Atraumatic Restorative Treatment Research Articles

Effectiveness of silver diamine fluoride application with atraumatic restorative treatment in arresting the progression of dental caries: a systematic review protocol.

This review aims to evaluate the effectiveness of silver diamine fluoride application along with atraumatic restorative treatment in arresting the progression of dental caries when compared with other caries-arresting treatments in children and adults. A combination of silver diamine fluoride with atraumatic restorative treatment is a minimally invasive and cost-effective method to treat dental caries. It offers a solution for the progression of caries and restoration of cavitated lesions in both primary and permanent teeth. A comprehensive summary of the evidence will assist dental clinicians and guide subsequent clinical research. Randomized controlled trials involving human participants of any age with cavitated dental caries lesions will be included. The intervention arm will evaluate the effectiveness of silver diamine fluoride application with atraumatic restorative treatment in dental caries arrest with a control arm of either atraumatic restorative treatment (ART) or silver diamine fluoride (SDF) application; or composite restoration; or sodium fluoride varnish or a placebo; or a study group with no intervention. Systematic searches for relevant studies will be conducted across multiple databases, including MEDLINE, Scopus, Cochrane CENTRAL, Dentistry and Oral Sciences Source, CINAHL, and Web of Science. ProQuest Dissertations and Theses and Google Scholar will also be searched for gray literature. The databases will be searched from January 2016 to the present. No restrictions will be imposed on the country of publication. Data appraisal, extraction, and synthesis will follow JBI guidance for systematic reviews of effectiveness. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system will be used to grade the certainty of evidence, and a Summary of Findings will be prepared. PROSPERO CRD42023426766.

Noninferiority of Silver Diamine Fluoride vs Sealants for Reducing Dental Caries Prevalence and Incidence

Dental caries is the world's most prevalent noncommunicable disease and a source of health inequity; school dental sealant programs are a common preventive measure. Silver diamine fluoride (SDF) may provide an alternative therapy to prevent and control caries if shown to be noninferior to sealant treatment. To determine whether school-based application of SDF is noninferior to dental sealants and atraumatic restorative treatment (ART) in the prevalence of dental caries. The Silver Diamine Fluoride Versus Therapeutic Sealants for the Arrest and Prevention of Dental Caries in Low-Income Minority Children (CariedAway) study was a pragmatic noninferiority cluster-randomized clinical trial conducted from February 2018 to June 2023 to compare silver diamine fluoride vs therapeutic sealants for the arrest and prevention of dental caries. Children at primary schools in New York, New York, with at least 50% of the student population reporting as Black or Hispanic and at least 80% receiving free or reduced lunch were included. This population was selected as they are at the highest risk of caries in New York. Students were randomized to receive either SDF or sealant with ART; those aged 5 to 13 years were included in the analysis. Treatment was provided at every visit based on need, and the number of visits varied by child. Schools with preexisting oral health programs were excluded, as were children who did not speak English. Of 17 741 students assessed for eligibility, 7418 were randomized, and 4100 completed follow-up and were included in the final analysis. Participants were randomized at the school level to receive either a 38% concentration SDF solution or glass ionomer sealants and ART. Each participant also received fluoride varnish. Primary study outcomes were the prevalence and incidence of dental caries. A total of 7418 children (mean [SD] age, 7.58 [1.90] years; 4006 [54.0%] female; 125 [1.7%] Asian, 1246 [16.8%] Black, 3648 [49.2%] Hispanic, 153 [2.1%] White, 114 [1.5%] multiple races or ethnicities, 90 [1.2%] other [unspecified], 2042 [27.5%] unreported) were enrolled and randomized to receive either SDF (n = 3739) or sealants with ART (n = 3679). After initial treatment, 4100 participants (55.0%) completed at least 1 follow-up observation. The overall baseline prevalence of dental caries was approximately 27.2% (95% CI, 25.7-28.6). The odds of decay prevalence decreased longitudinally (odds ratio [OR], 0.79; 95% CI, 0.75-0.83) and SDF was noninferior compared to sealants and ART (OR, 0.94; 95% CI, 0.80-1.11). The crude incidence of dental caries in children treated with SDF was 10.2 per 1000 tooth-years vs 9.8 per 1000 tooth-years in children treated with sealants and ART (rate ratio, 1.05; 95% CI, 0.97-1.12). In this school-based pragmatic randomized clinical trial, application of SDF resulted in nearly identical caries incidence compared to dental sealants and ART and was noninferior in the longitudinal prevalence of caries. These findings suggest that SDF may provide an effective alternative for use in school caries prevention. ClinicalTrials.gov Identifier: NCT03442309.

