The ART approach: clinical aspects reviewed

Abstract

The success of ART as a caries management approach is supported by more than 20 years of scientific evidence. ART follows the contemporary concepts of modern cariology and restorative dentistry. It challenges treatment concepts such as step-wise excavation and the need for complete removal of affected dentine. The ART approach so far has mainly used high-viscosity glass-ionomer as the sealant and restorative material. Cariostatic and remineralization properties have been ascribed to this material which requires further research to establish its clinical relevance. The adhesion of high-viscosity glass-ionomer to enamel in pits and fissures is apparently strong, as its remnants, blocking the pits and fissures, have been considered a possible reason for the low prevalence of carious lesion development after the glass-ionomer has clinically disappeared from it. encapsulated high-viscosity glass-ionomers may lead to higher restoration survival results than those of the hand-mixed version and should, therefore, not be neglected when using ART. Similarly, the use of resin-modified glass-ionomer with ART should be researched. The effectiveness of ART when compared to conventional caries management approaches has been shown in numerous studies. Proper case selection is an important factor for long-lasting ART restoration survival. This is based on the caries risk situation of the individual, the size of the cavity opening, the strategic position of the cavitated tooth and the presence of adequate caries control measures. As the operator is one of the main causes for failure of ART restorations, attending a well-conducted ART training course is mandatory for successful implementation of ART.

Survival analysis of ART restorations in primary molars of preschool children: 1 year follow-up

“…The cost of the more resistant high-viscosity GICs recommended by literature 16 is approximately three times higher than similar GICs manufactured in Brazil. This price difference has a large impact on the development and expansion of oral health to poorer populations at high risk of caries.…”

“…Specially designed for ART, the high-viscosity GICs have a relatively slow curing and improved mechanical properties compared to low and medium viscosity cements, which has resulted in increased survival of restorations 13 . Recent systematic reviews have shown that the longevity of ART restorations with high-viscosity GICs is similar to the gold standard treatment with amalgam 12,[14][15][16] .…”

Efeito da técnica de inserção na resistência mecânica de dois cimentos de ionômero de vidro de alta viscosidade

“…O CIV possui propriedades físicas favoráveis tais como adesão ao esmalte, à dentina e ao metal, além da propriedade anticariogênica pela liberação de íons flúor. Além disso, apresenta coeficiente de expansão térmica semelhante à da estrutura do dente, biocompatibilidade e baixa citotoxidade 1,[3][4][5][6][7]23 .…”

Clinical Evaluation of Multiple-surface ART Restorations: Three-Year Follow-up

“…he Atraumatic Restorative Treatment (ART) approach combines the preventive component with the restorative procedure, and has the potential to be minimally invasive and to maximally preserve the tooth structure [1,2,3]. It involves the removal of infected tooth tissues using hand instruments, and the cavity including adjacent pits and fissures is restored using a filling material, usually a glassionomer cement (GIC) [1,3,4].…”

“…It involves the removal of infected tooth tissues using hand instruments, and the cavity including adjacent pits and fissures is restored using a filling material, usually a glassionomer cement (GIC) [1,3,4].…”