Does ART have a place in preservative dentistry?

Area of Science:

• Restorative Dentistry
• Pediatric Dentistry
• Dental Materials Science

Background:

• Atraumatic Restorative Treatment (ART) involves manual excavation of carious tissue and restoration with highly viscous glass ionomer cement.
• While ART offers benefits like minimal intervention and tooth structure conservation, current retention rates in primary teeth are suboptimal.
• Improved materials and methods are essential for successful long-term caries management using the ART technique.

Purpose of the Study:

• To evaluate the effectiveness of the ART technique in restorative dentistry.
• To identify the limitations of current ART materials, particularly highly viscous glass ionomer cements.
• To explore the need for advanced materials that improve caries management outcomes and tooth survival.

Main Methods:

• Review of existing studies on the ART technique and its associated materials.
• Analysis of the ideal properties for an ART direct-filling material.
• Comparison of current glass ionomer cements against ideal material characteristics.

Main Results:

• Current highly viscous glass ionomer cements used in ART meet some ideal criteria but have deficiencies in marginal sealing and desiccation sensitivity.
• Fluoride release from glass ionomer cements may not be sufficient to prevent caries progression in high-risk individuals.
• Adjunctive use of chlorhexidine with fluoride is suggested for caries arrest and remineralization in high-caries-risk patients.

Conclusions:

• The ART technique provides benefits for restoring function and slowing caries progression.
• Current ART materials are unlikely to completely arrest caries progression in high-risk individuals.
• Further development of ART materials is necessary to improve long-term success rates and address challenges in high-risk populations.