Is ART really atraumatic?

Atraumatic restorative treatment (ART) is an approach to the management of carious lesions that uses only hand instruments to remove carious tissue an d 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 evaluat e whether ART is atraumatic in terms of both patient discomfort and tooth t issue conservation. Three hundred and fifty-nine patients were divided in t wo groups: one group was treated with hand instruments and the other with r otary 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 com pared to conventional restorations made using rotary instruments and amalga m. Moreover, preparations with hand instruments were smaller than those pro duced with rotary instruments. Reported discomfort was associated with the size of the preparation, although the influence of the operator on both cri teria was considerable. A patient effect was also observed since patients w ho reported discomfort during the first treatment were more likely to repor t discomfort after the second treatment. Ln conclusion, the choice of the t erm "ART" as an atraumatic procedure is defensible.