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Survival estimates of atraumatic restorative treatment versus traditional restorative treatment: a systematic review with meta-analyses

British Dental Journal (2021)Cite this article

Abstract

Objectives The hypothesis tested was that there is no significant difference between the survival estimates of atraumatic restorative treatment/high-viscosity glass-ionomer cement (ART/HVGIC) restorations, in posterior primary and permanent teeth, and traditional amalgam and resin composite restorations.

Data sources The databases PubMed, DOAJ, LILACS, IndMed, Google Scholar and CNKI were searched.

Data selection Using inclusion and exclusion criteria led to 14 eligible randomised trials. A low risk of bias was observed for two reports. Homogeneity was obtained for single-surface ART restorations after one and two years in the primary dentition.

Data synthesis No statistically significant difference was found between the weighted mean survival percentages of ART/HVGIC and traditional treatments in both single- and multiple-surface restorations in primary molars and in single-surface restorations in posterior permanent teeth at years 1, 2, 3 and 5. At years 4.3 and 6.3, the difference between the two treatments was statistically significant, favouring the ART/HVGIC restorations. No statistically significant difference was found between the weighted mean survival percentages of ART/HVGIC and traditional treatments in multiple-surface restorations in posterior permanent teeth.

Conclusion The ART method using HVGICs can be considered as a replacement for traditional restorations in single- and multiple-surface cavities in primary molars, and in single-surface cavities in posterior permanent teeth, particularly for amalgam.

Key points

  • No significant differences in survival percentages between ART and traditionally-produced single-surface restorations in primary and permanent (pre)molars were observed.

  • No significant differences in survival percentages between ART and traditionally-produced multiple-surface restorations in primary molars were observed.

  • The high-viscosity glass-ionomer cements tested can be used to replace amalgam in single-surface cavities in primary and permanent (pre)molars and in multiple-surface cavities in primary teeth treated according to ART.

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References

  1. Frencken J E, Peters M C, Manton D J, Leal S C, Gordan V V, Eden E. Minimal intervention dentistry for managing dental caries - a review: report of a FDI task group. Int Dent J 2012; 62: 223-243.

  2. World Dental Federation. Policy statement: Minimal intervention dentistry (MID) for managing dental caries. 2016. Available online at https://www.fdiworlddental.org/resources/policy-statements-and-resolutions/minimal-intervention-dentistry-mid-for-managing-dental (accessed January 2021).

  3. Schwendicke F, Frencken J E, Bjorndal L et al. Managing carious lesions: consensus recommendations on carious tissue removal. Adv Dent Res 2016; 28: 58-67.

  4. Arrow P, Klobas E. Minimal intervention dentistry for early childhood caries and child dental anxiety: a randomized controlled trial. Aust Dent J 2017; 62: 200-207.

  5. Faustino-Silva D D, Figueiredo M C. Atraumatic restorative treatment - ART in early childhood caries in babies: 4 years of randomized clinical trial. Clin Oral Investig 2019; 23: 3721-3729.

  6. Heasman P A, Ritchie M, Asuni A, Gavillet E, Simonsen J L, Nyvad B. Gingival recession and root caries in the ageing population: a critical evaluation of treatments. J Clin Periodontol 2017; 44 Suppl 18: S178-S193.

  7. Allen P F, Da Mata C, Hayes M. Minimal intervention dentistry for partially dentate older adults. Gerodontology 2019; 36: 92-98.

  8. De Amorim R G, Frencken J E, Raggio D P, Chen X, Hu X, Leal S C. Survival percentages of atraumatic restorative treatment (ART) restorations and sealants in posterior teeth: an updated systematic review and meta-analysis. Clin Oral Investig 2018; 22: 2703-2725.

  9. Mickenautsch S, Yengopal V. Failure rate of high-viscosity GIC based ART compared with that of conventional amalgam restorations-evidence from an update of a systematic review. South Afr Dent J 2012; 67: 329-331.

  10. Mickenautsch S. High-viscosity glass-ionomer cement for direct posterior tooth restorations in permanent teeth: the evidence in brief. J Dent 2016; 55: 121-123.

