Class III Atraumatic Restorative Treatment (ART) in adults living in West Africa - outcomes after 48 months
ABSTRACT This observational study assessed the effectiveness of class III restorations using the atraumatic restorative treatment (ART) approach in permanent anterior teeth over a 48-month period.
Dental auxiliaries placed a total of 117 class III ART restorations in 2004, using a cosmetically improved glass-ionomer (Ionofil® Plus; VOCO, Cuxhafen, Germany), in 67 patients with a mean age of 27.3 years in the rural Jahali Health Center, The Gambia. Independent examiners evaluated the restorations after 24 and 48 months using the clinical ART evaluation criteria.
Seventy-six of the restorations could be observed over 48 months in 51 patients. After 48 months, 53 of 76 restorations were classified as clinically acceptable (without or with minor intervention (repair) needed), and 23 restorations were classified as insufficient. There was no statistical difference in a clustered performance rating between restorations placed in central and lateral incisors (P=1.0).
The adoption of the ART approach to class III caries cavities made restorative dental care in anterior teeth available in a West African region. The long-term performance was comparable to other studies. Longitudinal clinical studies with greater populations are required to substantiate these results.
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- "Um estudo publicado por Prakki et al., em 2008 9 avaliando restaurações de Classe III, após seis anos de acompanhamento mostrou um índice de 73,8% de sucesso. Outro estudo avaliando restaurações de Classe III após 48 meses em adultos foi publicado por Jordan et al., em 2011 10 obtendo sucesso em 70% das restaurações. Uma das prováveis causas da não utilização de restaurações de ART em dentes anteriores era a falta de estética dos ionômeros de vidro. "
ABSTRACT: The Atraumatic Restorative Treatment (A R T) is understood as a minimally invasive approach comprising preventive, therapeutic and restorative measures in relation to dental caries and in the control of this disease, including in attendance to patients of special needs. The treatment is done only with the use of hand instruments and with the use of glass ionomer cement (GIC), applied to the sealing of pits and fissures in caries risk and in the restoration of teeth with cavities in which the adjacent pits and fissures are also sealed. The most frequent reasons for the failures of ART restorations are the displacement of the glass ionomer due to inadequate removal of demineralized enamel and dentin decomposed; improper handling of the glass ionomer powder and liquid; degree of humidity and temperature of the mix GIC at the time of handling; not full fill of the cavity with the restorative material; contamination by saliva and/or blood; cleaning or conditioning of cavities; degree of cooperation of the patient; skill of the operator. Materials with improved aesthetic properties have emerged on the market and must serve as a stimulus for the works of ART in the anterior teeth. In the preparation of the tooth for class II ART restorations, we recommend that you make additional retentions in the vestibular and lingual walls to prevent the displacement of the restoration. The ART is able to reduce the level of anxiety and fear of patients when the operator is not an expert, and is a treatment that provides less pain and discomfort, and can be performed in a dental office or out of it. Suggestions for new research agendas on the ART are proposed.Revista paulista de odontologia 08/2015; 69(3):289-301.
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ABSTRACT: The purpose of this study was to investigate the effectiveness of basic root canal treatment (BRT) with tactile working length determination in terms of radiographic and clinical outcome parameters compared with endodontic treatment with standard radiographic working length control. This was a clinical, multicenter, controlled, open-label trial to evaluate BRT effectiveness after 24 months. The primary end point was the apical extension score of the radiographic quality parameter of root canal fillings. The secondary radiographic end point was the periapical index, and the secondary clinical end point was tooth tender to percussion. The safety end point was tooth loss as a consequence of endodontic failure. Statistical analyses of binary and categoric data were calculated using cross tables and the chi-square test. BRT with tactile working length determination compared with standard radiographic working length control did not significantly differ in terms of radiographic and clinical outcomes after 24 months. The apical extension of the root canal fillings and the periapical anatomic structures showed no significant differences according to radiographic analyses (P = .5). Corresponding results were found in clinical aspects of tooth tender to percussion (P = .6) and tooth loss (P = .7). Tactile working length determination in BRT resulted in comparable treatment outcomes compared with standard endodontic treatment with radiographic working length control and turned out to be an accurate method in BRT.Journal of endodontics 04/2014; 40(4):465-70. DOI:10.1016/j.joen.2013.10.028 · 3.38 Impact Factor