Dilemma of Managing Multi-surface Dental Caries in the Primary Dentition Using the Atraumatic Restorative Treatment: Renaissance or Dimming Hope.

BACKGROUND A lot of research work has been carried out to determine the effectiveness of using a traumatic restorative treatment (ART) in the management of dental caries, but there are still unresolved issues surrounding the use of the technique particularly in very large carious lesions. OBJECTIVE To determine the current survival rates of multi-surface ART restorations placed in the primary dentition and any consequences to the restored tooth after premature loss of the restoration. STUDY SELECTION Using a set of specific key words, a Pubmed/Medline search was carried out to retrieve all publications on ART restorations placed in primary teeth in the period January 2000 to December 2011. Only publications whose studies had multi-surface ART restorations as an item of study were retrieved and relevant data extracted. DATA SYNTHESIS Twelve studies contained in 12 publications fulfilled the selection criteria and were included in the study. The selected publications were analysed by the author to establish the study follow-up period and the survival rate of the multi-surface ART restorations for the different follow-up periods. Further information was adduced on any other effects of restoration on the tooth after premature loss of the restoration. RESULTS The search findings indicated that the survival rate for most of the multi-surface restorations were generally very low. Further, there were indications that even after the premature loss of the ART restorations, most of the affected teeth survived for the period of the study with a number of them having shown no signs of secondary caries or associated dental abscessees. CONCLUSION While the survival rates of multi-surface ART restorations in the studies documented in the review were low, the ART restorations appeared to provide some beneficial effects to the retention-longevity of the restored tooth even after their premature loss.