scholarly journals Minimal intervention dentistry for managing carious lesions into dentine in primary teeth: an umbrella review

2021 ◽  
Author(s):  
A. BaniHani ◽  
R. M. Santamaría ◽  
S. Hu ◽  
M. Maden ◽  
S. Albadri
Keyword(s):  
Systematic Reviews ◽  
Primary Teeth ◽  
Selective Removal ◽  
Atraumatic Restorative Treatment ◽  
Fissure Sealants ◽  
Minimal Intervention ◽  
Resin Infiltration ◽  
Restorative Treatment ◽  
Carious Lesions ◽  
Stepwise Excavation

Abstract Purpose This umbrella review systematically appraised published systematic reviews on Minimal Intervention Dentistry interventions carried out to manage dentine carious primary teeth to determine how best to translate the available evidence into practice, and to provide recommendations for what requires further research. Method An experienced information specialist searched MEDLINE, Embase, Cochrane Database of Systematic Reviews, Epistemonikos, Joanna Briggs Institute Database of Systematic Reviews and Implementation Reports, and the NIHR Journals Library. In addition, the PROSPERO database was searched to identify forthcoming systematic reviews. Searches were built around the following four concepts: primary teeth AND caries/carious lesion AND Minimal Intervention Dentistry AND systematic review/meta-analysis. Searches were restricted to English language, systematic reviews with/without meta-analyses published between January 2000 and August 2020. Two reviewers independently screened all titles and abstracts. Interventions included involved no dentine carious tissue removal (fissure sealants, resin infiltration, topical application of 38% Silver Diamine Fluoride, and Hall Technique), non-restorative caries control, and selective removal of carious tissue involving both stepwise excavation and atraumatic restorative treatment. Systematic reviews were selected, data extracted, and risk of bias assessed using ROBIS by two independent reviewers. Studies overlap was calculated using corrected covered area. Results Eighteen systematic reviews were included in total; 8 assessed the caries arresting effects of 38% Silver Demine Fluoride (SDF), 1 on the Hall Technique (HT), 1 on selective removal of carious tissue, and eight investigated interventions using atraumatic restorative treatment (ART). Included systematic reviews were published between 2006 and 2020, covering a defined time frame of included randomised controlled trials ranging from 1969 to 2018. Systematic reviews assessed the sealing efficacy of fissure sealants and resin infiltration in carious primary teeth were excluded due to pooled data reporting on caries arrest in both enamel and outer third of dentine with the majority of these carious lesions being limited to enamel. Therefore, fissure sealants and resin infiltration are not recommended for the management of dentinal caries lesions in primary teeth. Topical application of 38% SDF showed a significant caries arrest effect in primary teeth (p < 0.05), and its success rate in arresting dental caries increased when it was applied twice (range between 53 and 91%) rather than once a year (range between 31 and 79%). Data on HT were limited and revealed that preformed metal crowns placed using the HT were likely to reduce discomfort at time of treatment, the risk of major failure (pulp treatment or extraction needed) and pain compared to conventional restorations. Selective removal of carious tissue particularly in deep carious lesions has significantly reduced the risk of pulp exposure (77% and 69% risk reduction with one-step selective caries removal and stepwise excavation, respectively). ART showed higher success rate when placed in single surface compared to multi-surface cavities (86% and 48.7–88%, respectively, over 3 years follow-up). Conclusion Minimal Intervention Dentistry techniques, namely 38% SDF, HT, selective removal of carious tissue, and ART for single surface cavity, appear to be effective in arresting the progress of dentinal caries in primary teeth when compared to no treatment, or conventional restorations. There is clear need to increase the emphasis on considering these techniques for managing carious primary teeth as a mainstream option rather than a compromise option in circumstances where the conventional approach is not possible due to cooperation or cost.

scholarly journals UK dentists' attitudes and behaviour towards Atraumatic Restorative Treatment for primary teeth