Evaluating Glass Ionomer Cement Longevity in the Primary and Permanent Teeth-An Umbrella Review.

The aim of this umbrella review was to evaluate the longevity of glass ionomer cement (GIC) as a restorative material for primary and permanent teeth. Research in the literature was conducted in three databases (MedLine/PubMed, Web of Science, and Scopus). The inclusion criteria were: (1) to be a systematic review of clinical trials that (2) evaluated the clinical longevity of GICs as a restorative material in primary and/or permanent teeth; the exclusion criteria were: (1) not being a systematic review of clinical trials; (2) not evaluating longevity/clinical performance of GICs as a restorative material; and (3) studies of dental restorative materials in teeth with enamel alterations, root caries, and non-carious cervical lesions. Twenty-four eligible articles were identified, and 13 were included. The follow-up periods ranged from 6 months to 6 years. Different types of GICs were evaluated in the included studies: resin-modified glass ionomer cement (RMGIC), compomers, and low- and high-viscosity glass ionomer cement. Some studies compared amalgam and composite resins to GICs regarding longevity/clinical performance. Analyzing the AMSTAR-2 results, none of the articles had positive criteria in all the evaluated requisites, and none of the articles had an a priori design. The criteria considered for the analysis of the risk of bias of the included studies were evaluated through the ROBIS tool, and the results of this analysis showed that seven studies had a low risk of bias; three studies had positive results in all criteria except for one criterion of unclear risk; and two studies showed a high risk of bias. GRADE tool was used to determine the quality of evidence; for the degree of recommendations, all studies were classified as Class II, meaning there was still conflicting evidence on the clinical performance/longevity of GICs and their recommendations compared to other materials. The level of evidence was classified as Level B, meaning that the data were obtained from less robust meta-analyses and single randomized clinical trials. To the best of our knowledge, this is the first umbrella review approaching GIC in permanent teeth. GICs are a good choice in both dentitions, but primary dentition presents more evidence, especially regarding the atraumatic restorative treatment (ART) technique. Within the limitation of this study, it is still questionable if GIC is a good restorative material in the medium/long term for permanent and primary dentition. Many of the included studies presented a high risk of bias and low quality. The techniques, type of GIC, type of cavity, and operator experience highly influence clinical performance. Thus, clinical decision-making should be based on the dental practitioner's ability, each case analysis, and the patient's wishes. More evidence is needed to determine which is the best material for definitive restorations in permanent and primary dentition.

Minimal intervention dentistry: What is its clinical application and effectiveness in different continents? - A scoping review.

The aim of minimal intervention dentistry (MID) is to maximize the preservation of dental tissues through the use of modern and effective techniques and procedures. The central objective of MID is to increase the functional life of dental elements and, consequently, the quality of life of the population. The present study aimed to analyze and map the diffusion and clinical application of MID in different continents around the world. To perform this scoping review, the PRISMA checklist was used, adopting the following: population - dentists; concept - effectiveness of MID; and context - continents. The following databases were used: PubMed, European Archives of Paediatric Dentistry, Scientific Electronic Library, Latin Literature American and Caribbean Association in Health Sciences, and SCOPUS. The following keywords were used in the searches: "pediatric dentistry," "atraumatic restorative treatment," "dental caries," "child health," and "glass ionomer cements" using "and" and "or" combined with "minimal intervention dentistry." Studies published before 2010 as well as theses, dissertations, opinion articles, editorials, and guidelines, were excluded from the study. A total of 160 articles were obtained, and 17 articles were screened and selected for full reading. The analysis of the studies reveals the disparity in the use of minimal intervention techniques among continents due to a lack of knowledge of these techniques or lack of confidence in changing professional approaches, thus emphasizing the need for the dissemination and teaching of MID.

