Clinical outcome of root caries restorations using ART and rotary techniques in institutionalized elders

Abstract

The aim of this study was to compare the clinical performance of root caries restorations after a six-month period using two methods, a conventional technique with rotary instruments and an atraumatic restorative technique (ART), in an institutionalized elderly population in the city of Bogotá, Colombia. Root caries represents a multifactorial, progressive, chronic lesion with softened, irregular and darkened tissue involving the radicular surface; it is highly prevalent in the elderly, especially in those who are physically or cognitively impaired. A quasi-experimental, double-blind, longitudinal study was carried out after cluster randomization of the sample. Two different experienced dentists, previously trained, performed the restorations using each technique. After six months, two new investigators performed a blind evaluation of the condition of the restorations. The results showed a significantly higher rate of success (92.9%) using the conventional technique (p < 0.03). However, we concluded that ART may have been the preferred technique in the study population because 81% of those restorations survived or were successful during the observation period.

Root caries and it's management- a review

“…Studies that assess ART for root caries of permanent teeth are rare. [26] The conventional technique with rotary instrumentation continues to be the method of choice as long as the patient can visit a dental clinic or when a portable dental unit is available to perform the procedures at a geriatric institution. [25].…”

Glass ionomer cement as alternative treatment for vulnerable geriatric patients with caries or cavities

“…8 Root caries represent a progressive, multi factorial chronic lesion, with irregular, darkened and softened tissue involving the root surface and can affect the cement, dentin, and enamel; it is very common among elderly patients, especially those with cognitive or physical disabilities. [9][10][11][12] Burrow & Stacey 9 highlight that the high root carie rates in elders has been growing and the philosophy centered on a conservative treatment will likely provide these patients more chances to keep their teeth. 9 Besides, oral bacterias can be introduced in the circulatory system through infected teeth or caries, forming vegetations in compromised cardiac valves.…”

“…[9][10][11][12] Burrow & Stacey 9 highlight that the high root carie rates in elders has been growing and the philosophy centered on a conservative treatment will likely provide these patients more chances to keep their teeth. 9 Besides, oral bacterias can be introduced in the circulatory system through infected teeth or caries, forming vegetations in compromised cardiac valves. The Staphylococcus aureus and the Streptococcus viridans can be present in the oral cavity and are the organism most commonly responsible for infectious endocarditis.…”

“…21,23 Even though the use of ART and its success rates in permanent teeth have been documented in the literature, 24,21 many dentists are still reluctant to its adoption in their daily practice, especially when it comes to adults and elders. 9 The method is promising as a way of dealing with cavity lesions of root caries and can be a useful alternative for institutionalized patients who are incapable of paying a visit to the dentist's office on a regular basis, proving to be a better kind of treatment in elderly after one year in comparison to conventional restorations. 12,[23][24][25] Another advantage of ART is the possibility of conducting multiple restorations in different quadrants, once local anesthesia is not needed.…”

“…The results show an 85% survival rate for ARTs, demonstrating its place as an efficient tool to provide dental treatment for vulnerable elders, particularly in non-clinical environments. Gonzalez & Zuluaga 9 Balgi et al 27 Serpa et al 28 Dornellas et al 29 Amer & Kolker, 4 Amorim et al 21 also concluded that ART restorations were considered clinically well succeeded with excellent results.…”