BDJ ◽  
2005 ◽  
Vol 199 (6) ◽  
pp. 365-369 ◽  
Author(s):  
F J T Burke ◽  
S McHugh ◽  
L Shaw ◽  
M -T Hosey ◽  
L Macpherson ◽  
...  
Keyword(s):  
Primary Teeth ◽  
Atraumatic Restorative Treatment ◽  
Restorative Treatment

scholarly journals Caries burden and suitability for atraumatic restorative treatment among schoolchildren in Indonesia

2020 ◽  
Vol 3 ◽  
pp. 77-81
Author(s):  
Irene Adyatmaka ◽  
Jilen Patel
Keyword(s):  
Dental Caries ◽  
Mixed Dentition ◽  
Caries Experience ◽  
Good Effect ◽  
Atraumatic Restorative Treatment ◽  
Older Children ◽  
Cross Sectional ◽  
Restorative Treatment ◽  
Stage Of Development ◽  
Carious Lesions

Objectives: Dental caries remains among the most prevalent chronic conditions in childhood and remains highly prevalent among schoolchildren in Indonesia. Globally, atraumatic restorative treatment (ART) has been used to good effect in the management of carious lesions among high-risk cohorts, particularly in challenging environments. However, in settings, where labor, time, facilities, and materials are particularly limited, strategic triaging of teeth suitable for ART restorations may be valuable to better direct public health expenditure. Therefore, this study aims to (i) describe the prevalence of dental caries among Indonesian schoolchildren and (ii) evaluate the proportion of lesions indicated for ART. Materials and Methods: A cross-sectional cohort study of elementary schoolchildren from West Java, Indonesia, was examined and categorized according to Hellman’s dental development stages (Groups 1–4 corresponding to the early mixed dentition through to complete permanent dentition). Descriptive statistics and proportional analysis were conducted with the following variables being evaluated: Teeth with early caries (EC), late/advanced caries (LC), recurrent caries (RC), and total caries experience (TC = EC+ART+LC+RC). In evaluating the suitability for ART, additional variables of ART indicated carious lesions (ART) and lower molars with lesions indicated for ART (LM) were assessed. Results: A total of 437 children ranging from 8 to 14 years of age were examined. Out of 8882 teeth examined, 996 had active carious lesions and only 57 had received satisfactory restorative treatment. Children in Hellman’s Group 1 stage of development had the highest prevalence of EC (62%) and ART indicated caries (32%). Meanwhile, older children in Group 4 experienced the highest portion of advanced caries (15%). The proportion of lower molars indicated for ART was 87%, 76%, 70%, and 67% in Groups 1–4, respectively. Conclusion: Indonesian schoolchildren face a high burden of untreated dental caries from a young age. The younger the developmental stage, the higher the prevalence of early and ART-indicated lesions with the majority being found in lower permanent molars. Although ART and preventive strategies show the highest potential in the early mixed dentition, they alone cannot completely meet the dental needs of populations such as this where the severity and disease burden are extremely high.

Effect of Papacarie and Alternative Restorative Treatment on Pain Reaction during Caries Removal among Children: A Randomized Controlled Clinical Trial

2017 ◽  
Vol 41 (3) ◽  
pp. 219-224 ◽  
Author(s):  
AMG Abdul Khalek ◽  
MA Elkateb ◽  
WE Abdel Aziz ◽  
M El Tantawi
Keyword(s):  
Clinical Trial ◽  
Primary Teeth ◽  
Pediatric Dentistry ◽  
Controlled Clinical Trial ◽  
Kappa Statistics ◽  
Atraumatic Restorative Treatment ◽  
Public Health Department ◽  
Restorative Treatment ◽  
Randomized Controlled ◽  
Caries Removal