Educators' perception of oral health in children's schools in Brazil

This study aimed to explore educators' perceptions regarding oral health promotion and the application of Atraumatic Restorative Treatment in the school environment. It is an exploratory descriptive observational study with a qualitative approach. The sample consisted of 18 educators from an Early Childhood Education Center. For data collection, a form was used with open and closed questions about oral health care for children: recreational and educational activities, supervised brushing and Atraumatic Restorative Treatment. Data were analyzed by descriptive analysis and by the Discourse of the Collective Subject. About 60% of educators considered caries a disease, 50% having observed toothache in children in the school environment. The educators considered the educational/preventive activities and the use of Atraumatic Restorative Treatment beneficial to the children. They reported relevance in oral health prevention and promotion actions carried out in the school environment, observing the generation of autonomy and empowerment in children. They also cited a favorable opinion on the use of Atraumatic Restorative Treatment.

Effectiveness of mixing procedure on the microleakge of glass ionomer cement as filling material in primary molars (in vitro study)

Background: Well-adapted restorations with adequate marginal sealing are of extreme importance for the success of atraumatic restorative treatment, The present study was carried out to find if the mixing procedure affect the marginal seal of hand mixed and capsulated glass-ionomer in Class I cavities of 30 non carious primary molars.Materials and Methods:Standardized Class I cavity preparations were prepared in 30 extracted sound primary molars. The teeth were then randomly divided into two groups: Group I: filled with mechanically mixed (capsulated) glass ionomer cement (GIC). Group II: filled with hand mixed glass ionomer . After that the teeth were subjected to 250 thermal cycles with a 15 second dwell time in each, then sectioned to be examined under the stereo microscope.Results:The sealing ability of the GIC filling materials was determined by their ability to inhibit dye penetration. Data were analyzed according to t-test. The hand mixed GIC provides a better seal than capsulated GIC, there were no significant differences between the two studied groups in their resistance to dye penetration. Conclusion: Hand mixed GIC presented a better performance regarding microleakage in comparison to capsulated GIC.

Peningkatan Kesehatan Gigi dan Mulut Melalui Revitalisasi Usaha Kesehatan Gigi Sekolah di SDN Pasar Kamis 2 Kabupaten Banjar

Pasar Kamis 2 elementary school is one of the elementary schools in Kertak Hanyar District that has not implemented a phase III school dental health program, so it is necessary to revitalize the school dental health program. The revitalization of school dental health programs aims to revive promotional programs for dental and oral health in elementary schools. The method applied for this community service activity is by carrying out promotional activities in the form of teacher training for school dental health businesses, training for little doctors, health promotion through the media snakes and ladders and the song SIGIBER, as well as joint toothbrushing activities. Preventive activities carried out include carrying out dental and oral health screening and carrying out fissure sealant treatment and atraumatic restorative treatment based on the results of the screening. Evaluation of community service activities is carried out by measuring the results of pretest and posttest students' knowledge and analyzing the provision of preventive measures to students. The results of this service show that there is a difference in knowledge before and after being given health promotion interventions, as well as an improvement in students' dental and oral health after preventive measures are given in the form of pit and fissure sealants and atraumatic restorative treatment. Revitalization of school dental health businesses is important so that promotional activities for dental and oral health in the school environment are not neglected so that they can improve dental and oral health and school children's achievement in learning.

Cost-effectiveness of dental caries prevention strategies in South African schools

