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      Twelve-month evaluation of the atraumatic restorative treatment approach for class III restorations: An interventional study

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          Abstract

          BACKGROUND

          Atraumatic restorative treatment (ART) may be appropriate for populations without accessibility and affordability. More data are required regarding the success rate of ART in anterior teeth.

          AIM

          To evaluate the clinical performance of restoring class III cavities in anterior teeth of permanent dentition using the ART approach.

          METHODS

          A longitudinal interventional field study was carried out at two rural primary health centers, Tumkur district, India. A total of 54 teeth in 39 patients were evaluated for the survival rate of class III restorations in permanent anterior teeth using the ART approach in children and adult populations. Evaluation of ART restoration was carried out using Frencken J criteria, the mean procedure time, patient acceptance and reported pain severity during the ART approach were evaluated using a visual analog scale. Calculation of the cost of ART was also performed.

          RESULTS

          The mean time taken to perform the ART procedure was 14.79 ± 5.8 min with the majority of patients reporting only mild pain. At 6 mo follow-up, 72.2% remained in a good state, but this reduced to 27% at 12 mo. The cumulative survival rate of the restorations was 94.4% at 6 mo and 80.9% at 12 mo follow-up. Estimation of the direct cost for a single class III restoration was 186.50 INR (2.64 USD).

          CONCLUSION

          ART may be a good comprehensive option for basic oral health care for underserved or inaccessible populations, and preventive care for patients.

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          Most cited references33

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          Minimal intervention dentistry for managing dental caries - a review: report of a FDI task group.

          This publication describes the history of minimal intervention dentistry (MID) for managing dental caries and presents evidence for various carious lesion detection devices, for preventive measures, for restorative and non-restorative therapies as well as for repairing rather than replacing defective restorations. It is a follow-up to the FDI World Dental Federation publication on MID, of 2000. The dental profession currently is faced with an enormous task of how to manage the high burden of consequences of the caries process amongst the world population. If it is to manage carious lesion development and its progression, it should move away from the 'surgical' care approach and fully embrace the MID approach. The chance for MID to be successful is thought to be increased tremendously if dental caries is not considered an infectious but instead a behavioural disease with a bacterial component. Controlling the two main carious lesion development related behaviours, i.e. intake and frequency of fermentable sugars, to not more than five times daily and removing/disturbing dental plaque from all tooth surfaces using an effective fluoridated toothpaste twice daily, are the ingredients for reducing the burden of dental caries in many communities in the world. FDI's policy of reducing the need for restorative therapy by placing an even greater emphasis on caries prevention than is currently done, is therefore, worth pursuing.
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            A new translucent cement for dentistry. The glass ionomer cement.

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              Atraumatic restorative treatment (ART): rationale, technique, and development.

              Despite long-term efforts to use appropriate dental equipment for treating dental caries in economically less developed countries, the predominant treatment remains extraction. The reasons for this failure to save teeth are given in this paper. Supported by results of research undertaken in economically developed countries, a 15-step treatment module for dental caries is presented. This technique, which is called Atraumatic Restorative Treatment (ART), is based on removing decalcified tooth tissue using only hand instruments and restoring the cavity with an adhesive filling material. The technique does not require electricity. The advantages and limitations of the technique are discussed and its use in a school oral health program in Zimbabwe presented. We conclude that ART can make restorative oral care more available to a larger part of the world population than it is today.
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                Author and article information

                Contributors
                Journal
                World J Clin Cases
                WJCC
                World Journal of Clinical Cases
                Baishideng Publishing Group Inc
                2307-8960
                26 September 2020
                26 September 2020
                : 8
                : 18
                : 3999-4009
                Affiliations
                Community Dentistry, Penang International Dental College, Jalan Bagan Luar 12000, Malaysia
                Department of Public Health Dentistry, Sri Ventkateshwraa Dental College, Ariyu 605102, India
                Preventive Dental Science Department, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
                Dental Biomaterials Research Chair, Dental Health Department, College of Applied Medical Sciences, King Saud University, P. O. Box: 10219, Riyadh 11433, Saudi Arabia. sachinnaiksln@ 123456gmail.com
                Dental Biomaterials Research Chair, Dental Health Department, College of Applied Medical Sciences, King Saud University, P. O. Box: 10219, Riyadh 11433, Saudi Arabia
                Dental Biomaterials Research Chair, Dental Health Department, College of Applied Medical Sciences, King Saud University, P. O. Box: 10219, Riyadh 11433, Saudi Arabia
                Dental Biomaterials Research Chair, Dental Health Department, College of Applied Medical Sciences, King Saud University, P. O. Box: 10219, Riyadh 11433, Saudi Arabia
                Author notes

                Author contributions: Shivanna MM contributed as the first author in designing and overall concept of the study; Ganesh S contributed in preparing material and methods; Khanagar SB reviewed the literature; Naik S wrote the discussion and comparison of studies; Divakar DD interpreted the results; Al Kheraif AA edited and wrote the manuscript; Jhugroo C drafted and revised the manuscript.

                Supported by the deanship of Scientific Research, King Saud University for funding through Vice Deanship of Scientific Research Chairs .

                Corresponding author: Sachin Naik, MDS, Associate Professor, Dental Biomaterials Research Chair, Dental Health Department, College of Applied Medical Sciences, King Saud University, PO Box 7805, Riyadh 11433, Saudi Arabia. sachinnaiksln@ 123456gmail.com

                Article
                jWJCC.v8.i18.pg3999
                10.12998/wjcc.v8.i18.3999
                7520763
                a3f0f32a-c45f-42ee-81c7-434449e94c54
                ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.

                This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.

                History
                : 28 March 2020
                : 30 April 2020
                : 30 July 2020
                Categories
                Clinical and Translational Research

                atraumatic restorative treatment,anterior teeth,composite,glass ionomer cement,permanent dentition,rural area

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