title: Influence of occlusal access on demineralized dentin removal in the atraumatic restorative treatment (ART) approach.
abstract: OBJECTIVE
  To verify the influence of cavity access diameter on demineralized dentin removal in the ART approach.
  
  
  METHODS
  40 non-carious human premolars were randomly divided into four groups. The occlusal surface was ground flat and the teeth were sectioned mesio-distally. The hemi-sections were reassembled and occlusal access preparations were carried out using ball-shaped diamonds. The resulting size of the occlusal opening was 1.0 mm, 1.4 mm, 1.6 mm and 1.8 mm for Groups A, B, C, and D, respectively. Standardized artificial carious lesions were created and demineralized dentin was excavated. After excavation, the cavities were analyzed using: (a) the tactile method, (b) caries-detection dye to stain demineralized dentin, as proposed by Smales & Fang, and (c) Demineralized Tissue Removal index, as proposed in this study. Statistical analysis was performed using Fisher, Spearman correlation coefficient, kappa, Kruskal-Wallis and Miller tests (P < 0.05).
  
  
  RESULTS
  The three methods of evaluation showed no significant difference between Groups A vs. B, and C vs. D, while statistically significant differences were observed between Groups A vs. C, A vs. D, B vs. C and B vs. D. Based on the results of this study, the size of occlusal access significantly affected the efficacy of demineralized tissue removal.
authors.affiliation: Department of Operative Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla 9-75, Bauru, SP, Brazil. mflnavar@usp.br
authors.forename: Maria Fidela Lima
authors.initials: MF
authors.lastname: Navarro
authors.forename: Cynthia Junqueira
authors.initials: CJ
authors.lastname: Rigolon
authors.forename: Terezinha Jesus Esteves
authors.initials: TJ
authors.lastname: Barata
authors.forename: Eduardo
authors.initials: E
authors.lastname: Bresciane
authors.forename: Ticiane Cestari
authors.initials: TC
authors.lastname: Fagundes
authors.forename: Mathilde C
authors.initials: MC
authors.lastname: Peters
mesh_terms: D001641:Bicuspid; D004396:Coloring Agents; D003737:Dental Cavity Preparation / Q000295:instrumentation / Q000379:methods*; D003793:Dental Restoration, Permanent / Q000379:methods*; D003804:Dentin / Q000473:pathology*; D018130:Diamond / Q000737:chemistry; D004867:Equipment Design; D006244:Hardness; D006801:Humans; D023861:Photography, Dental; D012394:Rosaniline Dyes; D017001:Tooth Demineralization / Q000628:therapy*
chemical_list: D004396:Coloring Agents; D012394:Rosaniline Dyes; C025485:basic fuchsin; D018130:Diamond