  11. Raggio D P, Hesse D, Lenzi T L, Guglielmi C A, Braga M M. Is Atraumatic restorative treatment an option for restoring occlusoproximal caries lesions in primary teeth? A systematic review and meta-analysis. Int J Paediatr Dent 2013; 23: 435-443.

  12. Tedesco T K, Calvo A F, Lenzi T L et al. ART is an alternative for restoring occlusoproximal cavities in primary teeth - evidence from an updated systematic review and meta-analysis. Int J Paediatr Dent 2016; 27: 201-209.

  13. Schwendicke F, Göstemeyer G, Blunck U, Paris S, Hsu L Y, Tu Y K. Directly placed restorative materials: review and network meta-analysis. J Dent Res 2016; 95: 613-622.

  14. Mickenautsch S. Letter to the Editor: Composites - The best choice for load-bearing cavitated lesions in permanent teeth? J Dent Res 2016; 95: 1073.

  15. Schwendicke F, Göstemeyer G, Blunck U, Paris S, Hsu L Y, Tu Y K. Response to Letter to the Editor: Composites - the best choice for load-bearing cavitated lesions in permanent teeth? J Dent Res 2016; 95: 1074.

  16. Kielbassa A M, Glockner G, Wolgin M, Glockner K. Systematic review on highly viscous glass-ionomer cement/resin coating restorations (Part I): Do they merge Minamata Convention and minimum intervention dentistry? Quintessence Int 2016; 47: 813-823.

  17. FDI World Dental Federation. Policy statement: Carious lesions and first restorative treatment. 2019. Available online at https://www.fdiworlddental.org/resources/policy-statements/carious-lesions-and-first-restorative-treatment (accessed January 2021).

  18. Małkiewicz K, Wychowański P, Olkowska-Truchanowicz J et al. Uncompleted polymerization and cytotoxicity of dental restorative materials as potential health risk factors. Ann Agric Environ Med 2017; 24: 618-623.

  19. Celik N, Binnetoglu D, Ozakar Ilday N, Hacimuftuoglu A, Seven N. The cytotoxic and oxidative effects of restorative materials in cultured human gingival fibroblasts. Drug Chem Toxicol 2019; 31: 1-6.

  20. Paula A B, Toste D, Marinho A et al. Once resin composites and dental sealants release Bisphenol-A, how might this affect our clinical management? - A systematic review. J Environ Res Public Health 2019; 16: 1627.

  21. Kingman A, Hyman J, Masten S A et al. Bisphenol A and other compounds in human saliva and urine associated with the placement of composite restorations. J Am Dent Assoc 2002; 143: 1292-1302.

  22. Berge T L L, Lygre G B, Jönsson B A G, Lindh C H, Björkman L. Bisphenol A concentration in human saliva related to dental polymer-based fillings. Clin Oral Investig 2017; 21: 2561-2568.

  23. Konieczna A, Rutkowska A, Rachoń D. Health risk of exposure to Bisphenol A (BPA). Rocz Panstw Zakl Hig 2015; 66: 5-11.

  24. World Dental Federation. Policy statement: Bisphenol-A in dental restorative and preventive materials. 2013. Available online at https://www.fdiworlddental.org/resources/policy-statements-and-resolutions/bisphenol-a-in-dental-restorative-and-preventive (accessed January 2021).

  25. Dursun E, Fron-Chabouis H, Attal J P, Raskin A. Bisphenol A release: survey of the composition of dental composite resins. Open Dent J 2016; 10: 446-453.

  26. Bakopoulou A, Papadopoulos T, Garefis P. Molecular toxicology of substances released from resin-based dental restorative materials. Int J Mol Sci 2009; 10: 3861-3899.

  27. European Commission. Communication from the Commission to the European parliament, the European Council, the Council, the European Economic and Social Committee and the Committee of the Regions: The European Green Deal. 2019. Available online at https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=CELEX%3A52019DC0640 (accessed January 2021).

  28. European Commission. Communication from the Commission to the European Parliament, the European Council, the Council, the European Economic and Social Committee and the Committee of the Regions: A European Strategy for Plastics in a Circular Economy. 2018. Available online at https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=COM%3A2018%3A28%3AFIN (accessed January 2021).

