This document discusses the Atraumatic Restorative Treatment (ART) approach. ART involves removing decay using only hand instruments and restoring cavities with adhesive materials. It was developed as a cost-effective technique for public health programs. The key aspects of ART are minimal intervention, minimal cavity preparation while conserving tooth structure, and use of hand instruments and adhesive restorative materials. The document outlines the ART procedure and materials used.

1. Guided By:
Dr. Swagat Mahanta
HOD Of Public Health Dentistry
Presenter:
Manila Upreti
B.D.S Final Year
Phase I

2. It is the procedure based on removing
carious tooth tissue using hand
instruments alone and restoring the
cavity with adhesive restorative
materials.

3.  It was first evaluated in Tanzania in the mid
1980s.
 ART was introduced in south Africa by its
Dutch Inventor , Prof. Jo Frencken in 1996

4. Based on modern principle of:
Minimal intervention
Minimal invasion
Minimal cavity preparation

5.  Removing carious tooth using hand
instruments
 Restoring the cavity with an adhesive
restorative material

6.  Removing carious tooth using hand
instruments
 Restoring the cavity with an adhesive
restorative material

7.  Use of biological approach which requires
minimal cavity preparation that conserves
sound teeth
 Cost effective
 Limitation of pain that reduces the need for
local anesthesia
 Infection control

8. Bonds chemically to enamel and dentin
Release of flouride – Anticariogenic
Similar to hard tissue and non irritating
to oral soft tissue

9. Bonds chemically to enamel and dentin
Release of flouride – Anticariogenic
Similar to hard tissue and non irritating
to oral soft tissue

10. Bonds chemically to enamel and dentin
Release of flouride – Anticariogenic
Similar to hard tissue and non irritating
to oral soft tissue

11.  Only in small cavities (involving dentin only)
 Cavities accessible to hand instruments
 Public health programs

12.  Only in small cavities (involving dentin only)
 Cavities accessible to hand instruments
 Public health programs

13.  Only in small cavities (involving dentin only)
 Cavities accessible to hand instruments
 Public health programs

14.  Presence of swelling or abscess or fistula
near carious tooth
 Pulp of tooth is exposed
 History of pain and chronic irreversible
pulpitis
 Cavities inaccessible to hand instruments

15.  Presence of swelling or abscess or fistula
near carious tooth
 Pulp of tooth is exposed
 History of pain and chronic irreversible
pulpitis
 Cavities inaccessible to hand instruments

16.  Presence of swelling or abscess or fistula
near carious tooth
 Pulp of tooth is exposed
 History of pain and chronic irreversible
pulpitis
 Cavities inaccessible to hand instruments

17.  Presence of swelling or abscess or fistula
near carious tooth
 Pulp of tooth is exposed
 History of pain and chronic irreversible
pulpitis
 Cavities inaccessible to hand instruments

18.  Biological approach that requires minimal
cavity preparation that conserve sound teeth
 Painless
 Infection control
 Cost effective
 Easy to operate

19. • Operator position
• Patient position
Arranging good
working
environment
• Sterilization and
disinfection
Hygiene and
control of cross
infection • Hand instruments
• Removal of caries
• Restoration with
adhesive materials
Restoration of
cavity

20.  Mouth miror
 Explorer
 Tweezer
 Spoon excavator
 Dental hatchet
 Carver
 Mixing pad and Agate spatula
 Cottols rolls and pellets
 Petroleum jelly
 Plastic strips
 Wedges GIC cement

21. ISOLATION
PREPARATION
OF THE CAVITY
CLEANING
THE
PREPARED
CAVITY
RESTORING
THE CAVITY
MIXING THE
RESTORATIVE
MATERIALS

22. Cotton rolls effective at absorbing
Saliva and can provide short term
Protection from moisture.

23.  To improve the chemical bonding of GIC to
tooth tooth structure
 Dentin conditioner espicially development
for this purpose (liquid is supplied with GIC)
10%
Polyacrylic
acid

24. Powder:
Silica
CaF
Aluminium oxide
LIQUID:
Polyacrylic acid
TYPE 9
is used
P/L =
3:1

25.  Rub a small amount of petroleum jelly on the
gloved index finger
 Press the soft restorative material firmly into the
cavity and fissure
 Then slide the finger smoothly across the
occlusal surface of teeth so that the GIC will get
deposited in the remaining of fissure

26.  Excess material is removed with carver
 Cover the ART with petroleum jelley
 Patient is not allowed to eat for at least 1
hour

28. Restoration is completely missing
Part of restoration has broken away
Restoration has fractured
Restoration has worn away
Caries has developed in the adjacent
fissure of surface