Atraumatic restorative-treatment-(art)

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1. ATRAUMATIC RESTORATIVE TREATMENT Guided By: Dr. Swagat Mahanta HOD Of Public Health Dentistry Presenter: Manila Upreti B.D.S Final Year Phase I

2. Definition It is the procedure based on removing carious tooth tissue using hand instruments alone and restoring the cavity with adhesive restorative materials.

3. History of art It was first evaluated in Tanzania in the mid 1980s. ART was introduced in south Africa by its Dutch Inventor , Prof. Jo Frencken in 1996

4. Principle of art Based on modern principle of: Minimal intervention Minimal invasion Minimal cavity preparation

5. Principle of art Removing carious tooth using hand instruments Restoring the cavity with an adhesive restorative material

6. Principle of art Removing carious tooth using hand instruments Restoring the cavity with an adhesive restorative material

7. Reasons for using hand instruments Use of biological approach which requires minimal cavity preparation that conserves sound teeth Cost effective Limitation of pain that reduces the need for local anesthesia Infection control

8. Reason for using gic Bonds chemically to enamel and dentin Release of flouride – Anticariogenic Similar to hard tissue and non irritating to oral soft tissue

9. Reason for using gic Bonds chemically to enamel and dentin Release of flouride – Anticariogenic Similar to hard tissue and non irritating to oral soft tissue

10. Reason for using gic Bonds chemically to enamel and dentin Release of flouride – Anticariogenic Similar to hard tissue and non irritating to oral soft tissue

11. Indications Only in small cavities (involving dentin only) Cavities accessible to hand instruments Public health programs

12. Indications Only in small cavities (involving dentin only) Cavities accessible to hand instruments Public health programs

13. Indications Only in small cavities (involving dentin only) Cavities accessible to hand instruments Public health programs

14. contraindications Presence of swelling or abscess or fistula near carious tooth Pulp of tooth is exposed History of pain and chronic irreversible pulpitis Cavities inaccessible to hand instruments

15. contraindications Presence of swelling or abscess or fistula near carious tooth Pulp of tooth is exposed History of pain and chronic irreversible pulpitis Cavities inaccessible to hand instruments

16. contraindications Presence of swelling or abscess or fistula near carious tooth Pulp of tooth is exposed History of pain and chronic irreversible pulpitis Cavities inaccessible to hand instruments

17. contraindications Presence of swelling or abscess or fistula near carious tooth Pulp of tooth is exposed History of pain and chronic irreversible pulpitis Cavities inaccessible to hand instruments

18. advantages Biological approach that requires minimal cavity preparation that conserve sound teeth Painless Infection control Cost effective Easy to operate

19. procedure

20. armamantarium Mouth miror Explorer Tweezer Spoon excavator Dental hatchet Carver Mixing pad and Agate spatula Cottols rolls and pellets Petroleum jelly Plastic strips Wedges GIC cement

21. Steps in ART

22. isolation Cotton rolls effective at absorbing Saliva and can provide short term Protection from moisture.

23. Cleaning the prepared cavity To improve the chemical bonding of GIC to tooth tooth structure Dentin conditioner espicially development for this purpose (liquid is supplied with GIC) 10% Polyacrylic acid

24. Mixing of restorative material Powder: Silica CaF Aluminium oxide LIQUID: Polyacrylic acid TYPE 9 is used P/L = 3:1

25. Restoring cavity Rub a small amount of petroleum jelly on the gloved index finger Press the soft restorative material firmly into the cavity and fissure Then slide the finger smoothly across the occlusal surface of teeth so that the GIC will get deposited in the remaining of fissure

26. Restoring cavity Excess material is removed with carver Cover the ART with petroleum jelley Patient is not allowed to eat for at least 1 hour

27. Failed or defective restoration Restoration is completely missing Part of restoration has broken away Restoration has fractured Restoration has worn away Caries has developed in the adjacent fissure of surface