  29. Goldman A, Frencken J E, De Amorim R G, Leal S C. Replacing amalgam with a high-viscosity glass-ionomer in restoring primary teeth: a cost-effectiveness study in Brasilia, Brazil. J Dent 2018; 70: 80-86.

  30. Moher D, Liberati A, Tetzlaff J, Altman D G, the PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement. BMJ 2009; DOI: 10.1136/bmj.b2535.

  31. Gurgan S, Kutuk Z B, Yalcin Cakir F, Ergin E. A randomized controlled 10 years follow up of a glass ionomer restorative material in class I and class II cavities. J Dent 2020; 94: 103175.

  32. Frencken J E, Taifour D, van't Hof M A. Survival of ART and amalgam restorations in permanent teeth of children after 6.3 years. J Dent Res 2006; 85: 622-626.

  33. Taifour D, Frencken J E, Beiruti N, van't Hof M A, Truin G J, van Palenstein Helderman W H. Comparison between restorations in the permanent dentition produced by hand and rotary instrumentation - survival after 3 years. Community Dent Oral Epidemiol 2003; 31: 122-128.

  34. Gao W, Peng D, Smales R, Yip K H K. Comparison of atraumatic restorative treatment and conventional restorative procedures in a hospital clinic: evaluation after 30 months. Quintessence Int 2003; 34: 31-37.

  35. Yip K H K, Smales R J, Gao W, Peng D. The effects of two cavity preparation methods on longevity of glass ionomer cement restorations. An evaluation after 12 months. J Am Dent Assoc 2002; 133: 744-751.

  36. Yu C, Gao X J, Deng D M, Yip H K, Smales R J. Survival of glass ionomer restorations placed in primary molars using atraumatic restorative treatment (ART) and conventional cavity preparations: 2-year results. Int Dent J 2004; 54: 42-46.

  37. Yip H K, Smales R J, Yu C, Deng D M. Comparison of Atraumatic Restorative Treatment and conventional cavity preparations for glass-ionomer restorations in primary molars: one-year results. Quintessence Int 2002; 33: 17-21.

  38. Molina G F, Faulks D, Mulder J, Frencken J E. High-viscosity glass-ionomer vs. composite resin restorations in persons with disability: five-year follow-up of clinical trial. Braz Oral Res 2019; DOI: 10.1590/1807-3107bor-2019.vol33.0099.

  39. Pan American Health Organization. Oral health of low-income children: Procedures for Atraumatic Restorative Treatment (PRAT). 2006. Available at https://www.paho.org/hq/dmdocuments/2009/oh_top_pt_low06.pdf (accessed January 2021).

  40. Cumpston M. Exploring heterogeneity - slidecast. 2013. Available at http://training.cochrane.org/resource/exploring-heterogeneity (accessed February 2018).

  41. The R Foundation. The R Project: A language and environment for statistical computing. 2017. Available online at https://www.r-project.org/ (accessed January 2021).

  42. Honkala E, Behbehani J, Ibricevic H, Kerosuo E, Al-Jame G. The atraumatic restorative treatment (ART) approach to restoring primary teeth in a standard dental clinic. Int J Paediatr Dent 2003; 13: 172-179.

  43. Taifour D, Frencken J E, Beiruti N, van't Hof M A, Truin G J. Effectiveness of glass-ionomer (ART) and amalgam restorations in the deciduous dentition - results after 3 years. Caries Res 2002; 36: 437-444.

  44. Rahimtoola S, Van Amerongen W E. Comparison of two tooth saving preparation techniques for one surface cavities. J Dent Child 2002; 69: 16-26.

  45. Ersin N K, Candan U, Aykut A, Onçag O, Eronat C, Kose T. A clinical evaluation of resin-based composite and glass ionomer cement restorations placed in primary teeth using the ART approach: results at 24 months. J Am Dent Assoc 2006; 137: 1529-1536.

  46. Molina G F, Faulks D, Mazzola I, Cabral R J, Mulder J, Frencken J E. Three-year survival of ART high-viscosity glass-ionomer and resin composite restorations in people with disability. Clin Oral Investig 2018; 22: 461-467.

