Effectiveness of Dental Restorative Materials in the Atraumatic Treatment of Carious Primary Teeth in Pediatric Dentistry: A Systematic Review

Aim: This systematic review evaluates the effectiveness and clinical outcomes of Atraumatic Restorative Treatment (ART) in pediatric dentistry, comparing it with other restorative techniques, analyzing material performance, assessing cost-effectiveness, and exploring the long-term success in managing dental caries. Background: ART is a minimally invasive approach that removes decayed tissue using hand instruments and restores teeth with adhesive materials like glass ionomer cement (GIC). ART is particularly valuable in pediatric dentistry due to its simplicity, reduced discomfort, and suitability for resource-limited settings. It eliminates the need for anesthesia and expensive dental equipment, making it accessible in remote and underserved areas. Studies have shown its effectiveness in providing durable restorations while improving patient comfort. Materials and Methods: This systematic review follows the PRISMA guidelines. PubMed, Web of Science, and Scopus were searched for studies published in the last ten years. The inclusion criteria included in vivo studies on children, randomized controlled trials, and case-control studies assessing ART's effectiveness. Quality and risk of bias were evaluated using the ROBINS-I tool. Results: Eighteen studies met the inclusion criteria. ART effectively managed dental caries, especially with high-viscosity GIC. Comparisons with the Hall Technique and Papacarie showed that ART remains a viable, cost-effective option. Conclusions: ART is a reliable, minimally invasive technique for pediatric restorative dentistry. Its accessibility and cost-effectiveness make it suitable for low-resource settings. High-quality materials and technique modifications further enhance restoration longevity.