BackgroundIn South Africa, an estimated 85% of the population relies on the public sector for oral health services. With poor infrastructure and inadequate personnel, over 80% of children with dental caries remain untreated. To reduce this burden of disease, one key goal is to promote good oral health and address oral diseases through prevention, screening, and treatment among children. While all policies have been proven to be effective in the control and prevention of dental caries, it is unclear which of those strategies provide value for money. This study evaluated five caries preventative strategies in terms of the cost and benefits among South African school children.MethodsThe study uses a hypothetical South African population of school aged learners aged 5–15. The context and insights of the strategies utilized at the schools were informed by data from both grey and published literature. Using Markov modeling techniques, we conducted a cost-effectiveness analysis of Acidulated Phosphate Fluoride (APF) application, atraumatic restorative treatment (ART), sugar-reduction and fissure sealants. Markov model was used to depict the movement of a hypothetical patient cohort between different health states over time. We assessed both health outcomes and costs of various interventions. The health outcome metric was measured as the number of Decayed, Missing, Filled Tooth (DMFT). The net monetary benefit was then used to determine which intervention was most cost-effective.ResultsThe results showed that school-based caries prevention strategies are cost-effective compared to the status quo of doing nothing. The average cost per learner over the 10-year period ranged from ZAR4380 to approx. ZAR7300 for the interventions considered. The total costs (including screening) associated with the interventions and health outcome (DMFT averted) were: sugar reduction (ZAR91,380, DFMT: 63,762), APF-Gel (ZAR54 million, DMFT: 42,010), tooth brushing (ZAR72.8 million, DMFT: 74,018), fissure sealant (ZAR44.63 million, DMFT: 100,024), and ART (ZAR45 million, DMFT: 144,035). The net monetary benefits achieved for APF-Gel, sugar reduction, tooth brushing, fissure sealant and ART programs were ZAR1.56, ZAR2.45, ZAR2.78, ZAR3.81, and ZAR5.55 billion, respectively.ConclusionBased on the net monetary benefit, ART, fissure sealant and sugar-reduction appear to be the most cost-effective strategies for preventing caries in South Africa. In a resource-scarce setting such as South Africa, where there is no fluoridation of drinking water, this analysis can inform decisions about service packages for oral health.

Minimally invasive dentistry: history, theory and perspectives

The article is a literature review concerning certain aspects of the history of Russian dentistry. In this regard, minimally invasive methods are discussed, including air-abrasive, laser, sonic and ultrasonic preparation, as well as atraumatic restorative treatment without mechanical preparation. Indications for minimally invasive methods, assessment of caries activity and prognosis, causes and mechanisms of the accelerated restoration cycle are discussed. The need to preserve dental tissues has been undervalued in the past. Non-selective preparation to hard dentin is currently considered hypertherapy. The concept of minimally invasive dentistry is also applied in endodontics and periodontology. In patients with gingival recession, it is important to protect atrophic tissues from further damage. After a tooth extraction, excessive socket curettage should be avoided. The research in dentistry should be protected from conflicts of interest. Patients should be objectively informed about treatment options, given recommendations based on clinical indications, wishes and possibilities. It is also necessary to develop economic measures in order to reorient private dental clinics to receive patients with compulsory medical insurance and the use of minimally invasive methods.

Atraumatic Restorative Treatment (ART) as public policy: a Scoping Review

AbstractThis scoping review aimed to identify, describe, and analyze the use of Atraumatic Restorative Treatment (ART) as public policy. Inclusion criteria: studies on public oral health policies; dental caries; ART. Exclusion criteria: clinical studies; specific interventions; studies that report public policies that do not use ART as a strategy for caries treatment. The search was conducted in PubMed, BVS, Epistemonikos, Health Systems Evidence, and Rxforchange. The selection process and data extraction were performed by two authors independently according to the stages and categories of a conceptual framework. Of the 2253 eligible articles, 139 were duplicates, and 1680 were not included after reading the title and abstract. After assessing the full text, 414 articles were excluded. Twenty articles were included. Nineteen were conducted in nine countries (South Africa, Bolivia, Cambodia, Egypt, Mexico, Tanzania, East Timor, Tunisia, and Zimbabwe), and one in the Americas. The studies reported high prevalence of dental caries and lack of access to restorative procedures in health services as common problems. Policy developments followed a similar process, with the presence of governments, conceptual use of scientific evidence, and induction by the World Health Organization. Regarding implementation barriers, the included studies mentioned the lack of supplies and lack of induction by managers,while in relation to the facilitators, permanent education and professional practice were mentioned. Cohort studies have shown a survival rate greater than 80% after one year of follow up of the restorations performed. The findings of this review indicate that the use of ART in public policies is promising, however, its use is still in an early stage. Keywords: Dental Atraumatic Restorative Treatment. Dental Caries. Public Policy. Community Dentistry. Oral Health. ResumoEsta revisão de escopo teve como objetivo identificar, descrever e analisar o uso do Tratamento Restaurador Atraumático (ART) como política pública. Critérios de inclusão: estudos sobre políticas públicas de saúde bucal; cáries dentárias; ART. Critérios de exclusão: estudos clínicos; intervenções específicas; estudos que relatam políticas públicas que não utilizam o ART como estratégia para o tratamento de cárie. A pesquisa foi realizada no PubMed, BVS, Epistemonikos, Health Systems Evidence e Rxforchange. O processo de seleção e extração de dados foram realizados por dois autores, de forma independente, de acordo com as etapas e categorias de um quadro conceitual. Dos 2.253 artigos elegíveis, 139 eram duplicados e 1.680 não foram incluídos após a leitura do título e do resumo. Após avaliação do texto completo, foram excluídos 414 artigos. Vinte artigos foram incluídos. Dezenove foram realizados em nove países (África do Sul, Bolívia, Camboja, Egito, México, Tanzânia, Timor Leste, Tunísia e Zimbábue) e um nas Américas. Os estudos relataram alta prevalência de cárie dentária e falta de acesso a procedimentos restauradores nos serviços de saúde como problemas comuns. Os desenvolvimentos de políticas seguiram um processo semelhante, com a presença de governos, uso conceitual de evidências científicas e indução da Organização Mundial da Saúde. Quanto às barreiras de implementação, foram mencionadas a falta de insumos e a falta de indução por parte dos gestores. Quanto aos facilitadores, foram citados a educação permanente e a prática profissional. Estudos de coorte mostraram sobrevida superior a 80% após um ano de acompanhamento. Os achados desta revisão indicam que a utilização da ART nas políticas públicas é promissora, porém, sua utilização ainda é incipiente. Palavras-chave: Tratamento Dentário Restaurador sem Trauma. Cárie Dentária. Política Pública. Odontologia Comunitária. Saúde Bucal.

