An RCT of atraumatic restorative treatment for older adults: 5 year results

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Date
2019
Authors
da Mata, C.
McKenna, G.
Anweigi, L.
Hayes, M.
Cronin, M.
Woods, N.
O'Mahony, D.
Allen, P. F.
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Elsevier Ltd
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Abstract
Objectives: to compare the survival of ART and a conventional restorative technique (CT) for restoring carious lesions in older adults after 5 years. Methods: In this parallel randomised controlled clinical trial, 219 independently-living adults were recruited from a dental hospital/community and a geriatric day hospital. Ninety-nine patients who met the inclusion criteria and presented with carious lesions were randomly allocated to receive either ART or conventional restorations (anaesthesia, rotary instruments and resin-modified glass ionomer). The status of restorations was assessed 6 months, 1, 2 and 5 years after restoration placement. Estimates of cumulative survival were calculated for each interval between assessments and a Cox Proportional Hazards (PH) model was fitted to the interval-censored survival time. Results: Three hundred restorations (ART n=142; CT n=158) were placed on 99 patients, 46 males and 53 females, with a mean age of 73.2, SD: 6.8 (65–90 yrs). After 5 years, ART and CT presented cumulative probability of survival of 85% and 79% (p=0.8095), respectively. Conclusions: ART presents survival rates comparable to a conventional technique, when treating older adults after 5 years. The ART approach could be a useful tool to provide dental care for older adults particularly in the nonclinical setting. (Trial Registration number: ISRCTN 76299321). Clinical Relevance: This study shows that ART presents survival rates comparable to conventional techniques to treat carious lesions in older patients after 5 years. It is well accepted by this age cohort, and therefore could be an alternative to treat the elderly, especially those who are homebound or cannot attend the dentist. © 2019 Elsevier Ltd
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Keywords
ART , Caries removal , Elderly , Gerodontology , Restorative treatment , Root caries
Citation
Da Mata, C., McKenna, G., Anweigi, L., Hayes, M., Cronin, M., Woods, N., O’Mahony, D. and Allen, P. F. (2019) 'An RCT of atraumatic restorative treatment for older adults: 5 year results', Journal of Dentistry, 83, pp.95-99. https://doi.org/10.1016/j.jdent.2019.03.003
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