1. ATRAUMATIC RESTORATIVE TREATMENT(ART ) Dr.Rai Tariq Masood

2. ”The Atraumatic Restorative Treatment (ART) is a procedure based on excavating the dental caries, using only hand instruments and restoring the cavity with an adhesive restorative material, usually glass ionomer.” ART includes both prevention as well as treatment. The technique is simple enough to train non- dental personnel or primary health care workers.

3. Principles of ART  Removing carious tooth lesions using hand instruments only.  Restoring the cavity with an adhesive restorative material (glass ionomer).

4. Advantages of ART  It makes restorative treatment accessible for all population groups.  The biological approach, which requires minimal cavity preparation that does not involve sound tooth tissues and causes less trauma to the dental tissues.  The low cost of instruments compared to electrical dental equipment.  Less of pain thus limiting the need for local anesthesia to a minimum and reduces discomfort and psychological trauma to patients.  Sterilization of hand instrument is very easy.

5. Evidence on the effectiveness of ART  Trials in Thailand, Zimbabwe and Pakistan in 1991,1993and 1995 respectively  71%(Thailand )and 85%(Zimbabwe) of restorations remained there after 3 years.

6. Evidence A study done by Smales & Yip (2002) shows that ART is effective both in primary and permanent teeth. Results show that in primary teeth, after 1 year, success rates have been approximately 80% to 95% for Class I cavities. In permanent teeth, after 2 to 3 years, success rates have been approximately 90% for Class I cavities.

7. Why Glass ionomer????? Chemically bind to the teeth so less tooth preparation is required. Harmless to dentine and pulp tissues Releases fluoride

8. Instruments for ART (Mouth mirror, Tweezers, Explorer and Spoon Excavators)

9. A mixing pad, spatula, cotton pellets/rolls, plastic strips, wedges etc for the restoration.

10. Position of the Operator

11. Indications for ART  Cavities involving Enamel and dentine  Cavities accessible to hand instruments

12. Contra-indications for ART  Abscess  Exposed pulp  Access to cavity with hand instrument is not easy

13. Procedure of ART Proper Position of Operator and patient Assistant Light Source Isolation Proper Hand Hygiene and Sterilization of Instruments Excavation of Caries Mixing Restoring the Cavity Application of Petroleum Jelly Check High Spots

14. THANK YOU