Two minimally invasive treatments for decayed primary molars 18 month results

Abstract

OBJECTIVE: To compare the success rates of atraumatic restorative treatment (ART) restorations, and silver diamine fluoride (SDF) applications in treating decayed primary molars in an outreach dental service. METHODS: Study was conducted in Guangzhou, China, in 2005. Primary molars with Class I caries lesions into dentine but not involving pulp in children aged 6-7 years, were randomly allocated into one of two treatment groups: (1) restored with glass ionomer using the ART technique, and (2) caries arrest treatment by annual topical applications of SDF solution. Treatments were provided in school using hand instruments only. The treated teeth were clinically assessed every 6 months by two calibrated examiners. ART treatment was classified as successful if the restoration was intact and had no major defects. SDF treatment was classified as successful if the treated lesion became arrested, i.e. surface hard on probing with a sharp explorer using a light force. For both treatments, failure was recorded if there was pain in the treated teeth, the tooth being non-vital, or received other treatments. RESULTS: At baseline, 67 and 73 Class I caries lesions in 103 children were treated with ART restoration and SDF application respectively. 97% and 96% of ART and SDF treated lesions respectively were followed for 18 months. In first year, the success rate of ART restorations was significantly higher than that of SDF treatment. At 6 months, the respective success rates were 94% and 55% (Chi-square test, P < 0.001). The respective 12-month success rates were 87% and 63% (P < 0.001). By 18 months, the difference in success rates between the two innovative treatments became insignificant (79% vs 77%, P > 0.05). CONCLUSION: The 18-month success rates of ART and SDF treatments for Class I caries lesions in primary molars were similar.