Approximal ART Restorations Using Different Filling Materials: 2-years RCT

Objectives: The aim of this study was to evaluate the survival rate of approximal ART restorations using three different filling materials.
Methods: A total of 290 primary molars with approximal caries lesions were selected in 4-7 years old children in Barueri city, Brazil. The patients were randomly allocated in three groups: G1 – high-viscosity GIC restoration (Equia Fil – GC Corp); G2 – compomer (Dyract Extra – Dentsply) and G3 – glass carbomer cement (GCC - Glass Carbomer – GCP Dental). All treatments were performed following the ART premises and all restorations were evaluated after 2, 6, 12, 18 and 24 months by single evaluator. Restoration survival was evaluated by Kaplan-Meier survival analysis and Log-rank test, while Cox regression analysis was used for testing association with clinical factors (α = 5).
Results: Two hundred eighty three (283) children were evaluated (drop-out=2.4%). There was difference in survival rate between the materials tested, with a poorer performance of GCC (HR=1.31; p=0.009; CI=1.07-1.61). No difference was found between GIC and COM (p=0.699). The overall survival rate of restorations was 58.3% and the survival rate per group was G1 = 57.51%; G2 = 52.75% and G3=39%. Cox regression test revealed influence of operator, presence of cavitated lesion in the tooth surface adjacent to the restored surface and dmft in the survival of restorations.
Conclusions: This study suggests that GCC is less suitable for the use in approximal ART restorations in primary molars than high-viscosity GIC and compomer.