Success Rates of Adhesive Materials in Atraumatic Restorative Treatment (ART) Restorations for Primary and Permanent Molars: A Systematic Review and Network Meta-Analysis

Success Rates of Adhesive Materials in Atraumatic Restorative Treatment (ART) Restorations for Primary and Permanent Molars: A Systematic Review and Network Meta-Analysis | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Systematic Review Success Rates of Adhesive Materials in Atraumatic Restorative Treatment (ART) Restorations for Primary and Permanent Molars: A Systematic Review and Network Meta-Analysis Jonathan Rafael Garbim, Sofie Hupfeld Toviansky, Rodolfo Carvalho Oliveira, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7398633/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Aim This systematic review and network meta-analysis evaluated which adhesive material provides the highest success rate for ART restorations in primary and permanent molars. Methods Searches were conducted up to August 5, 2024, in MEDLINE/PubMed, Web of Science, Scopus, EMBASE, and ProQuest. Randomized controlled trials reported ART success rates with attrition < 30%, ≥ 12-month follow-up, standardized evaluation criteria, and at least two restorative materials were included. Risk of bias was assessed with RoB 2 and certainty of evidence with GRADE. Network meta-analyses were performed with treatment success as the outcome, stratified by dentition (primary/permanent), cavity type (occlusal/occlusoproximal), and follow-up at 12 or 24 months. Results Of 1,536 studies, 11 met eligibility; 10 were included in quantitative synthesis. Materials assessed were composite resin, high-viscosity GIC (HVGIC), resin-modified GIC (RMGIC), zinc-reinforced GIC (ZRGIC), compomer, and glass carbomer cement (GCC). In primary teeth, RMGIC showed the highest success at 12 months, while no significant differences were observed at 24 months. GCC consistently performed worst. In permanent teeth, RMGIC ranked highest at 12 and 24 months, while ZRGIC had the poorest outcomes. Five studies had low risk of bias. Conclusion RMGIC showed the best overall performance. HVGIC and compomers also achieved good results, while GCC and ZRGIC were less successful. Evidence should be applied cautiously given risk of bias and low-to-moderate certainty. Clinical Relevance : RMGIC demonstrated the highest success rates in ART restorations, supporting its use for occlusal and occlusoproximal carious lesions in both dentitions. Dental Atraumatic Restorative Treatment Network Meta-Analysis as Topic Tooth Deciduous Dentition Permanent Full Text Additional Declarations No competing interests reported. Supplementary Files Supplementary1.docx Supplementary2.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7398633","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Systematic Review","associatedPublications":[],"authors":[{"id":508131702,"identity":"8e160b12-046d-4266-a6ec-fd6bca9916e8","order_by":0,"name":"Jonathan Rafael Garbim","email":"","orcid":"","institution":"University of São Paulo","correspondingAuthor":false,"prefix":"","firstName":"Jonathan","middleName":"Rafael","lastName":"Garbim","suffix":""},{"id":508131703,"identity":"60c18639-a5b9-4a4c-9ac4-b7b19b8a9345","order_by":1,"name":"Sofie Hupfeld Toviansky","email":"","orcid":"","institution":"University of São 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Permanent","lastPublishedDoi":"10.21203/rs.3.rs-7398633/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7398633/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eAim\u003c/h2\u003e\u003cp\u003eThis systematic review and network meta-analysis evaluated which adhesive material provides the highest success rate for ART restorations in primary and permanent molars.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eSearches were conducted up to August 5, 2024, in MEDLINE/PubMed, Web of Science, Scopus, EMBASE, and ProQuest. Randomized controlled trials reported ART success rates with attrition\u0026thinsp;\u0026lt;\u0026thinsp;30%, \u0026ge;\u0026thinsp;12-month follow-up, standardized evaluation criteria, and at least two restorative materials were included. Risk of bias was assessed with RoB 2 and certainty of evidence with GRADE. Network meta-analyses were performed with treatment success as the outcome, stratified by dentition (primary/permanent), cavity type (occlusal/occlusoproximal), and follow-up at 12 or 24 months.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eOf 1,536 studies, 11 met eligibility; 10 were included in quantitative synthesis. Materials assessed were composite resin, high-viscosity GIC (HVGIC), resin-modified GIC (RMGIC), zinc-reinforced GIC (ZRGIC), compomer, and glass carbomer cement (GCC). In primary teeth, RMGIC showed the highest success at 12 months, while no significant differences were observed at 24 months. GCC consistently performed worst. In permanent teeth, RMGIC ranked highest at 12 and 24 months, while ZRGIC had the poorest outcomes. Five studies had low risk of bias.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eRMGIC showed the best overall performance. HVGIC and compomers also achieved good results, while GCC and ZRGIC were less successful. Evidence should be applied cautiously given risk of bias and low-to-moderate certainty. \u003cb\u003eClinical Relevance\u003c/b\u003e: RMGIC demonstrated the highest success rates in ART restorations, supporting its use for occlusal and occlusoproximal carious lesions in both dentitions.\u003c/p\u003e","manuscriptTitle":"Success Rates of Adhesive Materials in Atraumatic Restorative Treatment (ART) Restorations for Primary and Permanent Molars: A Systematic Review and Network Meta-Analysis","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-09-03 11:47:48","doi":"10.21203/rs.3.rs-7398633/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"f7024d27-2f1d-4691-9076-f296b7cd04bd","owner":[],"postedDate":"September 3rd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-09-03T11:47:48+00:00","versionOfRecord":[],"versionCreatedAt":"2025-09-03 11:47:48","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7398633","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7398633","identity":"rs-7398633","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}