Guided By: Presenter:

Dr. Swagat Mahanta Manila Upreti

HOD Of Public Health Dentistry B.D.S Final Year
Phase I
It is the procedure based on removing
carious tooth tissue using hand
instruments alone and restoring the
cavity with adhesive restorative
materials.
 Itwas first evaluated in Tanzania in the mid
1980s.
 ART was introduced in south Africa by its
Dutch Inventor , Prof. Jo Frencken in 1996
Based on modern principle of:

Minimal intervention
Minimal invasion
Minimal cavity preparation
 Removing carious tooth using hand
instruments
 Restoring the cavity with an adhesive
restorative material
 Removing carious tooth using hand
instruments
 Restoring the cavity with an adhesive
restorative material
 Use of biological approach which requires
minimal cavity preparation that conserves
sound teeth
 Cost effective
 Limitation of pain that reduces the need for
local anesthesia
 Infection control
Bonds chemically to enamel and dentin
Release of flouride – Anticariogenic
Similar to hard tissue and non irritating
to oral soft tissue
Bonds chemically to enamel and dentin
Release of flouride – Anticariogenic
Similar to hard tissue and non irritating
to oral soft tissue
Bonds chemically to enamel and dentin
Release of flouride – Anticariogenic
Similar to hard tissue and non irritating
to oral soft tissue
 Only in small cavities (involving dentin only)
 Cavities accessible to hand instruments
 Public health programs
 Only in small cavities (involving dentin only)
 Cavities accessible to hand instruments
 Public health programs
 Only in small cavities (involving dentin only)
 Cavities accessible to hand instruments
 Public health programs
 Presence of swelling or abscess or fistula
near carious tooth
 Pulp of tooth is exposed
 History of pain and chronic irreversible
pulpitis
 Cavities inaccessible to hand instruments
 Presence of swelling or abscess or fistula
near carious tooth
 Pulp of tooth is exposed
 History of pain and chronic irreversible
pulpitis
 Cavities inaccessible to hand instruments
 Presence of swelling or abscess or fistula
near carious tooth
 Pulp of tooth is exposed
 History of pain and chronic irreversible
pulpitis
 Cavities inaccessible to hand instruments
 Presence of swelling or abscess or fistula
near carious tooth
 Pulp of tooth is exposed
 History of pain and chronic irreversible
pulpitis
 Cavities inaccessible to hand instruments
 Biological approach that requires minimal
cavity preparation that conserve sound teeth
 Painless
 Infection control
 Cost effective
 Easy to operate
 Hygiene and
control of cross
• Operator position infection • Hand instruments
• Patient position • Removal of caries
• Sterilization and
disinfection • Restoration with
adhesive materials

Arranging good
Restoration of
working
cavity
environment
 Mouth miror
 Explorer
 Tweezer
 Spoon excavator
 Dental hatchet
 Carver
 Mixing pad and Agate spatula
 Cottols rolls and pellets
 Petroleum jelly
 Plastic strips
 Wedges GIC cement
 MIXING THE
ISOLATION RESTORING
RESTORATIVE
THE CAVITY
MATERIALS

CLEANING
PREPARATION THE
OF THE CAVITY PREPARED
CAVITY
Cotton rolls effective at absorbing
Saliva and can provide short term
Protection from moisture.
 To improve the chemical bonding of GIC to
tooth tooth structure
 Dentin conditioner espicially development
for this purpose (liquid is supplied with GIC)

10%
Polyacrylic
acid
Powder:
Silica
CaF
Aluminium oxide

LIQUID:
Polyacrylic acid

TYPE 9
P/L =
is used
3:1
 Rub a small amount of petroleum jelly on the
gloved index finger
 Press the soft restorative material firmly into the
cavity and fissure
 Then slide the finger smoothly across the
occlusal surface of teeth so that the GIC will get
deposited in the remaining of fissure
 Excess material is removed with carver
 Cover the ART with petroleum jelley
 Patient is not allowed to eat for at least 1
hour
 Restoration is completely missing
Part of restoration has broken away
Restoration has fractured
Restoration has worn away
Caries has developed in the adjacent
fissure of surface