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Atraumatic restorative treatment (ART) [1] is a method for cleaning out tooth decay (dental caries) from teeth using only hand instruments (dental hatchet and spoon-excavator) and placing a filling. It does not use rotary dental instruments ( dental drills ) to prepare the tooth and can be performed in settings with no access to dental equipment.
Trauma to primary teeth occurs most commonly at the age of two to three years, during the development of motor coordination. [7] When primary teeth are injured, the resulting treatment prioritises the safety of the adult tooth, [7] and should avoid any risk of damaging the permanent successors. [8]
Before the discovery of antibiotics, chronic tooth infections were often linked to a variety of health problems, and therefore removal of a diseased tooth was a common treatment for various medical conditions. Instruments used for dental extractions date back several centuries.
A systematic review concluded that for decayed baby (primary) teeth, putting an off‐the‐shelf metal crown over the tooth (Hall technique) or only partially removing decay (also referred to as "selective removal" [5]) before placing a filling may be better than the conventional treatment of removing all decay before filling. [6]
Socket preservation or alveolar ridge preservation is a procedure to reduce bone loss after tooth extraction. [1] [2] After tooth extraction, the jaw bone has a natural tendency to become narrow, and lose its original shape because the bone quickly resorbs, resulting in 30–60% loss in bone volume in the first six months. [3]
The clinical examination will detect the reasons behind the failure of the restoration. Upon treatment the dentist will provide options on the tooth's prognosis, these may include a new restoration, extraction, root canal or placement of a crown. The tooth prognosis includes the tooth's vitality and restorability. [7] Crack, fracture and mobility
Patients report positive experiences during and after treatment; 97% success rate [28] Very low failure rate; Does not require local anesthetic or tooth removal (drilling) Lifespan is the same as that of an intact primary tooth/durability; Provide protection to the residual tooth structure that may be weakened
Endodontically treated teeth, especially those with little sound tooth tissue, are prone to fractures. The successful clinical outcome for these teeth relies not only on adequate root canal treatment, but also on the type of restorative treatment used, including the use of a post and core system and the type of extra-coronal restoration selected.