ART by Ashyana parveen

1. ATRAUMATIC RESTORATIVE
TREATMENT (ART)
SUBMITTED BY;
ASHYANA PARVEEN
BDS Final year

2. Content
• Introduction
• Principles
• Indications
• Contraindications
• Advantages
• Essential instruments for ART
• Procedure
• Conclusion

3. Introduction
• ART was introduced by Jo E. Frencken
in 1996.
• ART is defined as minimally invasive
care approach in preventive dental
caries and stopping its further
progression.

4. Principles
• The two main principle of ART are:
1. Removing carious tooth tissues using
hand instruments only
2. Restoring the cavity with a restorative
material that sticks to the tooth.

5. Indications
• Only in small cavities (involving dentin)
• In those cavities that are accessible to
hand instruments.
• Public health programs

6. Contra Indications
Art should not be used when
• There is presence of swelling or fistula.
• The pulp of the tooth is exposed.
• Teeth have been painful for a long time
(chronic pulpitis).
• There is an obvious carious cavity, but the
opening is inaccessible to hand
instruments.
• There are clear signs of a cavity, for
example in a proximal surface, but the
cavity cannot be entered from the
proximal or the occlusal direction.

7. Advantages
• ART is a biological approach that requires
minimal cavity preparation that conserves
sound tooth tissues and causes less
trauma to teeth.
• As ART is painless, the need for local
anaesthetics are reduced and so is the
psychological trauma to patients.
• Simplifies infection control as hand
instruments can easily be cleaned and
sterilized.

8. Advantages (Cont’d)
• No electrically driven and expensive dental
equipment is needed which enables ART to
be practiced in remote area and in the
field.
• This technique is simple enough to train
non – dental personnel or primary health
care workers.
• ART approach is very cost effective.

9. Advantages (Cont’d)
• Since it is friendly procedure, there are
great potentials for its use among
children, fearful adults, physically and
mentally handicapped and the elderly.
• It makes restorative care more accessible
for all population groups.

10. Essential Instruments for ART
• Mouth mirror
• Explorer
• Pair of tweezers
• Spoon Excavator
• Dental hatchet
• Applier / carver
• Mixing pad and
spatula
• Cotton wool rolls
and pellets
• Petroleum jelly
• Plastic jelly and
strip
• Wedges
• Glass ionomer
cement

11. Procedure
• Arrange a good working environment
• Hygiene and control of cross infection
• Restoring the cavity

12. Procedure (Cont’d)
Fig 1 : Circular scooping movements
of the excavator
Fig 2 : Fracturing off unsupported
enamel with a hatchet

13. Procedure (Cont’d)
Fig 3 : Application of dentine
conditioner
Fig 4 : The cavity and adjacent pits
and fissures are overfilled

14. Procedure (Cont’d)
Fig 5 : Press the restorative material
with gloved finger.
Fig 6 : Removal of excess material
by the carver blade of the carver.

15. Procedure (Cont’d)
Fig 7 : A restored one cavity
surface

16. Conclusion
• ART is a combined preventive and
curative oral procedure, which must be
administered along with health
promoting messages about a prudent
diet, good oral hygiene, use of fluoride
toothpaste and sealant application.
• ART is not compromise but a perfect
treatment approach for developing
countries and special groups in the
industrialized world.

17. Thank You