Glass carbomer and compomer for ART restorations: survival and cost-analysis

OBJECTIVES: The aim of this randomized clinical trial was to evaluate the survival and cost of Atraumatic Restorative Treatment (ART) restorations using high viscosity glass ionomer cement (GIC), compomer (COM) and glass carbomer (CAR) for occlusal and occlusoproximal cavitated dentin caries lesions in primary molars. METHODS: A total of 568 4‐7 y old children (287 occlusoproximal and 281 occlusal cavities) were selected in Barueri, Brazil. The patients were randomly allocated in three groups: GIC, COM and CAR and treated on school setting following ART premises. The time spent in each treatment, including direct cost (material and professional cost) and indirect (depreciation of procedures and instruments), were calculated. Evaluations were performed after 2, 6, 12, 18, 24 and 36 months. Restoration survival was evaluated using Kaplan‐Meier survival analysis and Log‐rank test. Cox regression analysis was used for testing association from failures with clinical factors. Linear Regression analysis was used for testing the total cost of the treatment and independent variables (α = 5%). RESULTS: The overall survival rate after 3 years of ART restorations was 60% (GIC=69%; COM=67%; CAR=50%). CAR restorations were less successful and had lower cost than GIC and COM (p<0.05). No difference was found between GIC and COM survival and cost (p>0.05). Occlusoproximal cavities showed higher cost and lower survival when compared to occlusal ones (p<0.05). CONCLUSIONS: Although CAR presented lower cost, its longevity was inferior to GIC and COM. Occlusal restorations presented higher longevity and lower cost when compared to occlusoproximal restorations.