5-Year survival of ART restorations with and without cavity disinfection

Objectives: The null-hypothesis tested was that there is no difference between the survival of ART restorations with, and without, cavity disinfection among adolescents after 5 years. Methods: Eligible students were allocated to one of the treatment groups. One operator placed a total of 90 restorations, 45 each per treatment group, in ninety 14-15 year olds. Restorations were evaluated on replica models at baseline and after 1 and 5 years, by two calibrated and independent evaluators using the ART criteria. The independent variables were gender, mean DMFT score at baseline, cavity size (small/large), cavity type (single-/multiple surfaces) and disinfected cavity (yes/no). Statistical analyses were done using the Kaplan-Meier method and log-rank test. Results: The cumulative survival percentage and standard error for the 61 ART restorations with and without disinfection at evaluation year 5 were 85% (S.E. = 6.1%) and 80% (S.E. = 7.1%), respectively: not significantly different (p = 0.37) from each other. The cumulative survival percentage and standard error for all ART restorations was 97% (S.E. = 2.0%) at evaluation year 1 and 82% (S.E. = 4.7%) at year 5, and it was 85% (S.E. = 5.4%) for single- and 77% (S.E. = 9%) for multiple-surface ART restorations at year 5. The cumulative survival percentage of all ART restorations at evaluation year 5 was statistically significant higher for boys than for girls (p = 0.03). Conclusions: Disinfecting a cavity cleaned according to ART with a 2% chlorhexidine solution is unnecessary. It is useful to introduce the ART approach systematically into the healthcare system in Egypt. © 2009 Elsevier Ltd. All rights reserved.