Two minimally invasive treatments for decayed primary molars -24-month results

OBJECTIVE: To compare the success rates of atraumatic restorative treatment (ART) restorations, and silver diamine fluoride (SDF) applications in treating decayed primary molars in an outreach dental service. METHODS: Study was implemented in Guangzhou, China, in April 2005. Primary molars with Class I caries lesions into dentine but not involving pulp in children aged 6-7 years were randomly allocated into one of two treatment groups: 1) glass ionomer restoration using the ART technique, and 2) caries arrest treatment by annual topical applications of SDF solution. Treatments were provided in school using hand instruments only. The treated teeth were clinically assessed every 6 months by two calibrated examiners. ART treatment was classified as successful if the restoration was intact and had no major defects. SDF treatment was classified as successful if the treated lesion became arrested. For both treatments, failure was recorded if there was pain in the treated teeth, the tooth being non-vital, or received other treatments. RESULTS: At baseline, 67 and 73 Class I caries lesions in 103 children were treated with ART restoration and SDF application respectively. About 95% of the treated lesions were followed for 24 months. The success rate of ART restorations started with a very high value and decreased gradually while that of SDF increased throughout the study. In the first year, the success rate of ART restorations was significantly higher than that of SDF treatment. At 12 months, the respective success rates were 87% and 63% (Chi-square test, p<0.001). By 24 months, the difference in success rates between the two treatments became insignificant (75% vs 70%, p>0.05). CONCLUSION: The 24-month success rates of ART and SDF treatments for Class I caries lesions in primary molars were similar. Funded by the Research Grants Council of Hong Kong (Ref: HKU7422/04M).