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Survival of atraumatic restorative treatment (ART) sealants and restorations: a meta-analysis
Open accessAbstract
UNLABELLED: The purpose of this study is to perform a systematic investigation plus meta-analysis into survival of atraumatic restorative treatment (ART) sealants and restorations using high-viscosity glass ionomers and to compare the results with those from the 2005 ART meta-analysis. Until February 2010, four databases were searched. Two hundred four publications were found, and 66 reported on ART restorations or sealant survival. Based on five exclusion criteria, two independent reviewers selected the 29 publications that accounted for the meta-analysis. Confidence intervals (CI) and or standard errors were calculated and the heterogeneity variance of the survival rates was estimated. Location (school/clinic) was an independent variable. The survival rates of single-surface and multiple-surface ART restorations in primary teeth over the first 2 years were 93% (CI, 91-94%) and 62% (CI, 51-73%), respectively; for single-surface ART restorations in permanent teeth over the first 3 and 5 years it was 85% (CI, 77-91%) and 80% (CI, 76-83%), respectively and for multiple-surface ART restorations in permanent teeth over 1 year it was 86% (CI, 59-98%). The mean annual dentine lesion incidence rate, in pits and fissures previously sealed using ART, over the first 3 years was 1%. No location effect and no differences between the 2005 and 2010 survival rates of ART restorations and sealants were observed. The short-term survival rates of single-surface ART restorations in primary and permanent teeth, and the caries-preventive effect of ART sealants were high. CLINICAL RELEVANCE: ART can safely be used in single-surface cavities in both primary and permanent teeth. ART sealants have a high caries preventive effect.
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“This limitation makes it more susceptible to premature deterioration, particularly in individuals who apply considerable masticatory forces [44].”
From Minimally Invasive Techniques for Managing Dental Caries in Children: Efficacy, Applications, and Future Directions (2025) · cites this paper as [44]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
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“ART is particularly sensitive to technique, requiring optimal moisture control during application to ensure optimal bonding and longevity of restorations [44].”
From Minimally Invasive Techniques for Managing Dental Caries in Children: Efficacy, Applications, and Future Directions (2025) · cites this paper as [44]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
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“A primary challenge is the decreased success rate noted in multi-surface lesions, where increased mechanical stress on restorations can lead to premature failure [44].”
From Minimally Invasive Techniques for Managing Dental Caries in Children: Efficacy, Applications, and Future Directions (2025) · cites this paper as [44]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
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“success rate noted in multi-surface lesions, where increased mechanical stress on restorations can lead to premature failure [44].”
From Minimally Invasive Techniques for Managing Dental Caries in Children: Efficacy, Applications, and Future Directions (2025) · cites this paper as [44]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“However, factors such as patient compliance, the operator's expertise, and environmental conditions, including moisture control during placement, are acknowledged as critical elements influencing the longevity of restorations [44].”
From Minimally Invasive Techniques for Managing Dental Caries in Children: Efficacy, Applications, and Future Directions (2025) · cites this paper as [44]
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“while glass ionomer cement (GIC) provides the advantage of fluoride release that contributes to ongoing caries prevention”
From Minimally Invasive Techniques for Managing Dental Caries in Children: Efficacy, Applications, and Future Directions (2025) · cites this paper as [44]
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“it lacks the wear resistance found in composite or amalgam restorations”
From Minimally Invasive Techniques for Managing Dental Caries in Children: Efficacy, Applications, and Future Directions (2025) · cites this paper as [44]
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BackgroundThe Use of Pit and Fissure Sealants—A Literature Review
Naaman, R., El‐Housseiny, A. A., & Alamoudi, N. (2017) · Dentistry Journal · doi:10.3390/dj5040034 · Cited by 169
Fluorides and Other Preventive Strategies for Tooth Decay
Horst, J. A., Tanzer, J. M., & Milgrom, P. (2018) · Dental Clinics of North America · doi:10.1016/j.cden.2017.11.003 · Cited by 173
Metadata
- Authors
- de Amorim, R. G., Leal, S. C., & Frencken, J. E.
- Affiliations
- Universidade de Brasília (BR)
- Radboud University Medical Center (NL)
- Corresponding author
- Frencken, Jo E.
- Venue
- Clinical Oral Investigations
- Published
- 2011-01-28
- Volume
- 16
- Issue
- 2
- Pages
- 429-441
- ISSN
- 1432-6981 (ISSN-L)
- 1436-3771
- PMC
- PMC3308010
- OpenAlex
- W2114683488
- Cited by
- 213
- References
- 82
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 6 · 2023: 8 · 2022: 13 · 2021: 20 · 2020: 31 · 2019: 23 · 2018: 20 · 2017: 15 · 2016: 16 · 2015: 15 · 2014: 14 · 2013: 16 · 2012: 8
- FWCI
- 2.26
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc
- Locations
- Clinical Oral Investigations (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Topics
- Health Sciences › Dentistry › General Dentistry › Dental materials and restorations
- Health Sciences › Dentistry › Oral Surgery › Endodontics and Root Canal Treatments
- Health Sciences › Dentistry › General Dentistry › Dental Health and Care Utilization
- Keywords
- atraumatic restorative treatment, restoration, high-viscosity glass ionomer, primary teeth, permanent teeth, dental caries prevention, pit and fissure sealants
- MeSH terms
- Dental Caries, Dental Clinics, Dental Fissures, Dentin, Glass Ionomer Cements, Humans, Schools, Dental, Tooth, Deciduous, Survival Analysis, Dental Restoration Failure, Dental Atraumatic Restorative Treatment
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