Silver diamine fluoride modified atraumatic restorative treatment compared to conventional restorative technique on carious primary molars–A randomized controlled trial

ObjectiveTo compare the success of silver diamine fluoride-modified atraumatic restorative technique (SMART) with that of the conventional drill and fill method in restoring carious lesions in primary molars. MethodChildren (4–8years old) reporting to a tertiary care hospital setting with asymptomatic cavitated dentinal carious lesions in primary molars were randomly allocated to two groups; SMART and Conventional; and subsequently restored with Glass Ionomer Cement (GIC). Follow-up evaluations were carried out by blinded independent evaluator at 6-months intervals to assess the status of restorations. Primary outcome was the success of restorations at 24 months and the secondary outcome was the child's behaviour and acceptance of the treatment at the time of interventions. Two sample Z-test of proportion, logistic regression analysis and Chi-square test were used to compare the outcomes in two groups. ResultsA total of 226 children (SMART group, 112 and conventional, 114) were included with 280 and 282 GIC restorations placed by the SMART and the conventional method respectively. At 24-months, 459 (81.6 %) primary molars were available for evaluation. Success rates of restorations was 38.4 % and 45.8 % % in SMART and conventional groups respectively (p = 0.105). The rate of acceptability of treatment in the SMART and conventional group was 79 % and 56 % (p<0.001) respectively. ConclusionThere was no significant difference in the success rates of GIC restorations by SMART and conventional technique in carious primary molars at 24 months. SMART was better accepted by children as compared to the conventional restorative technique. Clinical significanceSMART can be an alternative option to treat the asymptomatic carious lesions in primary molars and is well accepted by children than the conventional drill and fill technique thus implying that it has a useful role in un-cooperative children.

Short-term Clinical and Microbiological Performance of Resin-modified Glass Ionomer Cement Containing Chlorhexidine for Atraumatic Restorative Treatment.

This study evaluated the short-term clinical and microbiological performance of resin-modified glass ionomer cement (RM-GIC) cement containing chlorhexidine (CHX) for atraumatic restorative treatment (ART) in primary teeth. The clinical trial was conducted in 36 children that received ART in primary molars either with GIC (group I, n = 18) or GIC containing 1.25% CHX (group II, n = 18). The survival rate of restorations was checked 7 days, 3, and 6 months after their application when saliva and biofilm were collected for microbiological assessment of mutans streptococci (MS) counts. Data were analyzed using the Kruskal-Wallis/Mann-Whitney U tests for clinical analysis and microbiological evaluations (p < 0.05). The survival rate of restorations was similar comparing groups I with II. Microbiological analysis showed a significant reduction in MS levels 7 days after the treatment in both saliva and biofilm of children treated with RM-GIC containing CHX (group II); however, MS counts at 3 and 6 months did not differ from the initial counts. A total of 1.25% CHX improved the microbiological properties of GIC in the short term without impairing the clinical performance of ART restorations. Glass ionomer cement (GIC) containing CHX could be an alternative in ART procedures with the objective of promoting an additional antimicrobial effect, which is interesting for children with high counts of MS during the initial phase of adaptation to dental treatment. da Silva ME, de Sena MD, Colombo NH, et al. Short-term Clinical and Microbiological Performance of Resin-modified Glass Ionomer Cement Containing Chlorhexidine for Atraumatic Restorative Treatment. Int J Clin Pediatr Dent 2023;16(S-1):S27-S32.

