Is Atraumatic restorative treatment an option for restoring occlusoproximal caries lesions in primary teeth? A systematic review and meta-analysis

Background Atraumatic restorative treatment (ART) has demonstrated good longevity when used for single-surface restorations, but lower success rates are reported for occlusoproximal surfaces. Aim This systematic review and meta-analysis aimed to verify the pooled success rate of occlusoproximal ART restorations in primary teeth considering the outcomes: longevity, pulp damage, or caries lesion progression. Design Literature searching was carried out on the studies reporting clinical trials indexed in PubMed and in English language, comprising the outcomes. A meta-analysis was undertaken considering the results from reviewed studies. Results An initial search resulted in 126 articles, and three of them were finally selected. The main reasons for excluding articles were the absence of control group, as amalgam, composite resin, or compomer restorations to be compared with ART (hand excavation + high-viscous GIC). The pooled estimate (odds ratio; 95% confidence interval) for ART approach success was 1.04 (0.65–1.66). Conclusion Atraumatic restorative treatment restorations performed with high-viscous GIC present similar survival/success rates to conventional approach using composite resin or amalgam for occlusoproximal restorations in primary teeth and can be suggested as a good option for occlusoproximal cavities in primary molars. In addition, further randomized controlled clinical investigations concerning occlusoproximal restorations in primary teeth are still necessary