Atraumatic restorative treatment in permanent molars: a systematic review

ABSTRACT

Aim: This paper presents a systematic review of studies published within the last 10 years onAtraumatic Restorative Treatment (ART) in permanent molars. Methods: A systematic searchwas carried out in the MEDLINE and PubMed databases from April 1st 2001 to December 31st2010 using the term “atraumatic restorative treatment” and in the LILACS database using the term“tratamento restaurador atraumático”. The selection of publications was based on the followingcriteria texts written in English, Spanish or Portuguese; presence of an abstract; and investigationof clinical aspects related to ART in permanent molars. Results: The analysis of abstracts led tothe selection of 26 studies. Recent clinical studies on ART in permanent molars of children,adolescents and young adults mainly address the survival of restorations through a comparisonbetween caries removal methods and restorative materials. The publications report a survivalsuccess rate of ART restorations ranging from 30 to 100% in permanent molars, which is similarto that reported for treatments employing conventional methods and materials. The success rate ofART sealants ranged from 6.2 to 98.5%. The number of studies reporting on the retention andcaries preventive effect of ART sealants was small. Conclusions: This systematic review revealedhigh survival rates for single-surface ART restorations in permanent molars and lower successrates for multiple-surface restorations. Clinical studies conducted with children, adolescents andyoung adults demonstrate a reliable clinical performance of single-surface and multi-surface ARTrestorations for 3-year and 2-year periods, respectively. However, long-term clinical studies arescarce and most of them focus on one-surface cavities...