ART- ATRAUMATIC RESTORATIVE

TREATMENT

BY
ARCHUTHAMANAN.A
FINAL YEAR –BDS
INTRODUCTION

 The atraumatic restorative treatment is a

procedure removing carious tooth tissues
using hand intstrument restoring in the cavity
with an adhesive restorative material.
Another terminology used for ART is
alternative restorative treatment.
 Armamentarium, methods, materials and
patient preparation for ART.
 Correct position of the both they operator
and patient is essential good quality care.
THE OPERATORS WORK POSTURE AND
POSITION

 Operator should provide best view of the inside

of the patient mouth.
 And the same time both patient and operator
should be comfortable .
 Operator sits frimly on the stool, straight back,
thighs parallel to the floor and both feet flat on
the floor.
 The distance from the operators eye to patient
tooth usually between 30 – 35cm.
 Operator should be position behind head of the
patient
 ASSISTANCE
 When treating patient, particularly children
using ART, it is a great advantage if another
person can mix the glass ionomer.
 This allows the operator to concentrate on the
cavity.
 To maintain effective saliva cantrol
PATIENT POSITON

 Any other oral treatment, ART requires

control patient and operator position.
 The patient lying on the back of flat surface
will provide safe and secure body support and
comfortable and stable positon for lengthy
period of the time .
 OPERATING LIGHT
 Good vision is essential for working in
the oral cavity.
ESSENTIALS INSTRUMENT AND
MATERIALS
 Mouth mirror ; it is used to reflect light on the
field of operation.
 Explorers ; the instrument is used to identify
were soft caries dentin is present
 Tweezers.; this instrument is used for carying
cotton wools, rolls, wedges and articulating
paper.
 Spoon excavators; used to removed soft
caries dentin .
 Carver; the shorp end is designed to remove
excess restorative material and to shape the
glass ionomer.
 Petroleium jelly; this material is use to keep
moisture away from the glass ionomer
restoration and to prevent the examination
glove from sticking to glass ionomer as it sets
hard
 .plastic mylar strip; used for contouring the
proximal surface of multiple surface restoration
they are availbale in various sizes
 Cotton wool pellets; used for cleaning cavities.
PROCEDURE
 The tooth is isolated with cotton rolls
 The tooth surface to be treated is cleaned with a wet
cotton pellet
 The entrance of the lesion is slightly widened by
hand instrument to remove gross over hanging
unsupported enamel rods.
 The dental caries is removed by using either the
small or medium size spoon excavator
 It is necessary to provide pulpal production by
calcium hydroxide paste
 the cavity surface along the occlusal margin or
cleaned
 The cavity is acid etched
 According to manufacture is instrumentation
the glass ionomer cement is mixed
 The mixed glass ionomer is insterted in the
cavity slightly overfilled
 The gloved finger which is smeared with
petroleum jelly is pressed on top entire occlusal
surface and slight pressure is applied
 the bite is checked
 Excess material is removed with sharp carver
 The bite is rechecked with and high points are
removed
 the filling is covered with petroleum jelly one
second or varnish may be applied
 The patient is instructed not to bite with to the
tooth for the least half hour.
 ADVANTAGE
 Easy available
 Inexpensive hand instrument are used rather
than the expensive electrically drived dental
equipment.
 Almost painless procedure the need for local
anesthesia is eliminated.
 ART involves the removal of only decalcified
tooth tissues
 Sound tooth tissue need not be cut for retention
of filling material
 Simple infection cantrol is used without need to
use autoclaved hand piece
.
Less expensive and less timing
One sitting several filling can be done
 DISADVANTAGE
 ART restoration are not long lasting
 The average life is two years depending upon
the rate of caries activity of individual oral cavity.
 Because of low wear resistence and low
strength.
 The continous use of hand instrument over long
period of time may result in hand fatigue.
 The relativelty unstandardized mix of glass
ionomer may be produced hand mixing.
THE REASONS FOR USING GLASS
IONOMER
 Glass ionomer chemically bond to both
enamel and dentin the need to cut sound
tooth tissues to prepare the cavity is reduced.
 Fluoride is released from the restoration and
prevent secondary caries.
 Glass ionomer is biocompatible does not
cause any irritation to the pulp and gingiva
and coeefecient of thermal expansion similar
to the tooth structure.
 CONCLUSION
ART as part of the basic package of oral
care is an important cornerstone for the
development of global oral health alleviating
inequality in oral care.
REFERENCE

 NIKHIL MARWAH