ADVANTAGES AND LIMITATIONS OF ART
The advantages of ART include the following:
- The use of easily available and relatively inexpensive hand instruments rather than expensive electrically driven dental equipment.
- A biologically friendly approach involving the removal of only decalcified tooth tissues, which results in relatively small cavities and conserves sound tooth tissue.
- The limitation of pain, thereby minimizing the need for local anesthesia.
- A straightforward and simple infection control practice without the need to use sequentially autoclaved handpieces.
- The chemical adhesion of glass ionomers that reduces the need to cut sound tooth tissue for retention of the restorative material.
- The leaching of fluoride from glass ionomers, which prevents secondary caries development and probably remineralize carious dentin.
- The combination of a preventive and curative treatment in one procedure.
- The ease of repairing defects in the restoration.
- The low cost.
From experience gained thus far, the ART technique is a non threatening oral procedure. This characteristic has the great advantage of making oral care more popular among the population – in particular, the young. Fear inducing situations caused by threatening dental equipment are not involved, and there is no noise from a drill or from suction equipment. The maximum number of instruments in the mouth at anyone time is similar to that used during an oral examination, the mirror in one hand and a work instrument in the other. AFT is therefore, patient –friendly.
Obviously, one of the greatest advantages of ART is that it makes it possible to reach people who otherwise never would have received any oral care. The technique allows oral care workers to leave the clinic and to visit people in their own living environments, e.g. in senior citizen homes, institution for the handicapped, villages in rural and suburban areas in economically less developed countries, and in their own homes. From a health point of view, these possibilities must be considered a huge advantage.
Furthermore, ART supports health education and promotion programs, particularly in areas where oral care relies heavily on pain relief through extraction and oral health education. Using ART, a comprehensive package of education / promotion, prevention, curative treatment, and pain relief can be established and delivered to the population through a low cost, out reach oral health program.
The limitations of ART include the following:
- Long – term survival rates for glass ionomer ART restorations and sealants are not yet available; the longest study reported so far is of three year’s duration. The techniques acceptance by oral health care personnel is not yet assured.
- At the moment tissue is limited to small and medium sized, one-surface lesions because of the low wear resistance and strength of existing glass ionomer materials.
- The possibility exists for hand fatigue from the use of hand instruments over long periods.
- Hand mixing might produce a relatively unstandardized mix of glass ionomer, varying among operators and different geographical/climatic situations.
- The misapprehension that ART can be performed easily – this is not the case and each step must be carried out to perfection.
- The apparent lack of sophistication of the technique, which might make it difficult for ART to be easily accepted by the dental profession.
- A misconception by the public that the new glass ionomer “white fillings” are only temporary dressings.
Some of these disadvantages of glass ionomers, such as low wear resistance and reduced strength, are being addressed. When improved materials become available, larger one surface and small to medium sized multisurface lesions might also be managed with the ART technique. Also, the variation in mixtures of hand mixed glass ionomer can be reduced by making the materials more user friendly, a particularly important factor in the economically less developed countries where less than optimal operating conditions exist. The development of appropriate hand instruments will facilitate the execution of the ART technique and, one hopes, reduce the possibility of hand fatigue.
0 comments:
Post a Comment