{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T20:40:32Z","timestamp":1740170432111,"version":"3.37.3"},"reference-count":18,"publisher":"PeerJ","license":[{"start":{"date-parts":[[2020,2,7]],"date-time":"2020-02-07T00:00:00Z","timestamp":1581033600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"FAP-DF"},{"name":"Radboud University Nijmegen Medical Centre"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>An innovative caries treatment protocol for primary teeth, termed Ultra-Conservative Treatment (UCT), restores small cavities through the Atraumatic Restorative Treatment (ART) protocol and cleans medium to large open cavities with toothbrush and fluoride toothpaste. However, UCT-treated primary molars were found to exfoliate earlier than amalgam (CRT) and ART-restored cavities, which may lead to unacceptable loss of space for normal eruption of permanent successors. The null-hypothesis tested was that there is no difference between the three treatment protocols and the intra-arch distances, and index of orthodontic treatment need (IOTN) after 4 years.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Dental casts were taken at baseline (T0) and four (T4) years. The space of the premolars (D + E space), arch perimeter, anterior and total arch depth were measured using a morphometric computer programme. The presence and level of malocclusion were assessed according to the IOTN index. Dependent variables were all intra-arch distances and the IOTN while the independent variable was treatment protocol (CRT, ART and UCT). Data were analysed using linear and logistic regression.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>The sample consisted of 867 pairs of casts of 272 initial 6\u20137-year-olds. No difference was observed between the UCT protocol and the two restorative protocols for the intra-arch variables in both maxilla and mandible over the 4 year period. There was no difference between the UCT and the CRT and ART protocols regarding the occurrence of orthodontic treatment need (malocclusion). In conclusion, the UCT treatment protocol does not differ significantly from the traditional amalgam (CRT) and ART restorative protocols with respect to intra-arch distances and malocclusion. The earlier exfoliation of UCT-treated primary molars does not lead to a worsening of the eruption pattern of permanent successors.<\/jats:p>\n<\/jats:sec>","DOI":"10.7717\/peerj.8439","type":"journal-article","created":{"date-parts":[[2020,2,7]],"date-time":"2020-02-07T08:33:05Z","timestamp":1581064385000},"page":"e8439","source":"Crossref","is-referenced-by-count":2,"title":["Cavity treatment in primary molars and malocclusion: quasi-randomised clinical trial"],"prefix":"10.7717","volume":"8","author":[{"given":"Rafael T.","family":"Gomide","sequence":"first","affiliation":[{"name":"Division of Pediatric Dentistry, Dental School, Universidade de Bras\u00edlia, Bras\u00edlia, Distrito Federal, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jo E.","family":"Frencken","sequence":"additional","affiliation":[{"name":"Radboud Institute for Health Sciences, Department of Dentistry\u2014Oral Function and Prosthetic Dentistry, Radboud University Medical Center, Nijmegen, Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0564-406X","authenticated-orcid":true,"given":"Jorge","family":"Faber","sequence":"additional","affiliation":[{"name":"Unaffiliated, Bras\u00edlia, Distrito Federal, Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8172-0090","authenticated-orcid":true,"given":"Anne Marie","family":"Kuijpers-Jagtman","sequence":"additional","affiliation":[{"name":"Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia"},{"name":"Department of Orthodontics, University Medical Center Groningen, Groningen, Netherlands"},{"name":"Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Bern, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4834-0210","authenticated-orcid":true,"given":"Soraya C.","family":"Leal","sequence":"additional","affiliation":[{"name":"Department of Dentistry, Faculty of Health Sciences, Universidade de Bras\u00edlia, Bras\u00edlia, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"4443","published-online":{"date-parts":[[2020,2,7]]},"reference":[{"issue":"1","key":"10.7717\/peerj.8439\/ref-1","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1007\/s00784-013-0955-x","article-title":"Amalgam and ART restorations in children: a controlled clinical trial","volume":"18","author":"De Amorim","year":"2014","journal-title":"Clinical Oral Investigations"},{"issue":"5","key":"10.7717\/peerj.8439\/ref-2","doi-asserted-by":"publisher","first-page":"467","DOI":"10.1093\/ejo\/cjl027","article-title":"Prevalence of malocclusions in Hungarian adolescents","volume":"28","author":"G\u00e1bris","year":"2006","journal-title":"European Journal of Orthodontics"},{"issue":"6","key":"10.7717\/peerj.8439\/ref-3","first-page":"537","article-title":"Long-term effect of supervised toothbrushing on levels of plaque and gingival bleeding among schoolchildren","volume":"15","author":"Hilgert","year":"2017","journal-title":"Oral Health and Preventive Dentistry"},{"issue":"3","key":"10.7717\/peerj.8439\/ref-4","doi-asserted-by":"publisher","first-page":"159","DOI":"10.12968\/denu.2012.39.3.159","article-title":"Should deciduous teeth be restored? 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