Objective: To compare the effect of Papacarie and Atraumatic Restorative Treatment (ART) on pain and discomfort during caries removal among children. Study Design: Fifty healthy, 4–8 year-old children were equally and randomly allocated to Papacarie and ART to remove caries from decayed primary teeth. A randomized, controlled, blinded, two parallel-arms clinical trial was conducted in the clinic of the Pediatric Dentistry and Dental Public Health Department, Alexandria University, Egypt in March 2014. Pain and discomfort were assessed blindly by two independent investigators watching videotaped treatment sessions using the Sound, Eye and Motor scale (SEM). Their reliability was assessed using Kappa statistics. The effect of caries removal methods, time spent to remove caries and other confounders on SEM score was assessed using regression analysis. Results: Mean time to remove caries using Papacarie and ART was 5.8 and 4.8 minutes, P= 0.005. Median Paparie and ART scores for the S, E and M components were 1, 1, 1 and 3, 2, 3. Adjusted mean SEM score= 3.6 and 7.8, P &lt;0.0001. Method of caries removal was the only factor significantly affecting pain and discomfort. Conclusion: Papacarie is associated with minimal pain during caries removal from primary teeth compared to ART, although it has longer working time.

scholarly journals Cost and Time Differences between Three Types of Restorations for Primary Teeth: Amalgam, Composite and Glass-Ionomer Cement.

2020 ◽  
Author(s):  
Hanthao Thi Phan ◽  
John M. Powers ◽  
Franklin Garcia-Godoy ◽  
Timothy Brown ◽  
Lilliam Marie Pinzon
Keyword(s):  
Primary Teeth ◽  
Glass Ionomer Cement ◽  
The United States ◽  
Cross Sectional Study ◽  
Atraumatic Restorative Treatment ◽  
Glass Ionomer ◽  
Cross Sectional ◽  
Restorative Treatment ◽  
Costly Treatment ◽  
The Cost

Abstract Background: Early Childhood Caries is the most prevalent chronic disease among children in the United States. Three common approaches for treatment of dental caries in general population include: amalgam, composite, and glass ionomer. The purpose of this study was to measure the treatment cost differences for amalgam, composite, and atraumatic restorative treatment (ART) restorations of primary teeth and evaluate possible factors that could influence the cost of treatment. Methods: This cross-sectional study randomly selected data of 120 restorations from a clinical observational study of the restoration of primary teeth in children aged 5 – 10 years old. The 120 selected restorations in primary teeth, half with two surfaces and half with three surfaces, were performed by two operators at the Asian Health Center and Centro American Resources Center in California. Data were analyzed using multivariable linear regression. Results: Performing ART was found to take 7.8 minutes less than amalgam (p<0.01) and 19.0 minutes less than composite. ART was found to be 6.4% (p=0.01) less costly than amalgam and 62.4% (p<0.01) less costly than composite. Conclusions: ART was found to be the least costly treatment compared to amalgam and composite restoration procedures. ART also required the shortest time during the clinical procedure. Trial Registration: UCSF CHR Number: H55840-32823-02

scholarly journals Current status of atraumatic restorative treatment in restorative dentistry

2021 ◽  
Vol 1 ◽  
pp. 9-16
Author(s):  
Sumit Sharma ◽  
Ramya Raghu ◽  
Ashish Shetty
Keyword(s):  
Low Cost ◽  
Glass Ionomer Cement ◽  
Retention Rates ◽  
Current Status ◽  
Routine Practice ◽  
Atraumatic Restorative Treatment ◽  
Restorative Treatment ◽  
Aerosol Generation ◽  
Carious Lesions ◽  
Dental Profession

This review highlights the importance of atraumatic restorative treatment (ART) as a minimal intervention procedure for managing dental caries (pit and fissures caries) and restoring cavitated dentin carious lesions using restorative materials such as glass-ionomer cement. ART technique uses only hand instruments and requires no electricity. Its low cost and simplified protocol makes it more convenient and suitable for use in remote areas as well as underdeveloped nations with insufficient resources to provide the adequate restorative care. This technique can be used in all population groups including children, older people, and disabled. In the present scenario of the COVID-19 pandemic, the dental profession is facing a challenging task in managing restorative needs of the patients all over the world. ART technique is a safe and effective approach to manage the progression of carious lesions. As this technique involves no aerosol generation during the procedure, it should be well adopted in our routine practice by taking necessary precautions. The survival and retention rates of ART also appear to be fairly acceptable based on various studies.

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