Evaluation of the Efficiency of Enzyme-Based Chemomechanical Method in Atraumatic Restorative Treatment of Primary Molars

Aim: To compare clinical and radiographic successes and pain dimensions this chemomechanical agent and traditional Atraumatic Restorative Treatment (ART) method. Material and Methods: Children aged 3-8 years who applied clinic with their parents were included our study (n=38). Teeth included study; Traditional ART method with excavator, enamel chisel and probe and chemomechanical carious tissue removal method with Brix 3000 material were applied. After caries removal methods, restorations were completed with high viscosity glass ionomer cement (YVCIS). After restoration applications, evaluation was made according the Wong Baker Pain Scale. The clinical success restorations was followed up 3, 6 and 12 months according the modified USPHS criteria. Radiographic evaluation was performed 6 and 12 months. In whole study, error value was 5% and load was accepted maintaining the p&lt;0.05 value. Results: 3 and 6 months, there was difference marginal compliance criteria between chemomechanical caries removal and YVCIS restorations applied after traditional ART methods, under surveillance (3rd month p=0.040; 6th month p=0.047). YVCIS restorations applied after chemomechanical caries removal method had Charlie score 2.8% in secondary caries criterion 6th month follow-up. In evaluation made with Wong Baker Pain Scale, facial expression representing no pain expression was preferred most both groups. When all results were evaluated between the two groups, no difference was found when removed (p=0.536). Conclusion: Our study; The chemomechanical caries removal method used non-surgical and acceptable caries removal technique similar the conventional ART method.

Use of Silver Diamine Fluoride and Glass Ionomer Cement (SMART-Silver Modified Atraumatic Restorative Treatment) In Pediatric Dentistry

Using silver diamine fluoride and glass ionomer cement (SMART-Silver Modified Atraumatic Restorative Treatment) in pediatric dentistry can provide a cost-effective, fast, and non-invasive approach to restoring cavities. Silver diamine fluoride is a liquid fluoride that prevents cavity-causing germs from spreading. This can be paired with glass ionomer cement to fill cavities and restore tooth structure. This therapy technique also takes less time than typical restorative treatments so that children may be treated sooner and with fewer disturbances to their daily life. Silver diamine fluoride and glass ionomer cement have become popular in pediatric dentistry for treating cavities due to their numerous benefits. This literature review comprehensively assesses the utilisation of Silver Diamine Fluoride (SDF) and Glass Ionomer Cement (GIC) in pediatric dentistry in the context of SMART-Silver Modified Atraumatic Restorative Treatment. It summarises the findings of existing literature regarding the dental procedures, treatment approaches, and materials used for the treatment, as well as the clinical outcomes, advantages, limitations, and potential applications. SMART-Silver Modified Atraumatic Restorative Treatment is an effective and minimally invasive technique that is particularly useful during the current COVID-19 pandemic, as it does not require any aerosol output while allowing dental caries to be managed without local anaesthesia in a timely, efficient, and cost-effective manner [1]. It also eliminates the need for extracting and replacing decayed teeth, thus restoring dental health and overall quality of life. In addition, the Silver-modified Atraumatic Restorative Technique is an ideal approach for managing preschool caries, as it can halt and control the progression of caries without adversely affecting any surrounding healthy tooth structures. This review establishes the utility of SMART-Silver Modified Atraumatic Restorative Treatment and underlines its effectiveness in pediatric dentistry, particularly today. Treatment and underlines its effectiveness in pediatric dentistry, particularly today.  Keywords: Anaesthesia, Dentistry, Cavities, COVID-19 pandemic, Dental caries, Glass ionomer cement, Invasive, Pediatric, silver diamine fluoride, SMART-silver modified atraumatic restorative treatment

