Low-cost GICs reduce survival rate in occlusal ART restorations in primary molars after one year: A RCT

Abstract Introduction The high costs of the worldwide recommended GICs might be a barrier for the implementation of ART. To overcome this problem, low cost GIC are used even though there is a lack of evidence for the survival rate of restorations. Objectives To evaluate the performance of low-cost GICs used on occlusal ART restorations after one year. Methods A total of 150 primary molars in 150 children with occlusal caries lesions were selected in 4–8 year-old children. The patients were randomly allocated in three groups: G1–GC Gold Label 9 (GC Corp); G2–Vitro Molar (DFL) and G3–Maxxion R (FGM). All treatments were performed following the ART premises in school setting. Restorations were evaluated after 2, 6 and 12 months. Restoration survival was evaluated using Kaplan-Meier survival analysis and Log-rank test and Cox regression was used for testing association with clinical factors (α = 5%). Results GC Gold Label 9 had better performance compared to the low-cost GICs (HR = 1.47, CI = 1.04–2.08, p  = 0.027). The overall SR of restorations was 65.33% and the SR per group was G1 = 77.55%; G2 = 61.11% and G3 = 42.55%. Conclusions The low-cost GICs have a poorer performance than GC Gold Label 9 in occlusal ART restoration in primary molars.