title: Is ART really atraumatic?
abstract: Atraumatic restorative treatment (ART) is an approach to the management of carious lesions that uses only hand instruments to remove carious tissue and to restore the tooth involved. The name ART implies that the approach is atraumatic to both the patient and the tooth. This study set out to evaluate whether ART is atraumatic in terms of both patient discomfort and tooth tissue conservation. Three hundred and fifty-nine patients were divided in two groups: one group was treated with hand instruments and the other with rotary equipment. Each patient received two restorations: one using amalgam and one using glass ionomer as the restorative material, placed without the use of anaesthesia. Less discomfort was reported with the ART approach compared to conventional restorations made using rotary instruments and amalgam. Moreover, preparations with hand instruments were smaller than those produced with rotary instruments. Reported discomfort was associated with the size of the preparation, although the influence of the operator on both criteria was considerable. A patient effect was also observed since patients who reported discomfort during the first treatment were more likely to report discomfort after the second treatment. In conclusion, the choice of the term "ART" as an atraumatic procedure is defensible.
authors.affiliation: Department of Cariology, Endodontology Pedodontology, ACTA, Amsterdam, The Netherlands. w.e.van.amerongen@acta.nl
authors.forename: W E
authors.initials: WE
authors.lastname: van Amerongen
authors.forename: S
authors.initials: S
authors.lastname: Rahimtoola
mesh_terms: D000293:Adolescent; D002648:Child; D003723:Dental Amalgam; D003731:Dental Caries / Q000628:therapy; D003737:Dental Cavity Preparation / Q000009:adverse effects* / Q000295:instrumentation* / Q000379:methods / Q000523:psychology; D003754:Dental High-Speed Equipment; D003762:Dental Instruments; D003793:Dental Restoration, Permanent / Q000379:methods*; D005260:Female; D005899:Glass Ionomer Cements; D006801:Humans; D008297:Male; D010146:Pain / Q000209:etiology; D017060:Patient Satisfaction
chemical_list: D005899:Glass Ionomer Cements; D003723:Dental Amalgam