Trajtimi atraumatik restaurues në stomatologjinë e fëmijëve

Dental caries is one of the most prevalent multifactorial diseases in the world. In the field of dental caries manage- ment, Atraumatic Restorative Treatment is known as a minimal intervention and minimally invasive procedure and has shown to be successful in both, developed and devel- oping countries. The Atraumatic Restorative Treatment is the technique that involves removing carious tooth tissues using hand instruments only, without the use of anesthesia and electrically-driven equipment and restoring the cavity with adhesive restorative material usually a high-viscosity glass-ionomer cement. The Atraumatic Restorative Treat- ment in the single-surface restorations presented high sur- vival percentages in both primary and permanent posterior teeth, while in the multiple-surface restorations presented lower survival percentages. Researchers should focus on im- proving the materials of atraumatic restorative treatment restoration, extending the knowledge of the technique in association with pain and anxiety and encouraging the use of this approach in national oral health care systems.

Skills of undergraduate dental students in performing atraumatic restorative treatment one year survival rate of this restoration.

Objective: To assess the skills of the undergraduate dental students in performing Atraumatic Restorative Treatment and the one year survival of this restoration. Study Design: Cross sectional study. Setting: Department of Community Dentistry, Multan Medical &amp; Dental College, Multan. Period: Sept 2021 to Aug 2022. Material &amp; Methods: Through convenient purposive sampling selected 2nd year dental students were assigned to collect the extracted teeth to perform ART according to the given guidelines using Glass Ionomer Cement. The research supervisor assessed the characteristics of the filling and keeping in view the status of the restoration it has given Alfa, Bravo or Charlie score. The students who scored Alfa were then allowed to perform ART on patients in Out Patient Department. The demographics of the patients along with caries assessment (Class I, II &amp; III) were recorded. Patients were kept on telephonic contact and were recalled after 1 year to evaluate the survival rate. Results: A total 100 ART restorations were done on extracted teeth. Around 76 fillings were found to be perfect while 24 fillings were associated with any one or two defects. Later 100 patients were included having any of the 3 classes of caries. Mean age of the patients was 32 years. The success rate of ART restorations at 12 months was found to be 89% with highest success rate of 62% was reported in Class I ART restorations. Conclusion: Extraordinary high survivals rates of Atraumatic Restorative Treatment found in this study represented the reliability of this method as an affordable preventive and curative treatment for dental caries particularly in developing countries.

Atraumatic restorative treatment in management of dental caries - A review article

Dental caries is a long-term, sugar-dependent condition. It deteriorates the quality of life and has negative effects on the oral cavity, including pain induction, tooth structural damage, cavity development and tooth decay. The traditional technique of treating dental caries often entails rotary burs, local anesthesia, electrical supply and skilled workers. The development of atraumatic restorative therapy (ART) was prompted by the need to treat dental caries in children and the impoverished in less developed nations with limited access to dental facilities and qualified practitioners. Atraumatic restorative treatment treats decaying teeth with manual excavation rather than local anesthesia, rotary burs or advanced dental equipment. A variety of adhesive materials, including glass ionomer cement are used in ART to reconstruct teeth.

Effect of aging on mechanical and antibacterial properties of fluorinated graphene reinforced glass ionomer: In vitro study

