How it works and clinical effectiveness
ART restorations with HVGIC have shown high success in long-term follow-up studies for single surfaces, in the primary and permanent dentitions, with meta-analyses showing weighted mean annual failure percentages of 5% in primary molars over the first three years, and 4.1% over the first five years in permanent posterior teeth.29 However, there are not enough studies on multi-surface restorations in the permanent dentition to recommend it as a long-term strategy yet. A recent systematic review reported no significant differences in survival percentages between ART and traditionally produced multiple-surface restorations in primary molars,72,73 and for single-surface restorations in primary molars and posterior permanent teeth.73 Large-sized multi-surface ART/HVGIC restorations in primary molars were less successful because of poor restorative material performance rather than the caries removal technique. However, ART may be a good short-term strategy for large multi-surface cavities or for stabilising the dentitions before other restorative interventions.