  47. Higgins J P, Thompson S G, Deeks J J, Altman D G. Measuring inconsistency in meta-analyses. BMJ 2003; 327: 557-560.

  48. Mickenautsch S, Yengopal V, Banerjee A. Atraumatic restorative treatment versus amalgam restoration longevity: a systematic review. Clin Oral Investig 2010; 14: 233-240.

  49. Gurgan S, Kutuk Z B, Ozturk C, Soleimani R, Cakir F Y. Clinical performance of a glass hybrid restorative in extended size Class II cavities. Oper Dent 2020; 45: 243-254.

  50. Balkaya H, Arslan S, Pala K. A randomized, prospective clinical study evaluating effectiveness of a bulk-fill composite resin, a conventional composite resin and a reinforced glass ionomer in Class II cavities: one-year results. J Appl Oral Sci 2019; DOI: 10.1590/1678-7757-2018-0678.

  51. Diem V T, Tyas M J, Ngo H C, Phuong L H, Khanh N D. The effect of a nano-filled resin coating on the 3-year clinical performance of a conventional high-viscosity glass-ionomer cement. Clin Oral Investig 2014; 18: 753-759.

  52. Gurgan S, Kutuk Z B, Ergin E, Oztas S S, Cakir F Y. Four-year randomized clinical trial to evaluate the clinical performance of a glass ionomer restorative system. Oper Dent 2015; 40: 134-143.

  53. Firat E, Kutuk Z B, Gurgan S, Cakir F Y, Oztas S S. 24-month clinical performance evaluation of a current glass-ionomer restorative system. A U Hek Fak Derg 2011; 38: 53-61.

  54. Ergin E, Gurgan S, Kutuk Z B, Cakir F Y, Oztas S S. 36 months clinical performance evaluation of a current glass-ionomer restorative system. Cumhuriyet Dent J 2014; 17: 244-255.

  55. Celik E U, Tunac A T, Yilmaz F. Three-year clinical evaluation of high-viscosity glass ionomer restorations in non-carious cervical lesions: a randomised controlled split-mouth clinical trial. Clin Oral Investig 2019; 23: 1473-1480.

  56. Chen X, Wei X L. Clinical effects of glass ionomer cement FX in restoring deciduous molar teeth caries. Chin J Conserv Dent 2001; 5: 326-327.

  57. Jiang R L, Chen Y, Tang J W, Wei Y. Clinical observation of Fuji IX glass ionomer on treatment of root caries from aged patients. Chin J Aesthet Med 2013; 8: 865-867.

  58. Xiong Y. Comparative study on filling dental cavities with new material 3M Ketac Molar ultrahard glass ionomer cements and silver amalgams. J Clinic Rehab Tissue Engin Res 2009; 21: 4077-4079.

  59. Chen M M, Su T, Huang Y Q, Yuan Z Z. Clinic effect of SDR in restoring wedge-shaped defect. J Pract Stomatol 2017; 1: 121-123.

  60. Lei A P, Huang L. Clinical effect of 3 filling materials on the treatment of root caries from aged patients. Chin J Stomatol Res 2012; 3: 55-57.

  61. He M Y, Sun W G, Ying X X. Comparison of clinical efficacy between glass-ionomer cement and nanocomposite resin on filling proximal surface caries of deciduous teeth. Chin Dent Mat Devices 2016; 4: 217-220.

  62. Xiang S S. Comparison of therapeutic effects of two different materials on superficial caries of primary premolar teeth. Chin J Integr Tradit West Med 2014; 5: 437-438.

  63. Wang Y, Liu Y, Feng P X, Zhang Z X. Clinical observation of Fuji IX glass ionomer on filling caries of primary molar teeth. Chin Aesthet Med 2011; 10: 1619-1620.

  64. Lei M G. Clinical observation of Fuji IX glass ionomer in restoring wedge-shaped defect of elders' vital teeth. J Huaibei Profession Techn Coll 2014; 3: 143-144.

  65. You X J, Chen Y W. Clinical observation of glass ionomer in restoring wedge-shaped defect. Public Med Forum Magazine 2015; 5: 635-636.

