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Jordan RA, Hetzel P, Franke M, Markovic L, Gaengler P, Zimmer S. Class III Atraumatic Restorative Treatment (ART) in adults living in West Africa - outcomes after 48 months. Community Dent Oral Epidemiol 2011; 39: 164-170. © 2010 John Wiley & Sons A/S This observational study assessed the effectiveness of class III restorations using the atraumatic restorative treatment (ART) approach in permanent anterior teeth over a 48-month period. Dental auxiliaries placed a total of 117 class III ART restorations in 2004, using a cosmetically improved glass-ionomer (Ionofil Plus; VOCO, Cuxhafen, Germany), in 67 patients with a mean age of 27.3 years in the rural Jahali Health Center, The Gambia. Independent examiners evaluated the restorations after 24 and 48 months using the clinical ART evaluation criteria. Seventy-six of the restorations could be observed over 48 months in 51 patients. After 48 months, 53 of 76 restorations were classified as clinically acceptable (without or with minor intervention (repair) needed), and 23 restorations were classified as insufficient. There was no statistical difference in a clustered performance rating between restorations placed in central and lateral incisors ( P = 1.0). The adoption of the ART approach to class III caries cavities made restorative dental care in anterior teeth available in a West African region. The long-term performance was comparable to other studies. Longitudinal clinical studies with greater populations are required to substantiate these results. [ABSTRACT FROM AUTHOR]