20. Light Application and Succes Rate of ART Restorations
A.J.P. Van Strijp¹, C.R.G. Van den Breemer², A.M Bijlsma², G. Stel², W.E. Van Amerongen²
1) Department of Cariology Endodontology Pedodontology, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
2) University Medical Center Groningen, Center for Dentistry and Oral Hygiene, University of Groningen, The Netherlands
Introduction
Atraumatic Restorative Treatment (ART) involves removal of carious tissue using hand instruments and restoration of the tooth with an adhesive filling materi -al usually a high viscosity glassionomer cement (GIC). This method does not require electricity or running tap
water. Therefore, ART can be performed in underserved communities. To improve the mechanical properties of GIC restorations energy application is recommended dur -ing clinical set of the material (Kleverlaan et al., 2004; O’Brien et al., 2010).
Aim
To study the effect of light application during curing of ART restorations on success rate after 18 months.
Discussion
Application of light improved the mechanical properties of class I restorations resulting in a sig -nificant higher success rate. For class II restorations light application resulted in a higher, but statisti -cally not significant, success rate. An explanation for this difference between class I and class II restorations could be factors complicating the restorative procedure. Shortcomings in excavating the approximal lesion, marginal adaptation of the restoration and contamination of the restoration with blood or saliva could compromise the quality of the restoration.
Material and Methods
125 children (age 5-8 yrs) attending two primary schools on the island of Ometepe (Nicaragua) were included in the study. The Ministry of Health of Nicaragua approved the project. Informed consent was obtained from the parent, caretaker or teacher. Open carious lesions were treated with ART restorations conform the work sheet for ART restorations (Frencken and Holmgren, 1999). The children were randomly divided over four treatment groups: 1) GC Fuji IX ® without light source; 2) GC Fuji IX ® with light source; 3) Ketac Molar Easymix ® without light source; 4) Ketac Molar Easymix ® with light source. Light application was performed using a LED curing light (Elipar S10 LED; 3MESPE) operating at a center wave -length of 455 ± 10 nm with an intensity output of 1200 mW/cm 2. Restorations were irradiated from a distance of 1mm during 20 sec. After 18 months the success rate of the respective treatment modalities was evaluated according to the WHO criteria for ART restorations (WHO, 1997). According to these criteria code 00 and code 10 were considered success. 154 class I restorations and 223 class II restorations were available for evaluation. Data were analysed using Pearson chi-square tests.
Results
Success rate of class I and class II restorations was 61% and 29% respectively (p< 0.001; Figure 1). The application of light resulted in a significant higher success rate for class I restorations (p=0.035) but not for class II restorations (p=0.231; Figure 2). No difference in success rate was observed between the different restoration materials GC Fuji IX and Ketac Molar Easymix (Figure 3). Table 1 shows the overall results for class I and class II restorations.
Conclusion
The application of light during setting of class I ART restorations has a beneficial effect on the success rate after 18 months.
References
• Frencken JE, Holmgren CJ. Atraumatic Resto -rative Treatment for dental caries. Nijmegen, 1999. STI Book B.V., 1999; 39-54.
• Kleverlaan CJ, van Duinen RN, Feilzer AJ. Mechanical properties of glass ionomer cements affected by curing methods. Dent Mat 2004; 20: 45-50.
• O’Brien T, Shoja-Assadi F, Lea SC et al. Extrinsic energy sources affect hardness through depth during set of a glassionomer cement. J Dent 2010; 38: 490-495.
• World Health Organisation. Oral Health surveys. Basic methods. Geneva: WHO, 1997; 41-42.