Transcript Atraumatic Restorative Treatment

traumatic
estorative
reatment
• A Innovative treatment approach for Dental Caries .
• ART is maximally preventive and minimally invasive approach
to stop further progression of dental caries.
•ART - Approach is not only logical but based upon sound
scientifically based principles.
•Method of preserving decayed teeth in people of all ages both in
developing countries and disadvataged communities --- where
resources are scarce.
• ART does not rely on electricity or expensive equipment –
treatment could be provided anywhere.
• ART is appropriate and valid in outreach situations in
developing countries.
J. Frencken
C. Holmgren.
DEVELOPMENT OF ART





ART PIONEERED IN MID 1980s -- as part of
Primary Oral Health Care at Dar-El-Salaam,
Tanzania-- Jo E. Frencken.
First Clinical Trial conducted at Thailand
(1991).
Large scale Clinical Trial and Testing was
done at Zimbabwe (1993).
Later it was tried at Pakistan (1995).
Subsequently tried in USA & Europe.
World
Health
Organisation

WHO presented ART on “World Health
Day” on 7th April 1994.

Beginning of the Oral Health Year-1994-95.

FDI recommended and advocated the ART
in 1998.
ART can be applied when:
- There is a cavity involving the dentine, and
- That cavity is accessible to hand instruments.
Contraindications:(1)In the presence of abscess or fistula near the tooth.
(2)Where there is pulp is exposed .in this case we have to do
root canal treatment.
(3)Painful teeth and the pulp inflammation.
(4)The opening of pulp is in accessible to the hand
instruments. eg-in the proximal caries there is clear sign of
cavity but the instruments cant reach that point.
The two main principles of ART
are:


Removing carious tooth
tissue using hand
instruments only
Restoring the cavity with
glass ionomer
GLASS IONOMER CEMENT
Glass ionomer is very useful as dental restorative
material because:(1)They can be applied to caries in very early lesions.
(2)It adheres to the tooth structure chemically.
(3)It is anticariogenic because it releases fluoride.
(4)It does not inflame the pulp and gingiva.
The ART Technique
Two layers of carious
dentine
Outer (‘infected’)
–
–
Bacterial
Invasion
–
–
–
Unreminerizable
Dead
Without
sensation
Inner (‘affected’)
– Few Bacterial
– Reminerizable
– Alive
– Sensitive
Instruments & materials for ART properly
Packed & placed in a basket for easy
Transportation in an outreach situation
(Thailand)
The use of ART at a courtyard
Of A primary school in Syria
ART in schools.
a). China
b). New Zeeland
c). Zimbabwe. Equipment
Layout in a class room.
TM
CARISOLV




Earlier Chemo-Mechanical Preparation-CARIDEX (1978)
System based non-specific Proteolytic effect of
NaOCl.
The development of CMCR -- first initiated in
1980 by Swedish Scientists at Malmo, and
Goteborg, Sweden.
Christer started MediTeam (MT) and had joint
collaboration with Biochemist, Lars Strid -discovered the shortcoming of CARIDEX.





During 1980 Ericcson improved the CARIDEX
formula.
And later in 1990, in joint collaboration with
other Scientists developed CARISOLV.
CARISOLV DEVELOPMENT -- NaOCl with three
naturally occurring amino acids -- Glutamic
acid, Leucine and Lysine.
CARISOLV also contains Methyl
cellulose and Erythrocin.
Ph of CARISOLV is 11.
Carisolv
TM
Non invasive ,tissue – preserving
Caries removal
Step by Step treatment of root caries
lesions using CarisolvTM
Apply gel with the
Tip called star 3.
Wait 30 seconds
CLINICAL STUDIES AND EVIDENCE
CARISOLV did not affect healthy enamel and
Dentin compared with Phosphoric Acid
etching which increases surface roughness
of both healthy Enamel and Dentin ( Kalige
et al, 1999).