Silver-Modified Atraumatic Restorative Treatment (SMART) in Managing Carious Primary Molars: 1-Year Clinical Results

Purpose: Silver-modified atraumatic restorative treatment (SMART) is a minimally invasive method that can be utilized for the management of early childhood caries. This study aimed to assess the 12-month clinical success of the SMART technique in the management of carious primary molars. Methods: The analysis (Modified-United States Public Health Service Criteria) was performed on the 3rd, 6th and 12th months clinical records of 53 teeth of uncooperative patients aged between 2-6 years treated with the SMART technique. The included teeth with no spontaneous pain and sensitivity to percussion-palpation, were divided into groups by location (mandibular-maxillary) and carious cavities (occlusal, mesio/disto-occlusal, mesio-occlusal-distal). Fisher Exact Chi-Square test was used to determine the relation between the groups and p-value < 0.05 was accepted as statistically significant. Results: The success rate of SMART for retention, marginal discoloration, and secondary caries in the mandible (84.8%), was higher than the values detected in the maxilla (38.5%) and teeth with occlusal caries were significantly more successful at 12-month assessments (p= 0.038). Mandibular cases and occlusal cavities revealed better results in marginal adaptation assessments (78.8%, and 88.9%, respectively). Conclusions: This paper has the novelty of being the first study assessing the effect of the type of carious cavity and the tooth location in the clinical success of SMART technique. Accordingly, SMART may conclude to be an alternative for the treatment of carious teeth of uncooperative children at least for a period until the child becomes mature to comply with the advanced treatment procedures.