One-year evaluation of atraumatic restorative treatment and minimum intervention techniques on primary teeth

Atraumatic restorative treatment (ART) and minimal intervention treatment (MIT) techniques were evaluated under field conditions in 5 regions of the Western Cape Province of South Africa, where caries prevalence exceeds 60% and remains mostly untreated. The purpose of the study was to compare and evaluate results of ART and MIT techniques in the primary dentition of 6-9 year-old schoolchildren using glass-ionomer (GI) (Fuji IX) and compomer (Dyract AP) materials. At baseline 401 children were treated, and 1,119 restorations placed by 5 calibrated dentists, 53% with ART (using hand instruments only) and 47% with MIT (minimal use of slow hand-piece) techniques. Evaluations were done with a CPI periodontal probe to measure marginal defects and to detect decay. A pain assessment for the restoration procedures indicated that 80% of subjects experienced no pain, 18% discomfort and slight pain, and 2% required local anaesthetic. After one year 90.5% of subjects and 80% of restorations were followed up (11.1% lost as a result of exfoliation); of these restorations 86% were clinically acceptable (84.1% of the ART and 88% of the MIT). With the art technique 82.7% of GI restorations and 85.6%, of compomer restorations were acceptable. With the MIT technique 86.5% of GI restorations and 89.9% of compomer restorations were acceptable. Success of restorations per region varied significantly: regions 1 and 2-90%, region 3-80%, region 4-70% and region 5-95%. There were no significant statistical differences in respect of materials or methods employed. ART and MIT techniques were well accepted as complementary caries approaches by operators. One-year results show that ART and MIT techniques were successful, substantiating its use for the primary dentition in areas with high caries prevalence. Longer-term assessments are required.