Luz 2012.

Methods	Design: Parallel RCT Number of participant: 30 Setting: school of dentistry Country: Brazil Unit of randomisation: child Unit of analysis: child Follow‐up: 6 month Dropout: 23.3% after 6 months
Participants	Number randomised (participants): 30 children (16 ART group and 14 CT group) Number analysed: 23 children Age mean and SD (range): 4‐7 years Gender: Female 16 (53.3%), male 14 (46.7%) Average DMFT score: not reported Dentition: primary Type of caries lesion: approximal caries lesion Inclusion criteria: children who had at least one approximal active caries lesion in a primary molar and that was accessible to hand instruments. Exclusion criteria: children with spontaneous pain
Interventions	Two treatment arms: Group 1: ART approach + H‐GIC Group 2: CT + composite with anaesthesia Children in the ART Group were treated according to ART approach using only hand instruments, no anaesthesia and restorative material was glass ionomer (Ketak‐Molar 3‐M ESPE, St. Paul, Minnesota). Only the demineralised carious tissue and unsupported enamel were removed. Matrix band and wooden wedges were used. Children in CT group were treated with local anaesthesia, rubber dam, rotary instruments and the cavity was filled with composite resin ( Z 350 3‐M ESPE, St. Paul, Minnesota). Only the demineralised carious tissue and unsupported enamel were removed. Matrix band and wooden wedges were used. The interventions were conducted by 1 dentist.
Outcomes	Acceptability evaluated by Face Image Scale (5 pictures representing feelings ranging from very unhappy to very happy) before and after the procedure Pain assessed by asking if the child felt any pain during the treatment and were willing to received the same treatment again Success rate evaluated by USPH modified criteria after 6 months
Notes	Funding not stated Trial register number not reported Sample size not calculated Intraexaminer reproducibility high ‐ kappa > 0.8
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Quote: "Patients were randomly assigned to one of the treatment group after stratification for tooth in the upper/lower jaw using a ballot box"
Allocation concealment (selection bias)	Unclear risk	Comments: not reported
Blinding of participants and personnel (performance bias) ‐ participant	High risk	Comments: no information provided, but the participants could tell whether manual or rotary instruments were used
Blinding of participants and personnel (performance bias) ‐ operator All outcomes	High risk	Comments: blinding not possible ‐ operator knew the intervention
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Comments: not reported
Incomplete outcome data (attrition bias) All outcomes	Low risk	Comments: for the outcomes evaluated, all participants were assessed
Selective reporting (reporting bias)	Low risk	Comments: all prespecified (primary and secondary) outcomes reported
Other bias	Unclear risk	Comments: baseline characteristics and details about co‐interventions not reported