In vitro effectiveness of hand excavation of caries with the ART technique. Atraumatic restorative treatment.

The purpose of this study was to evaluate the effectiveness of the atraumatic restorative treatment (ART) hand-instruments and of round steel burs for removing caries at the enamel-dentine junction (EDJ) in occlusal cavities prepared in 50 extracted permanent molars. The teeth were divided randomly into two equal groups for the two treatments provided by 1 operator. Stained but hard dentine was not removed. The teeth were then sectioned vertically, buccolingually through the prepared cavities to give 200 sections, each 500 microm thick, which were photographed (x1 magnification) before and after staining with a caries detector dye. Assessments were made (x3 magnification) of (a) the amount of brown-stained residual dentine, and (b) the amount of red dye-stained dentine present at the EDJ, using two sets of standards devised and transparencies arranged as six-category incremental rating scales. There was no statistically significant difference found between the two caries-removal methods for the amount of residual brown-stained dentine present (chi(2 )= 3. 394, p = 0.64), but there was for the amount of red dye-stained dentine present (chi(2) = 32.137, p<0.0001), although 57% of the ART and 80% of the steel bur sections had very little to mild red-dye staining present. Excavation of caries at the DJE appeared to be less effective with the ART technique, although the clinical implications of this may not be significant.