Atraumatic restorative treatment technique

Recently fast-setting, high-viscosity conventional glass-ionomers have been developed [215]. These were made available during the early 1990s for use with the atraumatic restorative treatment (ART) technique in developing countries. They are considered later in this article, and the clinical success of the ART approach has relied on the improved properties of these newer glass-ionomer materials. 

Glass-ionomers are the materials of choice for use in the atraumatic restorative treatment (ART) technique [153]. The technique was originally developed under the aegis of the World Health Organisation to provide dental care in low- and middle-income... 

Glass-ionomers, by contrast, are themselves hydrophilic and inherently adhesive to the tooth surface. It therefore requires only slight pretreatment, typically conditioning with 10% aqueous polyacrylic acid. Glass-ionomers rapidly form durable bonds to the tooth surface through the development of an ion-exchange layer at the interface. This ability to bond is exploited in both the Atraumatic Restorative Treatment (ART) technique and in bonding of orthodontic brackets, both of which are described in detail in the chapter. 

The clinical technique known as Atraumatic Restorative Treatment (ART) has been developed since the mid-1980s in response to dental clinical needs in Third World countries. It is an important application of adhesive dental materials, specifically conventional glass-ionomer cements, and would not be possible without this type of adhesive material (Frencken et al. 2004). ART involves the removal of carious tooth tissue with hand instruments rather than conventional dental drills. These hand-held instruments are formed as spoon-shaped excavators, and come in graded sizes. 

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