  66. Cao J M. Clinical analysis of Fuji IX glass ionomer in restoring wedge-shaped defect. Nei Mongol J Tradit Chin Med 2014; 3: 48.

  67. He J. Comparison of therapeutic effects of two methods in restoring wedge-shaped defect. Guangxi Med J 2006; 4: 535-536.

  68. Chen H L, Xue J N, Liang H. Comparison of therapeutic effects of two different materials in restoring wedge-shaped defect. Fujian Med J 2010; 6: 72-73.

  69. Mo Q B. Clinical observation of sandwich technology by using light-cured tetric ceram and glass ionomer in restoring wedge-shaped defect. J Practic Stomatol 2006; 22: 626.

  70. Zhou X G. Comparison of therapeutic effects of sandwich technology and glass ionomer in restoring caries in proximal surface. Chin J Inform Tradit Chin Med 2011; 12: 108.

  71. Wang P, Kang P C. Clinical observation of three methods in restoring wedge-shaped defect. J Oral Sci Res 2009; 4: 526-529.

  72. Zhu Y, Shi F. Comparison of therapeutic effects of Fuji IX glass ionomer on the treatment of root caries of elders. Chin J Practic Stomatol 2013; 2: 114-115.

  73. Zhao J B, Sun D W, Du W, Shu L. Clinical observation of Fuji IX glass ionomer in restoring wedge-shaped defect. Chin J Conserv Dent 2007; 17: 519.

  74. Zhou L Z, Liu Y. Clinical observation of 3M Ketac Molar Easymix glass ionomer cements in filling moderate caries of primary teeth. Hainan Med J 2009; 9: 215.

  75. Liao L K. Clinical observation of different materials in restoring deep caries of molars in proximal and occlusal area. Guangxi Med 2010; 9: 1093-1095.

  76. Mijan M, de Amorim R G, Leal S C et al. The 3.5-year survival rates of primary molars treated according to three treatment protocols: a controlled clinical trial. Clin Oral Investig 2014; 18: 1061-1069.

  77. Molina G F, Faulks D, Mazzola I, Mulder J, Frencken J E. One-year survival of ART and conventional restorations in patients with disability. BMC Oral Health 2014; 14: 49.

  78. Peng D, Gao W, Smales R J, Yip H K. Evaluation of ART and conventional restorative procedures in a clinic after 30 months. J Modern Stomatol 2004; 6: 533-535.

  79. Zanata R L, Navarro M F L, Barbosa S H, Lauris J R P, Franco E B. Clinical evaluation of three restorative materials applied in a minimal intervention caries treatment approach. J Public Health Dent 2003; 63: 221-226.

  80. De Miranda L M S. Randomized and controlled clinical study comparing atraumatic restorative with amalgam conventional treatments in primary molars: 6 and 12 month evaluation. Rio de Janeiro: University of Rio de Janeiro, 2005. Thesis.

  81. Li H M, Dou Z H. Clinical observation of using different material in the elderly decayed tooth ART technique. Practic Clin Med 2005; 3: 105-107.

  82. Chen B X, Kang J, Guo N, Zhang S L. A clinical study of atraumatic restorative treatment (ART) in children with dental caries. Acta Acad Med Jiangxi 2006; 2: 97-99.

  83. Li X, Hu D Y, Wan H C, Xu X Y. A two-year clinical trial of atraumatic restorative treatment in primary teeth. West China J Stomatol 2002; 2: 125-127.

  84. Wang Q, Ding C S. Evaluation of the effects of atraumatic restorative treatment in primary caries. J Taizhou Polytech Inst 2004; 4: 63-67.

  85. Ling L, Wang X N. Evaluation of the effects of atraumatic restorative treatment and cooperation degree in primary caries. Stomatol 2003; 5: 290-291.

  86. She X Q, Li X, Wan H C, Fan X, Hu D Y. A 2-year clinic trial of atraumatic restorative treatment in primary teeth. J Practic Stomatol 2003; 1: 30-33.

