The atraumatic restorative treatment (ART) approach for primary teeth: review of literature.

Resident’s Name: Jessica Wilson

Program: Lutheran Medical Center - Providence


Article title: The atraumatic restorative treatment (ART) approach for primary teeth: review of literature.


Author(s): Smales, RJ and Yip, HK.


Journal: American Academy of Pediatric Dentistry


Year. Volume (number). Page #’s: 2000. 22(4). 294-297.


Major topic: ART approach and its effectiveness


Overview of method of research: Literature Review


Findings:
-Older Glass Ionomer Cements (GIC) w/ larger particle sizes had higher failure rates than newer, more esthetic GIC made specifically for ART. These newer GIC have only been researched in short term studies.
-Class I & V: highest survival rates (80-90% after 12 mo.)
-Class II: moderate survival rates (55-75%)
-Class III & IV: lowest survival rates (35-55%)
-Premature loss of restoration due to shallow or non-retentive preps, bulk fracture of multi-surface restorations and restoration wear.
-Although resin modified GIC offer more fracture resistance and adhesion, they also have higher wear rates.
-Recurrent caries not been shown as a problem at this time.


Key points/Summary:
-ART gaining interest & acceptance in treating primary dentition.
-ART involves removal of caries w/ hand instruments & sometimes slow speed. Not necessary or desired to remove all caries as intended to be pain-free procedure. Conditioner and GIC are then placed to seal preparation and adjacent pits and fissures. Excess material pressed into preparation w/ lubricated gloved finger.
-GICs release fluoride, have high pulpal biocompatibility and provide chemical adhesion to tooth structure.
-Most important factor in preparation is providing mechanical retention (most common cause of failure) as well as moisture control. Avoiding premature occlusal contacts is also especially important in GIC restorations due to their low fracture resistance.
-Need further research on long term clinical studies of cost-effectiveness of ART.
-ART is saving many teeth around the WORLD!


Assessment of Article: Unfortunately based on 10 studies done over 10 years ago, but we get the gist of it. Good summary article.