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


The atraumatic restorative treatment (ART) technique or approach has achieved considerable interest worldwide, especially for its application in developing countries where skilled human and other resources are not readily available or affordable to treat dental caries by more conventional means.

The ART approach involves the use of hand instruments only to remove carious tooth substance and then restoring the cavity and sealing any adjacent enamel fissures with usually a conventional glass polyalkenoate (ionomer) restorative cement (GIC).

GICs demonstrate sustained fluoride release, pulpal biocompatibility, and chemical adhesion to tooth substance.

The minimally-invasive procedure is largely pain-free and readily accepted by children; and is also gaining increasing acceptance in more developed countries for the management of early childhood caries.

A recent study demonstrated the dramatic improvements in oral health achieved in both the primary and permanent dentitions of children when the ART approach replaced the use of conventional instrumentation in mobile dental clinics.

Read Also: PULPECTOMY procedures in primary molar teeth

Even in some developed countries, many children are deprived of adequate dental care because of fear and for economic reasons.

The GICs used in earlier field trials were not specifically developed for the ART technique, and the relatively high failures found may have been partly related to the materials and to the technical skills of the operators.


° Roger J Smales MDS, DDSc, FDSRCS, FADM, FHKAM (Dental Surgery) Hak-Kong Yip BDS, PhD, MEd, MMedSc
° American Academy of Pediatric Dentistr
° Image : Mariana Minatel Braga, Isabela Floriano, Fernanda Rosche Ferreira, Juliana Mattos Silveira, Alessandra Reyes, Tamara Kerber Tedesco, Daniela Prócida Raggio, José Carlos Pettorossi Imparato and Fausto Medeiros Mendes (March 11th 2015). Are the Approximal Caries Lesions in Primary Teeth a Challenge to Deal With? — A Critical Appraisal of Recent Evidences in This Field, Emerging Trends in Oral Health Sciences and Dentistry, Mandeep Singh Virdi, IntechOpen, DOI: 10.5772/59600. Available from: https://www.intechopen.com/books/emerging-trends-in-oral-health-sciences-and-dentistry/are-the-approximal-caries-lesions-in-primary-teeth-a-challenge-to-deal-with-a-critical-appraisal-of-

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