Randomized clinical trial of class II restorations of ART and composite resin in permanent teeth

Author(s)

Rafael Menezes Silva

• Document type: Doctoral Thesis
• Press: Bauru.
• Institution: Universidade de São Paulo (USP). Faculdade de Odontologia de Bauru (FOB/SDB)
• Defense date: 2017-12-08

Examining board members

Maria Fidela de Lima Navarro; Ana Flávia Sanches Borges; Soraya Coelho Leal; Renata Corrêa Pascotto; Daniela Prócida Raggio

• Advisor: Maria Fidela de Lima Navarro

Abstract

This study evaluated the effectiveness of Class II restorations through the Atraumatic Restorative Treatment (ART) technique, with additional retentions in the proximal boxes, in permanent teeth, using high viscosity glass ionomer cement (HVGIC), as compared to restorations of composite resin. An epidemiological examination was conducted in a larger and representative population of the participants of study. One hundred and thirty three participants, aged 8 to 28 years, with good general health with 1 to 2 class II cavities in permanent teeth without pulp involvement and tooth pain were included in this study, with was approved by the Ethics Committee under the number: CAAE: 24012913.0.1001.5417. Seventy-seven restorations were made with each restorative material (Equia Fil-GC Corporation and Z350-3M). Restorations were evaluated at 6, 12, and 24 months by the criteria of ART and the modified United States Public Health Service (USPHS). Spearman Correlation and Multiple Linear Regression were performed between the variables tooth pain, visible plaque index (VPI), gingival bleeding index (GBI) and the CAST (The Caries Assessment Sprectrum and Treatment) and DMFT (Decayed, Missing and Filled teeth) obtained at the epidemiological survey using the Statistica program 7.1. As for restorative effectiveness, data were analyzed using the Mann-Whitnney, Chi-square, Fisher\'s Exact, Chi-square tests with linear trend and Logistic Regression by Enter method, where relevant (p<0.050). The Kaplan-Meier test evaluated the survival rates of the restorations in relation to the ART and modified USPHS criteria. The Log-Rank test compared the survival curves. From the CAST index (1.53; 2.17) it was possible to extract the DMFT (0.58; 1.32) which presented lower specificity and sensitivity in caries detection. The success rates for composite resin restorations were 100% (6 months), 98.7% (12 months) and 91.5% (24 months) for both assessment criteria and for ART restorations were the same for 6 months (98.7%) and 12 months (95.8%) and for 24 months were 92% when using the criteria of modified USPHS and 90.3% when using the criteria of ART, and no statistical difference was observed (p=0.466). The variables gender, locality, age, DMFT, VPI, GBI, toothache, occlusion, proximal contact, cavity size, anesthesia and cooperation of the participant did not present a statistical association with the success rates of the restorations (p>0.050). After 24 months, the VPI and GBI variables did not present a statistically significant odds ratio (OR) for ART restorations (p>0.050). ART restorations presented a lower survival rate by the criteria of ART (83.7%) when compared to the criteria of USPHS modified (87.8%), after 24 months (p=0.051). The survival of composite resin restorations was 90.7% for both evaluation criteria. It was concluded that there is no difference in the success rate of class II restorations of ART with HVGIC, in permanent teeth, with proximal retention grooves, compared to class II resin composite restorations, after 24 months. (AU)

• FAPESP's process: 14/01626-3 - Effectiveness of Class II ART restorations in primary and permanent dentitions using improved high-viscosity glass-ionomers with and without mechanical retention
• Grantee: Rafael Menezes Silva
• Support Opportunities: Scholarships in Brazil - Doctorate