Objective: A novel approach called silver-modified atraumatic restorative therapy (SMART) integrates glass ionomer cement (GIC) restorations with silver diamine fluoride (SDF). This new method combines the ability of GIC to seal the tooth and sever the nutrition that bacteria require to proliferate, with the bactericidal power of SDF. The purpose of this review is to evaluate and compare the available data regarding the efficacy of the SMART approach in treating children's carious primary teeth.

Materials and Methods: The earliest date accessible up until February 15, 2024, was thoroughly searched in databases including Scopus, PubMed, Cochrane, Science Direct, Lilacs, Science Direct, Web of Science, and Google Scholar. The review only comprised randomized controlled trials. The PICO strategy (P: Children with dental caries in primary teeth; I: SMART; C: Conventional drill and fill method or atraumatic restorative treatment [ART] therapy; O: Clinical success) was adopted. Risk of bias assessment and quality of evidence were assessed using the RoB-2 tool and GRADE tool, respectively.

Results: Four full-text publications that met the eligibility criteria underwent additional processing for data extraction and qualitative analysis. In three studies, no difference was found in the clinical performance of SMART and conventional drill and fill/ART therapy, whereas in one study, the clinical performance of SMART was found to be better than the conventional ART therapy.

Conclusion: SMART and conventional drill and fill/ART techniques have comparable clinical performance for carious primary teeth of children. SMART can be used to treat asymptomatic deep carious lesions as well as apprehensive children. However, the cost-effectiveness of SMART restorations needs to be investigated in a variety of demographics.

S.M. was responsible for the concept, design, and definition of intellectual content, literature search, data acquisition, data analysis, and manuscript preparation. R.M. was responsible for data acquisition, manuscript editing, and manuscript review.

The manuscript has been read and approved by all the authors, the requirements for authorship as stated earlier in this document have been met, and each author believes that the manuscript represents honest work.

Article published online:
29 July 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India