Related Experiment Video
Updated: Jul 3, 2026
Evaluating the Effects of Different Polishing Methods on Color Stability of Dental Restorations in Pediatric Dentistry
Published on: June 6, 2025
Six-year evaluation of the atraumatic restorative treatment approach in permanent-tooth Class III restorations
Anuradha Prakki1, Margareth C P Nunes, Daniela F G Cefaly
1Department of Operative Dentistry, Endodontics and Dental Materials, Bauru Dental School, University of São Paulo, Bauru, SP, Brazil. prakki@yahoo.com
Purpose:
The aim of this study was to assess the 6-year performance of the ART (atraumatic restorative treatment) approach in Class III restorations in permanent teeth.
Materials And Methods:
A total of 127 ART Class III restorations, using Ketac-Molar (3M ESPE) ionomer cement, was performed in 58 adult patients by one experienced operator in 1998. After a 6 years, 34 patients and 65 restorations were evaluated according to ART criteria. Two calibrated examiners carried out the evaluation. Data were analyzed by exact 95% Confidence Interval and Survival Analysis using the Jackknife method for standard error determination.
Results:
Among assessed restorations, 73.8% (95% CI = 61.5% to 86.2%) were in good condition and classified as successful, with a 67.6% (95% CI = 54.4% to 80.7%) cumulative survival rate. Failed restorations included 13.9% completely or partially missing restorations, 9.2% restorations that had been replaced by other treatment, 1.5% restorations with a large defect at the margin, and 1.5% restorations that presented high wear on the surface. No caries was observed even in those teeth in which restorations were absent.
Conclusion:
The 6-year success rate of the ART approach in anterior permanent teeth (Class III) was considered high.