Atraumatic Restorative Treatment (ART) for dental caries

Jo E. Frencken Christopher J. Holmgren

STI Book b.v. Nijmegen 1999

List of contents

Bibliography Acknowledgement Preface Foreword

1. Dentinal caries, its progression and how best to stop it

- Chapter objectives

- Introduction

- What is dentinal caries?

- How does dentinal caries progress?

- Has dentinal caries the ability to heal?

- Should there be a cavity design?

- How to increase the life of a tooth that requires a restoration?

-What happens to outer caries dentine that is not removed?

- Should all discoloured dentine be removed?

- What kind of instrumentation is required to remove demineralized tooth tissues?

- Summary

2. Adhesive restorative materials for minimum intervention approaches

- Chapter objectives

- Introduction

- Glass-ionomers

- How do glass-ionomers bond to tooth tissues?

- What is the function of a surface conditioner?

- What is the role of water in glass-ionomers?

-What does fluoride do in glass-ionomers?

- What happens to the fluoride that is released from the glass-ionomers?

- Have glass-ionomers the potential to remineralize carious lesions in adjacent tooth surfaces?

- How pulpal-friendly are glass-ionomers?

- What can be said about the physical characteristics of glass-ionomers?

- Conclusions

- Resin-modified glass-ionomers

- Composite resins

- Compomers

- Concluding comments

- Summary

3. Equipment and materials required for the ART approach

- Chapter objectives

- Introduction

-Why is there a need for appropriate support for the patient and the operator?

- Patient support

- Operator support

- Instrument support

- Which dental instruments are required for ART?

-Which adhesive restorative materials are required for ART?

- What are the other materials required for ART?

-What type of operating light can be used?

- Positioning the operating light

- Maintenance of ART instruments

- Sterilization of instruments

- Sharpening of ART instruments

- Sharpening the dental hatchet and carver

4. The ART approach - Step-by-Step

- Chapter objectives

- Introduction

-What are the applications for ART ?

-A step-by-step guide to restoring single-surface cavities using ART

- Preparation of the ART instruments and materials prior to cavity preparation

- Isolation of the operating site

- Examining the cavitated tooth

- Gaining access to the carious lesion

- Removal of soft, completely demineralized, dentine

- Conditioning the cavity and adjacent pits and fissures

- Mixing the glass-ionomer

- Restoring the cavity and filling the pits and fissures

- Restoring multiple-surface cavities using ART

- ART based fissure sealants

- Introduction

- A step-by-step guide to the placement of glass-ionomer sealants

5. Survival of single-surface ART restorations and sealants placed as part of the ART approach

- Chapter objectives

- Introduction

-Which criteria have been used to evaluate ART restorations?

- How well do ART restorations perform?

- ART restorations in the permanent dentition

- Development of the ART approach

- Material considerations

- Operator considerations

-Applicability of ART

- Effectiveness of hand instruments currently recommended for ART

- Size of preparation

- Discomfort during treatment

- Post-operative sensitivity

- Acceptance by care receivers

- Future considerations

- How do ART restorations compare to conventional restorations in the permanent dentition?

- ART restorations in the deciduous dentition

- Summary

- ART related sealants

- Introduction

-Which criteria have been used to evaluate glass-ionomer sealants placed as part of the ART approach?

- How well do sealants placed as part of the ART approach perform?

- How do glass-ionomer sealants compare to composite resin sealants?

- Retention compared

- Caries prevention compared

- Summary

6. Failed ART restorations: Cause and management

- Chapter objectives

- Introduction

- Material-related reasons included

- Operator-related reasons included

-What were the perceived reasons for failure of ART restorations?

-What are the reasons for replacement of amalgam and composite resin restorations in general practice?

-What can be concluded about restoration failures?

- How to manage a failed or defective ART restoration?

- Cause and Management

- If the restoration has shown severe wear

- If there is a fracture within the restoration

- If the restoration is completely or partly missing

- If a carious lesion has developed in the adjacent fissure or surface

- What to do with failed ART related sealants?

7. ART as a practice builder

- Chapter objectives

- Introduction

-The use of ART in the dental clinic setting

-The use of ART in outreach situations

-The use of ART in other specific situations

-Advantages and limitations of ART

- Post-graduate courses on ART

8. Future directions for ART

- Chapter objectives

- Introduction

- Further developments and investigations of ART

-The application of ART

- ART as a means to caries control

- Development and evaluation of improved restorative materials

- Improved instrumentation using hand instruments

- Concluding statement