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The present randomised clinical trial was aimed at comparing three minimally invasive restorative treatment approaches for managing dental caries in occlusal surfaces using a non-gamma-2 amalgam and a low-viscosity glass-ionomer as the restorative material. The treatment approaches tested in parallel groups were: conventional in a university setting, modified-conventional and ultraconservative (Atraumatic Restorative Treatment, ART) approaches in a field setting. A split-mouth design was used in which the two restorative materials were randomly placed in 430 matched contralateral pairs of permanent molar teeth. A total of 152 children from five primary schools were recruited and treated by a dental therapist. The restorations were evaluated after 6 years by 2 calibrated independent examiners. The 6-year successes for all occlusal amalgam and glass-ionomer restorations were 72.6 and 72.3%, respectively. There were no statistically significant differences observed between the successes for both amalgam and glass-ionomer restorations placed either by the ART (68.6%, with 95% CI = 61–76%) approach or by the conventional (74.5%, with 95% CI = 65–82%) and the modified-conventional (75.8%, with 95% CI = 67–83%) approaches after 6 years. There was also no statistically significant difference observed between the successes of occlusal ART restorations with glass-ionomer (67.1%, with 95% CI = 56–77%) and occlusal conventional restorations with amalgam (74%, with 95% CI = 61–85%) after 6 years. ‘Restoration fracture/marginal defects’ and ‘loss of material’ were the most common causes for failure. The former was more often recorded in amalgam restorations and the latter in glass-ionomer restorations. Secondary caries was observed for 2% of glass-ionomer and for 10% of amalgam restorations. This difference was statistically significant (p = 0.001). The ART approach using glass-ionomer performed equally well as conventional restorative approaches using electrically driven equipment and amalgam for treating dentinal lesions in occlusal surfaces after 6 years.Copyright © 2003 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

AbstractObjective: To determine the prevalence of dentinal lesions treatable through the atraumatic restorative treatment (ART) approach for high caries risk schoolchildren. Subjects and Methods: A convenience sample was taken of 1,542 grade 1 and 931 grade 2 children from 21 primary schools in a low socio-economic area in Damascus. Dentinal lesions in which the smallest excavator (diameter of 0.9 mm) could enter the cavitated lesion were considered treatable using the ART approach. Mann-Whitney U and ANOVA tests were used to analyse the data. Results: The mean dmfs and dmft scores of the 6- to 7-year-olds (grade 1) were 9.0 and 4.4, respectively. The mean DMFS and DMFT scores of the 7- to 8-year-olds (grade 2) were 1.6 and 1.4, respectively. At least 89.9 and 54.9% of the dentinal lesions in the deciduous and permanent dentition that were in need of a restoration, respectively, were diagnosed as treatable using ART. Conclusion: A high proportion of dentinal lesions in need of restorations in both deciduous and permanent dentitions in this high caries risk group of 6- to 8-year-olds were diagnosed as being treatable using the ART approach.Copyright © 2003 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]