2. HISTORY OF ART
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, but still widely unknown amongst
the general public -takes the dread from
the dentist visit and has the potential to
significantly improve the state of the
nation's teeth.
3. PRINCIPLES OF ART
It is based on modern knowledge about minimal
intervention, minimal invasion and minimal cavity
preparation for carious lesions.
It is a procedure based on removing carious tooth
tissues using hand instruments alone and restoring
the cavity with adhesive restorative material.
4. INDICATIONS OF ART
Only in small cavities
In those cavities that are accessible to hand
instruments
Public health programs
5. CONTRAINDICATIONS OF ART
Swelling, abscess or fistula near the carious tooth.
exposed pulp.
painful for a long time.
opening is inaccessible to hand instruments.
cavity cant be entered from proximal or occlusal
direction.
6. ADVANTAGES OF ART
A biological approach.
Conservation of sound tooth tissues.
Less trauma to teeth.
Painless
control simplified
Infection ctrl simplified
Cost effective
A friendly procedure, so great potentials for use in
children & in fearful adults.
for special groups such as the physically or
mentally handicapped , people living in nursing
homes & the home bound elderly.
8. WORKING ENVIRONMENT
A. OUTSIDE THE MOUTH
WORKING ALONE
The distance from the operator’s eye
to the patient’s tooth is usually
between 30-35cm.
ASSISTANCE
The assistant’s head should be
10-15cm higher than the operator.
9. WORKING ENVIRONMENT
B. INSIDE THE MOUTH
The success of ART lies in
control of saliva around the
tooth being treated.
Cotton wool rolls provide
short term protection from
moisture/saliva.
10. HYGIENE & CONTROL OF CROSS INFECTION
AUTOCLAVE
PRESSURE COOKER
Wash the instruments with brush in
soapy water
Put the clean instruments in an
autoclave.
Alternatively we can use a pressure
cooker
Take instruments out with forceps and
dry them with a clean towel.
Store in a covered metal box.
11. RESTORING THE CAVITY
Using press finger technique completes the filling:
the dentist slightly overfills the cavity and applies
light pressure onto it by using his gloved,
Vaseline coated index finger.
12. ESSENTIAL INSTRUMENTS FOR ART
•Reflects light
•Indirect vision
•Retraction of
cheek & tongue
Mouth Mirror
21. To keep moisture away from GIC
To prevent gloves from sticking to GIC
Petroleum jelly
22. To hold plastic strip close to
the shape of the proximal
surface of the tooth
Wedges
23. POWDER:Si oxide, Al
oxide, Ca flouride
LIQUID:Polyacrylic acid
or Demineralized water
Type п GIC is used
for restoring the
cavities.
P/L ratio -3:1
Glass Ionomer Cement
24. ADVANTAGES OF USING GIC
The result is a sealed restoration with
the filled cavity and sealed pits and
fissures adjacent to it, which provides
additional protection against recurrent
caries attacks.
International research shows that ART
restorations are as durable and
successful as conventional restorations
and are considered as permanent
fillings. Not only does the procedure
help to reduce bacteria causing caries,
but chemically bonds the filling material
to cavity walls, thus preventing any
further nutrient supply to remaining
bacteria. In effect bacteria ‘starve’ and
become inactive. Continued fluoride
release by the filling material also acts
toxic against bacteria and assist in the
remineralisation and rebuild of
weakened tooth tissues.
25. PRECAUTIONS FOR GIC MATERIAL
Dispense P/L only when cavity is properly dried.
Recap the bottles immediately after use. This
prevents uptake of moisture from the air or
evaporation of water component from the liquid.
If more than 30 seconds are used for mixing and
the mixture looks dry , discard it because there will
be poor adhesion to the tooth structure.
26. FACTS ABOUT ART
ART was officially endorsed by the World Health
Organization in1994.
Its inventor, Prof. Jo Frencken introduced ART, to mainly
academic dental institutions in South Africa in 1996.
The National Department of Health and Provincial Health
Authorities as well as the World Health Organization
(WHO) have highlighted the importance of ART for South
Africa.
The Health Profession Council of SA has accredited ART
training for dentists as Continued Professional
Development (CPD) activity.
The listing of ART training courses within the National
Qualification Framework by the South African
Qualification Authority is on the way.
27. r seen as the inflictor of pain, a perception, which causes much stress amongst oral health professionals in their daily practice. A
CONCLUSION
Although no ‘magic bullet’ to solve all problems
related to dental caries, the ART concept holds
many advantages, for the dental practice. The
mechanics needed for ART does not depend on
complicated mechanical instruments but rather
makes use of the already sufficient number of
available hand instruments in any dental clinic.
These are not only more durable and cheaper to buy
and maintain, but also significantly reduces the risk
of cross infection.
Since ART is painless, only removing the soft, non
sensitive carious tooth.
oThe dentist is no longer seen as the inflictor of
pain, a perception, which causes much stress
amongst oral health professionals in their daily
practice. All in all, a win situation.
28. REFERENCES
Soben Peter’s Textbook of preventive and
community dentistry, 4th Edition.
Shobha Tondon’s Textbook of Pedodontics , 13th
Edition.
