The atraumatic restorative treatment (ART) approach for primary teeth: review of literature

There is widespread interest in and increasing usage of the atraumatic restorative treatment (ART) technique or approach for the restoration of primary teeth, especially in developing countries. However, most of the published reports of the clinical performance of newer, more-viscous esthetic conventional glass ionomer restorative cements marketed for the technique have been from short-term studies, and there have been very few reports comparing different types of restorative materials and methods of cavity preparation. After 12 months, Class II/multisurface and Class III/IV ART restorations have generally shown success rates of approximately 55-75% and 35-55%, respectively. Failures were usually from restoration losses and fractures. Class I & V/single-surface ART restorations have had much better short-term success rates of approximately 80-90%. Recurrent caries was not a concern at this time, but occlusal wear was relatively high. Further improvements in the mechanical and adhesive properties of the newer cements are still required, together with further clinical investigations of the remineralization of shallow open preparations as an alternative to placing restorations. The ART approach is readily accepted by children and has resulted in the retention of many teeth that would otherwise have been extracted.