Renaissance or dimming hope - The dilemma of managing multi-surface dental carious lesions in primary dentition using an Atraumatic Restorative Treatment (ART)

ABSTRACT

Introduction: Atraumatic restorative treatment (ART) has been in use for the last couple of years. The survival rate of multi-surface restorations using this method has generally been very low for any given follow-up period. Most commonly quoted as the causes for the low survival rate included early restoration loss, poor choice of the cavity to be restored, operator factors, material factors and patient related factors, among other factors. Speculation has been that the premature loss may not actually denote failure to preserve the carious dental element, and that probably, the fluoride leach from the glass ionomer cement used with the technique, might be helping elongate the survival of the restored tooth. The question is whether, therefore, it is important to only look at the survival of the ART restoration or to also consider the survival of the tooth with premature restoration loss. Objective: To determine the current general survival rates of multi-surface ART restorations in the primary dentition, while simultaneously considering any consequences of the premature loss of these restorations in the primary dentition. The data for the study was obtained through Pubmed/Medline search for publications on multi-surface ART restorations from 2000 to 2011. Only publications on ART in the primary dentition were included and analyzed for survival rate, premature loss of restoration and effect of such loss. Conclusion: While the survival rates of multi-surface ART restorations in the review studies were low, the restorations appeared to provide some beneficial effects to the retention-longevity of the restored tooth even after the premature loss of restorations...