  87. Qiu H L. Two-year clinical trial of atraumatic restorative treatment in primary teeth. Stomatol 2007; 8: 413-415.

  88. Ye X Y, Liu T, Huang S H. The effect of ART in the restoration of deciduous molars. J Dent Prev Treat 2006; 1: 39-40.

  89. Wu X P, Wang L L, Yu S C. Therapeutic effects of atraumatic restorative treatment (ART) in management of 117 patients with caries. Practic Prev Med 2005; 5: 1081-1082.

  90. Zhang X L, Fan Y, Hu Z, Wang Y Y. Restoration of carious primary teeth using atraumatic restorative treatment (ART). Pract New Med 2001; 5: 389-391.

  91. Lin B B, Ye W B. Clinical analysis of modified atraumatic restorative treatment (ART) in treatment of children's caries. J Med Theory Pract 2012; 5: 557.

  92. Hu Q L. Clinical observation of atraumatic restorative treatment (ART) in filling caries of primary molar teeth. Stomatol 2005; 2: 115.

  93. Huang G Q. Clinical analysis of atraumatic restorative treatment (ART) in restoring caries of primary molar teeth. Strait J Prev Med 2009; 5: 35-36.

  94. Liu H B. Clinical observation of atraumatic restorative treatment (ART) in restoring caries of children's primary teeth. Shandong Med J 2010; 10: 103.

  95. Zeng H Y, Pan Z H. Atraumatic restorative treatment (ART) and observation of micro-structure of primary teeth. J Sun Yat-sen Univ (Med Sci) 2006; 4S: 27-29.

  96. Ling L, Wang X N. Clinical observation of atraumatic restorative treatment (ART) in restoring primary molar caries in proximal and occlusal area. J Dent Prev Treat 2003; 1: 40-41.

  97. Wang M L. Clinical observation of atraumatic restorative treatment (ART) in restoring caries of primary molar teeth. Chin Med Fact Mine 2005; 5: 451-452.

  98. Weng S P. Clinical practice of atraumatic restorative treatment (ART) in restoring caries of primary molar teeth. Jiangxi Med 2005; 2: 95-96.

  99. Mo Q B. Clinical evaluation of atraumatic restorative treatment (ART) in restoring caries of primary molar teeth. Guangxi Med 2007; 7: 1071-1072.

  100. Hilgert L A, de Amorim R G, Leal S C, Mulder J, Creugers N H, Frencken J E. Is high-viscosity glass-ionomer-cement a successor to amalgam for treating primary molars? Dent Mater 2014; 30: 1172-1178.

  101. Menezes-Silva R, Velasco S R M, Bastos R S et al. Randomized clinical trial of class II restoration in permanent teeth comparing ART with composite resin after 12 months. Clin Oral Investig 2019; 23: 3623-3635.

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Acknowledgements

We would like to thank Professor S. Mickenautsch for sharing updated systematic literature search results, particularly for high-viscosity glass ionomers, from the RinshoTrial dataset (DOI: 10.13140/RG.2.2.13924.53126) and for critically reading the manuscript. Special thanks go to Mrs S. van Tonder for skilfully editing the text for English grammar and syntax. We very much appreciate the assistance of Dr E. Bronkhorst in analysing the data statistically. No funding was declared.

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Authors and Affiliations

  1. Department of Dentistry, Section of Function and Prosthetic Dentistry, Radboud University Medical Centre, Nijmegen, The Netherlands

    Jo E. Frencken & Qian Zhang

  2. The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China

    Shanshan Liang

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J. E. Frencken contributed to the conception, design, data collection, data extraction and construction of the manuscript. S. Liang contributed to data extraction and construction of the manuscript. Q. Zhang contributed to data collection, data extraction and construction of the manuscript. All authors gave final approval and agree to be accountable for all aspects of the work.

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Correspondence to Jo E. Frencken.

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J. E. Frencken is the originator of the ART approach and as such could be considered to have a conflict of interest. S. Liang and Q. Zhang declare that they have no conflict of interest.

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Frencken, J., Liang, S. & Zhang, Q. Survival estimates of atraumatic restorative treatment versus traditional restorative treatment: a systematic review with meta-analyses. Br Dent J (2021). https://doi.org/10.1038/s41415-021-2701-0

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