How effective is ART in the management of dental caries?

The ART approach involves excavating cavitated dentine caries with hand ins truments, then restoring the cavity and sealing any associated fissures and pits with an adhesive restorative material, resulting in a sealant restora tion. Until recently, ART has mainly been used under field conditions, and thus the adhesive restorative material used has been glass ionomer which do es not require mixing machines and curing lights. Since the inception of AR T, a growing number of studies world-wide have taken place. A total of four studies have reported 3-year survival percentages for one-surface ART rest orations. The highest 3-year survival percentage in permanent teeth was 88% , which is comparable to the 85% survival of one-surface amalgam restoratio ns placed under the same field conditions after 3 years. The outcomes depen d to some extent on the material used, operator experience and presence of caries. The presence of caries as a reason for failure was higher in the ea rly than in the most recent studies. Only one study has reported on the use of ART restorations in the deciduous dentition. It is concluded that: a ve ry large proportion of dentine lesions in the permanent teeth can be treate d using the ART approach; the 3-year survival rate of the more recently pla ced one-surface ART restorations in permanent teeth was higher than that of ART restorations placed in the beginning; the survival of one-surface ART restorations in the permanent dentition with newer glass ionomers is compar able to that of one-surface conventional restorations placed using amalgam in a comparable setting after 3 years; more studies of longer duration are needed to confirm these findings; ART should be considered a caries treatme nt modality that benefits people; and educational courses need to be organi sed before the approach is applied in the clinic.