Atraumatic restorative treatment: clinical, ultrastructural and chemical analysis

With the purpose of checking, in vivo, the effect of atraumatic restorative treatment (ART) on the remaining demineralized dentin, 12 primary molars with deep occlusal lesions from children with ages ranging from 3 to 7 were evaluated. After lesion excavation, and before glass ionomer cement placement, dentin samples were collected from the pulpal wall of the cavity. After 3 months, the restorations were removed and new samples were collected. Six microareas of each sample were analyzed by X-ray energy dispersion spectrometer. Samples obtained before treatment were infected and intertubular dentin had a loosely organized collagen matrix, with well-defined collagen fibers. Following treatment, in addition to a drastic reduction of the amount of bacteria, the intertubular dentin was denser, with more compact and closely packed collagen fibers. An increased calcium concentration was observed in dentin collected after treatment (p < 0.001), suggesting tissue remineralization, but fluoride was not detected. We conclude that ART allows a one-session approach, with the purpose of creating more favorable conditions for the healing process.