2-year survival and cost analysis of occlusoproximal ART restorations using encapsulated glass ionomer cement in primary molars: a randomized controlled trial

BMC Oral Health. 2024 Jun 1;24(1):647. doi: 10.1186/s12903-024-04357-9.

Abstract

Background: The survival of ART restorations can be influenced by the choice of the restorative material. The aim of this randomized non-inferiority controlled trial was to compare the 2-year survival rate and cost analysis of two encapsulated glass ionomer cements (GIC) as occlusoproximal restorative materials in primary molars.

Methods: Children from public schools in Tietê (Brazil), aged 4-8 years with occlusoproximal dentine carious lesions in primary molars were selected and randomly assigned to receive either Equia Forte (EF) or Riva Self Cure (RSC) as restorative materials. Treatment was carried out by two trained final-year dental students in schools following ART premises. Restorations were assessed by a trained and calibrated examiner after 2, 6, 12, 18, and 24 months. The primary outcome was restoration survival after 2 years, analyzed using Kaplan-Meier survival and Cox regression analysis (α = 5%). Professional and materials costs for each group were collected in Brazilian Reais (R$) and converted into US dollars (US$) and analyzed using Monte-Carlo simulation.

Results: A total of 152 children (76 per group) were included in the study, and 121 (79%) were evaluated after 2 years. The overall 2-year restoration survival rate was 39% (EF = 45%; RSC = 32%) with no difference between the groups. The baseline and 2-year total cost of restorations using RSC was lower when compared to EF (incremental cost: US$ 6.18).

Conclusion: After two years of follow-up, Riva Self Cure shows comparable restoration survival rates to Equia Forte, being more cost-effective in the Brazilian perspective.

Trial registration: This randomized clinical trial was registered on ClinicalTrials.Gov - NCT02730000.

Keywords: Clinical efficacy; Cost analysis; Dental atraumatic restorative treatment; Glass ionomer cement; Pediatric dentistry; Primary teeth.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Brazil
  • Child
  • Child, Preschool
  • Costs and Cost Analysis
  • Dental Atraumatic Restorative Treatment* / economics
  • Dental Atraumatic Restorative Treatment* / methods
  • Dental Caries / therapy
  • Dental Restoration Failure
  • Dental Restoration, Permanent / economics
  • Dental Restoration, Permanent / methods
  • Female
  • Glass Ionomer Cements* / economics
  • Glass Ionomer Cements* / therapeutic use
  • Humans
  • Male
  • Molar*
  • Tooth, Deciduous*

Substances

  • Glass Ionomer Cements

Associated data

  • ClinicalTrials.gov/NCT02730000