ObjectivesThis study: 1) aims to test the mechanical and antibacterial properties of fluorinated graphene strengthened glass ionomer materials (FG/GICs); 2) aims to investigate the effects of thermo-cycling on (FG/GICs). Materials and methodsFluorinated graphene (FG) with bright white color was prepared from fluorinated graphite (SIGMA Aldrich), using modified Hummer's method, to be added to conventional glass ionomer cements (GICs). In addition to a control group (group 1), experimentally modified GICs were prepared by adding FG to the conventional glass ionomer powder with three different weight ratios; (group 2, 1 wt %; group 3, 2.5 wt %; and group 4, 5 wt %) using mechanical blending method. Experimental groups of the specimens (n = 240) were divided, for each concentration (n = 120) half of the specimens were subjected to thermo-cycling. Hardness, compressive strength, and antibacterial activity of (FG/GICs) were measured with and without thermo-cycling. Compressive strength was measured by a universal testing machine, hardness was measured using a Vickers micro-hardness tester, and antibacterial effects against staphylococcus aureus and streptococcus mutans were tested by the pellicle sticking method. For statistical analysis, numerical data were explored for normality and variance homogeneity using Shapiro-Wilk and Leven's tests respectively. ResultsThe prepared (FG/GICs) showed an increase in hardness in group 4 (p < 0.001). Groups 3 and 4 gave the highest compressive strength values with no significant difference between them (p < 0.001). Groups 2, 3, and 4 showed improved antibacterial activity with no statistical difference between them (p > 0.001). Results after thermo-cycling showed significantly decreased hardness, and compressive strength values (p < 0.001), however, the results of antibacterial activity against streptococcus mutans showed no statistical difference after thermo-cycling (group 2, p = 0.05; group 3, p = 0.18; group 4, p = 0.26). The same results were observed for antibacterial activity against staphylococcus aureus (p = 0.92, p = 0.14, and p = 0.48 respectively). ConclusionFG can be considered a promising additive to GICs to promote its anti-cariogenic effects, however, these antibacterial effects are only useful in the short term, as aging adversely affected their mechanical properties. The 2.5 wt % FG/GICs is suggested to be the most encouraging, as after aging, it represented the highest compressive strength among all groups, while its hardness values were at least comparable to that of conventional glass ionomer. Clinical significanceFG/GICs can be considered an anti-cariogenic restoration in temporary restorative interventions, as in certain cases in deciduous teeth where considerable esthetics may be required, especially those with difficult moisture control, where neither resin composite restorations nor amalgam restorations will be indicated. It can also be used for patients with high caries index or in atraumatic restorative treatment (ART) in low-income countries.

COMPARISON BETWEEN ATRAUMATIC RESTORATIVE TREATMENT AND NON-RESTORATIVE TREATMENT FOR CARIES DISEASE CONTROL

Non-restorative treatment, along with atraumatic restorative treatment (ART) are considered minimally invasive procedures within dentistry. Non-restorative treatment basically consists of preventing, controlling and reversing the carious lesion and atraumatic restorative treatment (ART) in the removal of carious tissue using manual instruments, promoting remineralization of both enamel and dentin. These techniques are considered as an alternative to control fear and anxiety within Pediatric Dentistry, in patients with behavioral problems, in cases of anxious, non-collaborative children or those with systemic impairments. Thus, the present work turns to a literature review with the objective of comparing Atraumatic Restorative Treatment and Non-restorative Treatment within their indications for long-term caries control, describing the materials that are used and methods used. As a result, we observed the effectiveness of fluoride in its various compositions, the ability to prevent carious lesions using Silver Fluoride Diamine, the regression of lesions through the use of casein and the benefit of ART in reducing dental anxiety and patient discomfort. It is concluded that the type of treatment to be chosen depends on the characteristic and degree of the lesion. In the case of superficial stains, the procedure adopted is non-restorative and in the case of dentinal cavities, ART offers good results.

A systematic review on the effect of silver diamine fluoride for management of dental caries in permanent teeth.

The objective of this review is to assess the available literature systematically related to the effect of silver diamine fluoride (SDF) for the management of occlusal and root carious lesions in permanent teeth regardless of age. MATERIALSANDMETHODS: This systematic review was conducted according to the Cochrane Handbook for Systematic Reviews of Interventions and Preferred Reporting Items for Systematic Review and Meta-Analyses statement. A literature search was performed usingPubMed/MEDLINE, Cochrane Central Register of Controlled Trials, Web of Science, DOAJ, and Open Gray with no language restrictions up to December 2022. Three reviewers critically assessed the studies for eligibility. Any disputes between the reviewers were handled by a fourth independent reviewer. The quality assessment and data extraction of the studies were performed. A total of 2176 studies were screened. The titles and abstracts of the studies were then reviewed (n = 346), and 52 studies met the search criteria. Following the full-text review, 11 studies investigated the effect of SDF against other treatments such as chlorhexidine, sodium fluoride, ammonium bifluoride, tricalcium silicate paste, casein phosphopeptide amorphous calcium phosphate, glass ionomer cement (GIC) combined with fluoride varnish, resin-modified GIC, and atraumatic restorative treatment were assessed. Within the limitations of this review, the use of SDF is promising with high preventative fractions in permanent teeth of children and older populations when compared to other topical applications such as dental varnish containing sodium fluoride.