Discussion
caries, HT, cavitated caries lesions
SECONDARY, CONTRACTION, CARIES
The HT is considered the best treatment option for cavitated caries lesions in primary molars.In an earlier study, Araujo, et al.Furthermore, we are aware of the limitations of both techniques. In addition to those regarding composite resin, in cavities involving more than two surfaces, polymerization contraction stress, lack of marginal adaptation, and the presence of gaps can lead to failures.In addition, in reviewing previous randomly controlled trials (RCTs) published about the HT survival rate, different follow-ups have been considered, ranging from 6 to 72 months.The sample size calculation was based on a previous study that evaluated the survival rate of resin composite in only occluso-proximal cavities,Another relevant point is that the examiners of the outcomes were also the operators providing the interventions, which could introduce a detection bias. However, even if the examiner was a different researcher who did not perform the intervention, the difference between the interventions does not change the possibility of blinding for the outcome assessment. Moreover, we did not perform the intra-examiner and inter-examiner reliability of the assessments, which may affect the validity and reproducibility of the results. However, as previous mentioned, the examiners of outcomes received the training for the criterion used to evaluate the success of restorations.The multicenter design of this study also resulted in diverse operators performing the interventions, resulting in another possible limitation due to the operational difference of each dentist.In Brazil, we have a monetary difference between regions. Previous studies have reported low income as an additional factor in caries risk due to difficulty accessing the dentist and oral hygiene products.Thus, due to HT high survival rate, this technique can be indicated as a treatment type for multi-surface cavities with more than two surfaces involved in primary molars. Although our study did not report cost analysis, which will be performed as a secondary outcome, note that the HT results in lower financial expenditure.In Brazil, approximately 75% of the population uses the Unified Health System, which encompasses children’s dental care.Moreover, further randomized clinical trials focusing on approaches to treating cavities involving more than two surface are suggested, since this still seems to be an obstacle to restorative treatment in pediatric dentistry. However, the higher survival rate for HT compared with CR at 1-year follow-up is positive for this purpose.