Atraumatic Restorative Treatment During Orthodontic Treatment : a Case Report

INTRODUCTION. Atraumatic Restorative Treatment (ART) is a dental procedure created to perform restorations in an easy and affordable way. This technique was initially thought to be useful in community dentistry; nevertheless it has a potential during orthodontic treatments, considering it an accepted technique in minimal intervention/minimal invasive dentistry. ART is based on the removal of carious tissues using hand instruments only (spoons excavators and scalpels) and restoring the cavity with an adhesive restorative material (GIC – glass ionomer cement). This material possesses a caries-preventive effect due to its capacity to release fluoride ions. Fluoride decreases enamel demineralization and promotes its remineralization, reducing the risk of a recurrence of caries lesions and preventing the development of new lesions. A meta-analysis on ART use, performed on more than one hundred studies, states that the survival rates in primary teeth treated with ART restorations after 2 years is 93% for single surface, and 62% for multiple surfaces restoration. Furthermore a lot of clinical trials show that the medium life of an ART restoration on primary teeth is between 18 and 36 months, depending on different aspects such as diet, occlusion and caries risk. Those data suggest the need of a proper selection of patients for this dental procedure. For instance, every carious lesion on primary tooth is eligible for ART technique, when the expected exfoliation is between 1 and 2 years. CASE REPORT. A clinical case of an 11 years old child is presented. The child has undergone orthodontic therapy in order to obtain an upper molar distalization, using mini implants and a Pendulum appliance. A carious lesion on the mesial surface of 5.5 occurred. Considering the short remaining life of the tooth, and the high caries experience of the child, the ART technique was chose to restore it. CONCLUSIONS. ART technique should be considered when a restoration has to be performed during orthodontic treatment, especially in primary teeth, both for its easiness and for its fluoride releasing- caries preventive effect.