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Open Access Research article

One year survival of ART and conventional restorations in patients with disability

Gustavo F Molina1*, Denise Faulks2, Ignacio Mazzola1, Jan Mulder3 and Jo E Frencken3

Author Affiliations

1 Cátedra de Materiales Dentales, Facultad de Odontología, Universidad Nacional de Córdoba, Av. Maipú 177 4, B – 5000 Córdoba, Argentina

2 CHU Clermont-Ferrand, Service d’Odontologie and Clermont Université, Université d’Auvergne, EA4847 Clermont Ferrand, France

3 Department of Global Oral Health, College of Dental Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands

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BMC Oral Health 2014, 14:49  doi:10.1186/1472-6831-14-49

Published: 7 May 2014

Abstract

Background

Providing restorative treatment for persons with disability may be challenging and has been related to the patient’s ability to cope with the anxiety engendered by treatment and to cooperate fully with the demands of the clinical situation. The aim of the present study was to assess the survival rate of ART restorations compared to conventional restorations in people with disability referred for special care dentistry.

Methods

Three treatment protocols were distinguished: ART (hand instruments/high-viscosity glass-ionomer); conventional restorative treatment (rotary instrumentation/resin composite) in the clinic (CRT/clinic) and under general anaesthesia (CRT/GA). Patients were referred for restorative care to a special care centre and treated by one of two specialists. Patients and/or their caregivers were provided with written and verbal information regarding the proposed techniques, and selected the type of treatment they were to receive. Treatment was provided as selected but if this option proved clinically unfeasible one of the alternative techniques was subsequently proposed. Evaluation of restoration survival was performed by two independent trained and calibrated examiners using established ART restoration assessment codes at 6 months and 12 months. The Proportional Hazard model with frailty corrections was applied to calculate survival estimates over a one year period.

Results

66 patients (13.6 ± 7.8 years) with 16 different medical disorders participated. CRT/clinic proved feasible for 5 patients (7.5%), the ART approach for 47 patients (71.2%), and 14 patients received CRT/GA (21.2%). In all, 298 dentine carious lesions were restored in primary and permanent teeth, 182 (ART), 21 (CRT/clinic) and 95 (CRT/GA). The 1-year survival rates and jackknife standard error of ART and CRT restorations were 97.8 ± 1.0% and 90.5 ± 3.2%, respectively (p = 0.01).

Conclusions

These short-term results indicate that ART appears to be an effective treatment protocol for treating patients with disability restoratively, many of whom have difficulty coping with the conventional restorative treatment.

Trial registration number

Netherlands Trial Registration: NTR 4400

Keywords:
Disability and oral health; Atraumatic restorative treatment; Dental care for disabled; Professional practice; Dental caries; Glass-ionomer cement