49 - A Scoping Review of the Silver-Modified Atraumatic Restorative Technique (SMART)

Purpose: As minimally invasive dentistry becomes more prevalent in the face of mounting treatment needs in children, the silver-modified atraumatic restorative technique (SMART) has become a compelling option for the pediatric dentist. The purpose of this review is to identify and evaluate existing clinical trials involving SMART to better gauge its utility in the pediatric dentist’s armamentarium.

Methods: A search was conducted in four databases (Medline/PubMed, Embase, the Cochrane Library and Dentistry & Oral Sciences Source) and a scoping review was performed following the PRISMA Extension for Scoping Reviews checklist.

Results: From a total of 724 references, 94 articles were assessed for eligibility and 12 were included in the review. For both clinical and radiographic outcomes, this review shows that SMART demonstrates comparable survival rates when compared to stainless steel crown (SSC) or Hall technique (HT) treatments and seems to outperform ART alone. In addition, for other clinical factors such as caries incidence, patient acceptance, treatment time, and cost per treatment, SMART again shows an overall outperformance when compared to ART alone.

Conclusions: Existing clinical trials suggest there is no difference in clinical success when SMART is evaluated against conventional treatment (SSC or HT). The preponderance of current research suggests that for both clinical and radiographic outcomes, SMART appears to outperform ART alone and, ultimately, presents as a viable treatment option for treating early childhood caries (ECC).