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Updated: May 13, 2026

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Published on: January 10, 2025
A preliminary clinical trial using flowable glass-ionomer cement as a liner in proximal-ART restorations: the
Clarissa-Calil Bonifácio1, Daniela Hesse, Marcelo Bönecker
1Department of Conservative and Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), Gustav Mahlerlaan, 3004, 1081LA Amsterdam, The Netherlands. C.Bonifacio@acta.nl
Objectives:
This in vivo study was carried out to assess the influence of the operator experience on the survival rate of proximal-ART restorations using a two-layer technique to insert the glass-ionomer cement (GIC).
Study Design:
Forty five proximal cavities in primary molars were restored in a school setting according to the ART technique. The cavities were restored by two operators with Ketac Molar Easymix, and received a flowable layer of GIC prior to a second GIC layer with a regular consistency. The operators had different clinical experiences with ART (no experience or two years of experience), but both completed a one-week training to perform the restorations and the GIC mixing in this study.
Results:
After a 12-month follow-up, 74% of the restorations survived; the main reason for failure was bulk fracture or total loss of the restoration.There was no operator influence (long-rank test p=0.2) CONCLUSION: The results encourage future well designed controlled clinical trials using the two-layer technique for insertion of GIC in proximal-ART restorations, after training the operators.
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