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Active ImageAtraumatic Restorative Treatment (ART or PRAT in Spanish) is a simple method to treat dental caries in situations where traditional cavity preparations are not feasible. The technique was developed over 10 years ago and has been proven to be an effective treatment option. It involves the removal of soft, demineralized tissue followed by the restoration of the tooth with fluoride-releasing glass ionomer.

ART/PRAT systems have been successfully employed all over the world as it does not require electricity, running water, or anesthesia. PAHO, with the support of the Inter-American Development Bank (IADB), demonstrated the cost-effectiveness of ART/PRAT compared to amalgam restorations in three LAC countries over three years. Longer-term studies are currently underway. Results of this study can be found under the Related Methods section.

This section reviews the history, research and development of the technique, practical purposes, and current studies and trends.


Introduction and Fact Sheets

WHO Introduction

Restauración atraumática para el control de la caries dental: historia, características y aportes de la técnica

Revista Panamericana de la Salud Publica, 2005. Este trabajo presenta información de relevancia científica sobre la historia, características y aportes de la técnica de restauración atraumática en la prevención y el control de la caries dental.


Scientific and Technical Publications

 

icon La Salud Oral de los Niños de Bajos Ingresos. Procedimientos para el Tratamiento Restaurativo Atraumático. (979,08 kB) 

OPS. BID. 2009. ATN/JF-7025-RG. NÚMERO DE PROYECTO 091024. Informe final. Saskia Estupiñán-Day, Trevor Milner, Marisol Téllez

En el presente estudio, las técnicas básicas de evaluación económica, particularmente las técnicas de análisis costo-efectividad (ACE), se utilizaron para evaluar la práctica de la técnica PRAT. La investigación tuvo como objetivo introducir la técnica PRAT en los servicios de atención dental del gobierno en Panamá, Ecuador y Uruguay como una modalidad de tratamiento restaurador para el tratamiento de caries tanto en los dientes primarios como permanentes, ampliando así la cobertura de los servicios bucodentales a nuevas poblaciones de niños, incluidos los que actualmente carecen de acceso a tratamientos convencionales en base a Amalgamas.

icon Atraumatic Restorative Treatment (ART) to the Rural Population: A GOI – WHO Collaborative Programme (913.55 kB)

WHO, Mahatma Gandhi Post graduate Institute Of Dental Sciences & Government of Puducherry Institution, 2007. Report of use of ART in rural Puducherry grammar schools and colleges. Evaluation of cost effectiveness, and retention of fillings.

icon Oral Health of Low Income Children: Procedures for Atraumatic Restorative Treatment (PRAT) (2.6 MB)

PAHO, 2006. Basic techniques of cost-effectiveness analysis (CEA), PRAT in government dental care facilities in Panama, Ecuador and Uruguay, thus extending coverage of oral services to those without access to conventional Amalgam-based treatment.

icon Comparative economic evaluation of an Atraumatic Restoration Treatment Program (3.53 MB)

PAHO & InterAmerican Development Bank, 1999. Comparative economic evaluation of an Atraumatic Restoration Treatment Program: Study design and protocol for  selected countries. Document about concept, technical design, protocol and preliminary inputs for the cost-effectiveness analysis of Atraumatic RestorativeTreatment.

icon Atraumatic Restorative Treatment (ART) for Tooth Decay: Global Initiative 1998-2000 (660.18 kB)

WHO, 1998. Historical document showing WHO plans for promoting ART around the world.


Training Materials                                                               

icon Atraumatic Restorative Treatment (ART) for Tooth Decay: How to organize and run an ART training course (4.77 MB)

WHO, 2000. Educational material for facilitators of ART training based on experience gained in over 30 countries.

icon Practica de Restauracion Atraumatica (PRAT) para la Caries Dental – Como Organizar un Curso PRAT (2.68 MB)

OMS, Escuela de Odontología de la Universidad de Nijmegen, 2001. Materiales educativas para entrenar facilitadores en la técnica PRAT basado en experiencia recibido en más que 30 países. 

Seminal book (avaiable for free online) that is a step-by-step guide for treating a patient with the ART technique. 

Additional Resources

American Academy of Pediatric Dentistry, 2008.  Review of treatment options for dental caries in pediatric populations.

UMC St. Radboud Dental School, the Netherlands. ART Resource center especially useful for those considering ART implementation.

Saskia Estupiñán-Day. Asesora Regional de Salud Oral.Organización Panamericana de la Salud. Presentación en el II Congresso Mundial de Esperiencias de Odontologia na Saúde Pública. 11-13 de Julho de 2001. Londrina, Brazil

 

Videos 

Sources - Database:

General Health Sicience: LILACS, MEDLINE /International Agencies:  PAHO- Pan American Health Organization, WHOLIS - World Health Organization / Cochrane Library: Cochrane systematic reiews, Protocols of Cochrane systematic reviews, CENTRAL, Abstracts by INAHTA, economic studies and critically appraised, abstracts of quality assessments / BBO -Brazilian Dentistry Bibliography  / MEDCARIB - Caribbean Health Sciences Literature / Bandolier / Ibero-American Clinical Trials, Evidence. Updating in ambulatory, Reports / HIL- Internet Resources.

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