio, D. P., Chen, X., Hu, X., Leal, S. C.
• Format: Article
• Language: English
• Subjects: Bicuspid; Dental Atraumatic Restorative Treatment; Dental caries; Dental Caries - prevention & control; Dental Restoration Failure - statistics & numerical data; Dental sealants; Dentistry; Humans; Medicine; Meta-analysis; Molar; Pit and Fissure Sealants - therapeutic use; Review; Sealing compounds; Survival; Systematic review; Teeth
• ISSN: 1432-6981; 1436-3771
• DOI: 10.1007/s00784-018-2625-5

Objective The aim of the present study is to update the results of two previous meta-analyses, published in 2006 and 2012, on the survival percentages of atraumatic restorative treatment (ART) restorations and ART sealants. The current meta-analysis includes Chinese publications not investigated before. Materials and methods Until February 2017, six databases were interrogated (two English, one Portuguese, one Spanish and two Chinese). Using six exclusion criteria, a group of six independent reviewers selected 43 publications from a total of 1958 potentially relevant studies retrieved. Confidence intervals and/or standard errors were calculated and the heterogeneity variance of the survival rates was estimated. Results The survival percentages and standard errors of single-surface and multiple-surface ART restorations in primary posterior teeth over the first 2 years were 94.3% (± 1.5) and 65.4% (± 3.9), respectively; for single-surface ART restorations in permanent posterior teeth over the first 3 years, they were 87.1% (± 3.2); and for multiple-surface ART restorations in permanent posterior teeth over the first 5 years, they were 77% (± 9.0). The mean annual dentine-carious-lesion-failure percentages in previously sealed pits and fissures using ART sealants in permanent posterior teeth over the first 3 and 5 years were 0.9 and 1.9%, respectively. Conclusions ART single-surface restorations presented high survival percentages in both primary and permanent posterior teeth, whilst ART multiple-surface restorations presented lower survival percentages. ART sealants presented a high-caries-preventive effect. Clinical relevance ART is an effective evidence-based option for treating and preventing carious lesions in primary and permanent posterior teeth.