非创伤性修复治疗

对ART的评价-ART的优点
• • • • • • • 符合现代预防观点：最少的损伤，最佳的预防 手用器械 操作简单易学 控制交叉感染方便 病人容易接受 玻璃离子含氟 容易修补
可能影响其推广的因素
• • • • • • 充填微漏 玻璃离子的强度 长期保留率尚待观察 对ART技术的误解 误认为玻璃离子是临时充填材料 病例丢失率高
SUBJECTS AND METHODS: Ninety secondary school students, aged 14 and 15 years, were included in the study. The ART restorations were prepared in 90 cavities and restored using an encapsulated high-viscosity glass ionomer. The depth of the cavities was judged from radiographs and clinically into outer, middle and inner third of dentine. Using a graded periodontal probe, cavity size was measured, into approximately half the width of the mesiodistal and buccolingual/palatal distance of the occlusal surface. The students were asked about the level of sensation experienced during cavity preparation immediately after completion of restoration. chi(2)-Test was used to test the effect of cavity depth and size on sensitivity from the teeth.
Hobdell M, Petersen PE, Clarkson J, Johnson N. Global goals for oral health 2020. International Dental Journal. 2003 Oct;53(5):285-8.
ART的发展方向
• 充填材料的进步：更强的黏结性、更强的耐磨 性、较小的微漏、更强的再矿化能力 • 作为完整预防的一部分，与其他措施相结合 • 适用于所有经济发展水平的人群，符合现代预 防和口腔修复的概念，发展前景良好
• Med Princ Pract. 2009;18(1):26-30. Epub 2008 Dec 4. • Acceptance and discomfort from atraumatic restorative treatment in secondary school students in Egypt. • Farag A, Frencken JE. • Source • Department of Operative Dentistry, Faculty of Oral and Dental Medicine, Minia University, Minia City, Egypt.
RESULTS: Of the 90 students, 6 (6.6%) and 26 (29.2%) experienced pain and discomfort, respectively, during cavity preparation, more often in large than in small cavities (p = 0.003) and in cavities extending into the inner third than in the middle and outer third of dentine (p < 0.0001). Only 1 student reported postoperative sensitivity. CONCLUSIONS: The ART approach to treat dental cavities was well accepted by this group of secondary school students. Only a few reported pain during cavity instrumentation, and this was more prevalent in large cavities and in cavities with the floor close to the pulp.
非创伤性修复治疗 （Atraumatic restorative treatment, ART)
支清惠
由来、发展及临床效果
• • • • • • 发展中地区缺乏传统龋病充填治疗设备 汞合金的寿命问题 黏结性修复材料的发展 充填体和封闭物可使其下龋损停止进展 龋坏组织无需完全去除 释氟性材料玻璃离子的发展
• 更多的预防，更少的创伤来自ART的适应证• 恒牙和乳牙的中小龋洞，能允许最小的挖 器进入；无牙髓暴露，无可疑牙髓炎
基本材料和器械
• 材料： 玻璃离子粉、液 牙本质处理剂
基本材料和器械
• 器械： 口镜、镊子、探针、调拌纸、挖匙、牙用 手斧（锄形器）、雕刻刀、树脂条或T形 带、木楔等
操作步骤
• • • • 洞形准备 清洁 混合与调拌 充填
OBJECTIVES:
To assess the level of acceptance and discomfort experienced by secondary school students when undergoing an atraumatic restorative treatment (ART) restoration.