Clinical Oral Investigations

, Volume 23, Issue 9, pp 3623–3635 | Cite as

Randomized clinical trial of class II restoration in permanent teeth comparing ART with composite resin after 12 months

  • Rafael Menezes-SilvaEmail author
  • S. R. M. Velasco
  • R. S. Bastos
  • G. Molina
  • H. M. Honório
  • J. E. Frencken
  • M. F. L. Navarro
Original Article



This study evaluated the effectiveness of class II restorations, in permanent teeth, through the ART technique in comparison to composite resin.

Materials and methods

Participants (154), aged 8 to 19 years, with good general health, with class II cavities in permanent teeth, and without pulp involvement and tooth pain were included in this parallel and randomized clinical trial. The Ethics Committee approval number was CAAE: 24012913.0.1001.5417. Seventy-seven restorations were made with each restorative material (Equia Fil-GC Corporation and Z350-3M). Evaluations occurred at 6 and 12 months by the criteria of ART and the USPHS modified. Data were analyzed by Mann-Whitney, chi-square, Fisher’s exact, chi-square tests with linear trend and logistic regression by enter method (p < 0.050). The Kaplan-Meier test evaluated the survival rates of the restorations. The log-rank test compared the survival curves.


Regardless of the evaluation criteria used, the success rates of ART restorations were 98.7% (6 months) and 95.8% (12 months) and for composite resins were 100% (6 months) and 98.7% (12 months), with no statistical difference of restoration groups (p > 0.050). Survival rates for restorations, regardless of the evaluation criteria used, are the same as the success rates, with the exception of ART restorations at 12 months of follow-up (94.8%).


No differences in the success rates of class II restorations of ART compared to resin composite, in permanent teeth, were observed after 12 months.

Clinic significant

HVGIC can safely be used to restore proximal cavities in permanent teeth up to 12 months.


Glass ionomer cement Composite resin Posterior teeth Permanent dentition Atraumatic restorative treatment Clinical trial 



The work was supported by the São Paulo Research Foundation (FAPESP, grant 2014/01626–3).

Compliance with ethical standards

Conflict of interest

The authors declare that have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Rafael Menezes-Silva
    • 1
    Email author
  • S. R. M. Velasco
    • 2
  • R. S. Bastos
    • 3
  • G. Molina
    • 4
  • H. M. Honório
    • 3
  • J. E. Frencken
    • 5
  • M. F. L. Navarro
    • 1
  1. 1.Department of Dental Materials, Endodontics and Operative DentistryBauru School of DentistryBauruBrazil
  2. 2.Public Health FacultyUniversity of São PauloSão PauloBrazil
  3. 3.Department of Pediatric Dentistry, Orthodontics and Public HealthBauru School of DentistryBauruBrazil
  4. 4.Department of Dental Materials, School of DentistryNational University of CórdobaCórdobaArgentina
  5. 5.Department of Oral Function and Prosthetic DentistryRadboud University Medical CentreNijmegenThe Netherlands

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