OBJECTIVETo assess the long effect of atraumatic restorative treatment (ART) restorations in a school environment.

METHODSFive middle-level dentists placed 294 ART restorations in the permanent teeth of 197 children. Standard instruments and procedures for ART were used. The restorative material used was a high-strength glass-ionomer. The restorations were evaluated annually by the same examiner who was not involved in the placement of the restorations. Occlusal wear of the restoration was assessed using a standard rheinberger scale. At the 5th year examination an independent external examiner evaluated the restorations using USPHS criteria.

RESULTSThe cumulative survival rates of small class I restorations in the sixth year it was 75%. The corresponding figures for large class I restorations were 61% (P < 0.05). The net wear rate for both the small and large class I restorations in the first year was about 48 microm, which was significantly higher than those of the later years, which were about 20 - 25 micro m (P < 0.05). In the fifth year 93% of the small restorations were assessed as being satisfactory for marginal integrity, as against 80% for the large ones by using USPHS criteria.

CONCLUSIONSThe ART approach for treating tooth decay in school children was appropriate, effective and acceptable. The 6-year survival rates of the restorations are high but are related to the size and type of the restoration.