ART as a Better Economical Alternative in Clinical Setting: RCT

Objectives: The aim of this study is to compare the average time and costs spent during the atraumatic and conventional restorative treatments in the primary dentition.
Methods: This study is nested in a randomized clinical trial whose primary outcome is the efficacy of occlusal and occlusoproximal dental restorations performed with conventional treatment (CT) using resin composite or the atraumatic restorative treatment (ART) using high viscosity glass ionomer cement in primary molars. This clinical trial was approved by the Local Ethics Committee (#1.556.018) and registered in the Clinicaltrials.gov database (NCT02562456). Children from 3 to 6 years old presenting at least one eligible cavity was randomly assigned to ART or CT group. All treatments were performed in a dental care trailer set up as a regular dental office inside a school in the city of Barueri, Brazil. Each restorative treatment session was timed and the costs related to the professional and to the procedure, which includes equipment and instrumental depreciation, electricity and material cost, were considered to estimate the final cost of each treatment. The comparison between groups in relation to time and cost were done through multilevel linear regression.
Results: It was performed 215 of the 444 restorations needed, of which 105 were conventional and 110 were ART. The average time spent in an atraumatic restoration was significantly shorter than in the conventional approach. Both one and two-surfaces ART restorations were cheaper than the conventional ones. The cost of conventional restorations did not vary according to the number of surfaces restored, while the atraumatic single restorations showed a lower cost than the two-surfaces counterpart.
Conclusions: It can be concluded that in an economic point of view ART is a more feasible alternative than the conventional approach in the pediatric dental clinic due to its lower cost and less-time consuming profile.