traumatic estorative reatment A Innovative treatment approach for

traumatic estorative reatment

• A Innovative treatment approach for Dental Caries. • ART is maximally preventive and minimally invasive approach to stop further progression of dental caries. • ART - Approach is not only logical but based upon sound scientifically based principles. • Method of preserving decayed teeth in people of all ages both in developing countries and disadvataged communities --- where resources are scarce. • ART does not rely on electricity or expensive equipment – treatment could be provided anywhere. • ART is appropriate and valid in outreach situations in developing countries.

J. Frencken

C. Holmgren.

DEVELOPMENT OF ART PIONEERED IN MID 1980 s -- as part of Primary Oral Health Care at Dar-El-Salaam, Tanzania-- Jo E. Frencken. n First Clinical Trial conducted at Thailand (1991). n Large scale Clinical Trial and Testing was done at Zimbabwe (1993). n Later it was tried at Pakistan (1995). n Subsequently tried in USA & Europe. n

World Health Organisation

n WHO presented ART on “World Health Day” on 7 th April 1994. n Beginning of the Oral Health Year- 1994 -95. n FDI recommended and advocated the ART in 1998.

ART can be applied when: - There is a cavity involving the dentine, and - That cavity is accessible to hand instruments. Contraindications: (1)In the presence of abscess or fistula near the tooth. (2)Where there is pulp is exposed. in this case we have to do root canal treatment. (3)Painful teeth and the pulp inflammation. (4)The opening of pulp is in accessible to the hand instruments. eg-in the proximal caries there is clear sign of cavity but the instruments cant reach that point.

The two main principles of ART are: n Removing carious tooth tissue using hand instruments only n Restoring the cavity with glass ionomer

GLASS IONOMER CEMENT Glass ionomer is very useful as dental restorative material because: (1)They can be applied to caries in very early lesions. (2)It adheres to the tooth structure chemically. (3)It is anticariogenic because it releases fluoride. (4)It does not inflame the pulp and gingiva.

The ART Technique

Two layers of carious dentine Outer (‘infected’) – Bacterial – Invasion – – – Unreminerizable Dead Without sensation Inner (‘affected’) – Few Bacterial – Reminerizable – Alive – Sensitive

nstruments & materials for ART properly Packed & placed in a basket for easy. The use of ART at a courtyard Transportation in an outreach situation. Of A primary school in Syria (Thailand)

ART in schools. a). China b). New Zeeland c). Zimbabwe. Equipment Layout in a class room.

TM CARISOLV

n n Earlier Chemo-Mechanical Preparation --CARIDEX (1978) System based non-specific Proteolytic effect of Na. OCl. The development of CMCR -- first initiated in 1980 by Swedish Scientists at Malmo, and Goteborg, Sweden. Christer started Medi. Team (MT) and had joint collaboration with Biochemist, Lars Strid -- discovered the shortcoming of CARIDEX.

n n During 1980 Ericcson improved the CARIDEX formula. And later in 1990, in joint collaboration with other Scientists developed CARISOLV DEVELOPMENT -- Na. OCl with three naturally occurring amino acids -- Glutamic acid, Leucine and Lysine. CARISOLV also contains Methyl cellulose and Erythrocin.

Carisolv TM Non invasive , tissue – preserving Caries removal

Step by Step treatment of root caries lesions using Carisolv. TM Apply gel with the Tip called star 3. Wait 30 seconds

CLINICAL STUDIES AND EVIDENCE CARISOLV did not affect healthy enamel and Dentin compared with Phosphoric Acid etching which increases surface roughness of both healthy Enamel and Dentin ( Kalige et al, 1999).