Twenty-one studies were included. The number of participants and the study design were not reported though the studies appeared to be observational studies with no control group.
Primary teeth.
For single-surface ART restorations using high-viscosity glass-ionomers (7 studies), the weighted mean survival was 95% (95% CI: 94, 97) at 1 year and 91% (95% CI: 88, 93) at 2 years. One-year survival with medium-viscosity ionomers (1 study) was 79% (95% CI: 70, 86). For multiple-surface ART restorations using high- viscosity glass-ionomers (7 studies), the weighted mean survival was 73% (95% CI: 70, 77) at 1 year and 59% (95% CI: 55, 64) at 2 years. One-year survival with medium-viscosity ionomers (1 study) was 55% (95% CI: 46, 63). Mean survival rates were statistically significantly higher for single-surface compared with multiple-surface restorations after 1 and 2 years.
Permanent teeth.
For single-surface restorations with high-viscosity glass-ionomers (9 to 10 studies), the weighted mean survival was 97% (95% CI: 97, 98) at 1 year and 94% (95% CI: 92, 95) at 2 years. Survival with medium-viscosity ionomers (3 to 4 studies) was 95% (95% CI: 93, 97) at 1 year and 91% (95% CI: 88, 93) at 2 years. The authors stated that the difference between medium- and high-viscosity ionomers was statistically significant. The mean survival rates for partially and fully retained ART sealants were 76% (95% CI: 72, 79) for medium-viscosity and 90% (95% CI: 87, 93) for high-viscosity ionomers at 1 year (2 studies each). The difference between the two types of glass-ionomers was statistically significant (p=0.013). The mean annual caries rate in previously sealed pits and fissures using high-viscosity glass-ionomers via the press-finger technique was 1% over the first 3 years (2 studies).