ATRAUMATIC

RESTORATIVE
TREATMENT
(ART)
 Introduction
 A procedure involving removal of caries with
hand instruments and restoring the cavity with
an adhesive restorative material like glass
ionomer cement.
 Rationale
 Increasing caries prevalence in the developing and
underdeveloped countries in the late part of 20 th
century.

 Lack of accessibility for sophisticated dental care

in these countries

 High cost of electrically driven dental equipments

 History
 Pioneered in Tanzania in the mid 1980s
 A field trial in Thailand in the year 1991
 Another trial in Zimbabwe in 1993
Promotion of technique by WHO
 On 7th April 1994
 Principles in ART
 Removal of caries using hand instruments
alone

 Restoration of the tooth with an adhesive

restorative material that releases fluoride
 Instruments required
 Mouth mirror
 Explorer
 Tweezers
 Excavators (small, medium and large)
 Enamel hatchet
 Plastic filling instrument
 Carver
 Materials required
 Glass Ionomer Powder and Liquid
 Cotton rolls
 Cotton Pellets
 Petroleum Jelly
 Dentin conditioner
 Others like gloves, mouth mask, cotton holder
light source for better illumination etc
 Technique
 Cleaning the tooth to be restored
 Making the entrance into the cavity using
hatchet
 Caries excavation
 Removal of unsupported enamel
 Cleaning of prepared cavity
 Application of dentin conditioner
 Cleaning and drying of cavity
 Isolation
 Placement of glass ionomer cement
 Check for high points
 Recall
 Advantages
 More conservative
 Less expensive
 Applicability and feasibility in all conditions
 More acceptable to the patient
 Offers both curative and preventive treatment
 Easy repair of fractured fillings
 Sterilization of instruments easy
 Disadvantages
 Fatigue to the operator
 Failure of restorations because of improper
mix or salivary contamination
 Indications
 Small and medium sized carious cavities
without any evidence of pulpal involvement
 Contraindications
 Teeth with evidence of pulpal involvement
 Large carious cavities requiring extensive
restorations
 Feasibility in public programs
 No electrically driven instruments required
and hence feasible
 Conclusion
 Most suited for treating
 The rural population in developing and
underdeveloped countries
 Patients in old age homes, hospitals

 Mentally and Physically disabled at their

dwellings