- ATRAUMATIC RESTORATIVE TREATMENT is a procedure based on removing carious tooth tissue using hand instruments and restoring the cavity with an adhesive material.
- This technique is useful for nervous patients who are scared of drilling and restorative procedures.
- Removing carious tooth tissue using hand instruments only.
- Restoring the cavity with adhesive cement like GIC
- ATRAUMATIC RESTORATIVE TREATMENT was officially endorsed by the world health organization in 1994
Following are the reasons for using hand instruments only
- Tooth conservation
- Limitation of pain
- Reduce physical trauma
- Infection control
GIC AS RESTORATIVE MATERIAL IN ART
- GIC is the most commonly used adhesive material in ATRAUMATIC RESTORATIVE TREATMENT
- Release fluoride after setting which helps in preventing caries around restorations
- Chemically bind to the teeth so the need to cut the sound tooth tissue to prepare cavity is reduced
- Harmless to dentin and pulp
- Only in small cavities
- Only in those cavities which are accessible to hand instruments
Operators working position and posture
- The work posture and position of the operator should provide the best view of the inside of the patient’s mouth .
- The operator should be positioned behind the head of the patient
- Patient should be placed on flat surface a bamboo or a wooden bed , portable dental bed or a table
- Mouth mirror
- Spoon excavator
- Dental hatchet
- Mixing pad and spatula
- Providing indirect vision of any part of oral cavity
- To retract the lips cheek and tongue
- To provide direct illumination on the gums and teeth where direct light doesn’t reach.
- For the identification of soft carious dentin
- For carrying cotton wool rolls , cotton wool pellets ,wedges
- For removing soft carious dentin
- For removal of excess of GIC
- For widening the entrance to the cavity
- Removing the unsupported and carious enamel
- Cotton wool rolls
- Cotton wool pellets
- Petroleum jelly
- Plastic strips
- Glass Ionomer cement
- Mixing pad and spatula
- To keep moisture away from GIC
- To prevent gloves from sticking to GIC
RESTORATION OF A CAVITY PROCEDURE
- Prepare the restorative material
- Then we prepare a cavity
- Remove plaque from the tooth surface
- Dry the tooth surface with cotton wool pellets
- Remove carious dentin with excavator starting at enamel dentin junction.
- Clean the cavity with wet cotton pellets
- Dry the cavity with cotton pellets to complete the procedure
- Insert the mixture in small amounts in the prepared cavity using a carver
- Using press finger technique complete the filling.
- Remove visible excess of GIC with a medium or large excavator
- Apply a layer of petroleum jelly
- Remove cotton wool rolls
- Ask the patient not to eat for an hour
- Cost effective
- Less trauma to teeth
- Conservation of sound tooth tissues
- A friendly procedure , in children and in fear full adults.
- For special groups such as mentally and physically handicapped.
Author: Ayesha Khalil (3rd Year BDS)