Methods: Since October 2005, dentists and trained health workers have applied ART sealants and fillings in 1107 children from 15 primary schools in Apurimac, Peru. In total, 487 fillings and 1545 sealants in first permanent molars had been performed using KetacMolar® (3MEspe) according to the recommended protocol. All school-children performed daily tooth brushing in the schools and received oral health education. In August/October 2008, the ART restorations were clinically assessed according to ART-specific criteria. The data was statistically analysed (SAS v9.1) applying Kaplan-Meyer, Chi-square-test, Logrank-test and Wilcoxon test.
Results: 244 fillings and 1170 sealants in 790 children (drop-out 28.6%) could be examined after 6-36 months. After 1, 2 and 2.5 years, the cumulative survival rates of ART restorations were 96.7 % (N=168), 81.4 % (N=73) and 59.8 % (N=19), of ART sealants 97.5 % (N=1036), 84.9 % (N=582) and 57.8 % (N=114), respectively. There was no significant difference between the results of dentists and health workers, but a considerable individual operator effect could be demonstrated. No significant differences in the survival rates were noted with regard to upper or lower jaw and gender.
Conclusions: Compared to international studies, the survival rates after 12 and 24 months are within the expected range, but show a higher failure rate after 30 months. This may be due to various reasons: lack of experience in the first year, high drop-out of older children (leaving school), wrong clinical indication (type of fissures), incorrect performance of treatment protocol, negligence of operators. The good results after 24 months demonstrate the effect of additional training and improved supervision in 2006.