Dental Problems

Atraumatic Restorative Treatment

Dental CavityART or atraumatic restorative treatment is been in use for several years. This shows its effectiveness, but one must have a note on pros and cons of ART treatment before undergoing the treatment. In this article, there is a brief discussion on the atraumatic restorative treatment. Let us examine them.

Atraumatic restorative treatment :

The placement of a restoration in a large occlusal cavity can be done by means of Atraumatic Restorative Treatment or art technique. Once the bacterial involvement is eliminated and further ingress prevented it is possible for the tooth structure to heal. In the past a paste of zinc oxide and eugenol was used to provide the seal and the anti caries activity. Unfortunately, it was too weak and subject to water uptake and subsequent degeneration. In recent times, it has been realized that glass ionomer will perform exactly the same way and will also last much longer in the oral environment.

History of Atraumatic Restorative Treatment:

A group in Zimbabwe and another in Thailand began experimentation to check longevity and efficiency and their results were so encouraging that the system has been adopted by the WHO and is being promoted World Wide as a useful technique for communities that lack regular dental facilities.

Method of Atraumatic Restorative Treatment :

  • In this technique there will be only hand instruments available to open and clean the lesion and the restorative materials will be hand mixed.
  • A small selection of hand instruments has been designed to suit the system.
  • There is a type of hatchet with multiple blades to assist in opening through the enamel and provide immediate access to the lesion.
  • There is a group of spoon excavators suitable for cleaning the walls and it is expected that the floor will be left alone as far as possible.
  • It is only necessary to clean the cavity to the extent the walls are clear of the infected layer so that the ion exchange adhesion can be developed.
  • Also there is a need to create sufficient room for a substantial thickness of glass ionomer so that it will withstand occlusal load.
  • The glass ionomer is provided as a powder and liquid read for hand mixing.
  • A conditioner is used prior to the placement of the cement.
  • At the stage of placement, following cavity preparation an additional drop of liquid is placed in one corner of the mixing slab and once the isolation has been achieved this liquid is picked up on a wet cotton pellet and placed into the cavity as the conditioning agent.
  • It is wiped around the cavity and then immediately washed out using one or more wet cotton pellets.
  • This will remove debris and excess polyacrylic acid and prepare the cavity walls for the ion exchange adhesion.
  • Dry the cavity with further cotton pellet and prepare to mix the content.
  • The mix should be thick and it should be placed in the cavity and the gloved finger used as a matrix.
  • The finger can remain in place until the initial set has occurred thus ensuring that the restoration remains dry for that period of time. Cover the cement with varnish to keep the cement free from contamination till final setting takes place.
  • Adjust the occlusion using spoon excavators.
  • This technique has now been in extensive use in developing countries for several years and the success rate justifies its continuing use.

Conclusion of Atraumatic restorative treatment :

Atraumatic restorative treatment must be considered as a treatment and preventive modality for tooth caries in communities without the dentists. More studies regarding the atraumatic restorative treatment (ART) in both industrialized and developing countries need to validate its acceptability and effectiveness.

The above articles discusses briefly about the atraumatic restorative treatment.

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