非创伤性修复治疗

非创伤性修复治疗（Atraumaticrestorativetreatment,ART)支清惠由来、发展及临床效果•发展中地区缺乏传统龋病充填治疗设备•汞合金的寿命问题•黏结性修复材料的发展•充填体和封闭物可使其下龋损停止进展•龋坏组织无需完全去除•释氟性材料玻璃离子的发展•更多的预防，更少的创伤ART的适应证•恒牙和乳牙的中小龋洞，能允许最小的挖器进入；无牙髓暴露，无可疑牙髓炎基本材料和器械•材料：玻璃离子粉、液牙本质处理剂基本材料和器械•器械：口镜、镊子、探针、调拌纸、挖匙、牙用手斧（锄形器）、雕刻刀、树脂条或T形带、木楔等操作步骤•洞形准备•清洁•混合与调拌•充填对ART的评价-ART的优点•符合现代预防观点：最少的损伤，最佳的预防•手用器械•操作简单易学•控制交叉感染方便•病人容易接受•玻璃离子含氟•容易修补可能影响其推广的因素•充填微漏•玻璃离子的强度•长期保留率尚待观察•对ART技术的误解•误认为玻璃离子是临时充填材料•病例丢失率高ART的发展方向•充填材料的进步：更强的黏结性、更强的耐磨性、较小的微漏、更强的再矿化能力•作为完整预防的一部分，与其他措施相结合•适用于所有经济发展水平的人群，符合现代预防和口腔修复的概念，发展前景良好•MedPrincPract.2009;18(1):26-30.Epub2008Dec4.•AcceptanceanddiscomfortfromatraumaticrestorativetreatmentinsecondaryschoolstudentsinEgypt.•FaragA,FrenckenJE.•Source•DepartmentofOperativeDentistry,FacultyofOralandDentalMedicine,MiniaUniversity,MiniaCity,Egypt.OBJECTIVES:Toassessthelevelofacceptanceanddiscomfortexperiencedbysecondaryschoolstudentswhenundergoinganatraumaticrestorativetreatment(ART)restoration.SUBJECTSANDMETHODS:Ninetysecondaryschoolstudents,aged14and15years,wereincludedinthestudy.TheARTrestorationswerepreparedin90cavitiesandrestoredusinganencapsulatedhigh-viscosityglassionomer.Thedepthofthecavitieswasjudgedfromradiographsandclinicallyintoouter,middleandinnerthirdofdentine.Usingagradedperiodontalprobe,cavitysizewasmeasured,intoapproximatelyhalfthewidthofthemesiodistalandbuccolingual/palataldistanceoftheocclusalsurface.Thestudentswereaskedaboutthelevelofsensationexperiencedduringcavitypreparationimmediatelyaftercompletionofrestoration.chi(2)-Testwasusedtotesttheeffectofcavitydepthandsizeonsensitivityfromtheteeth.RESULTS:Ofthe90students,6(6.6%)and26(29.2%)experiencedpainanddiscomfort,respectively,duringcavitypreparation,moreofteninlargethaninsmallcavities(p=0.003)andincavitiesextendingintotheinnerthirdthaninthemiddleandouterthirdofdentine(p0.0001).Only1studentreportedpostoperativesensitivity.CONCLUSIONS:TheARTapproachtotreatdentalcavitieswaswellacceptedbythisgroupofsecondaryschoolstudents.Onlyafewreportedpainduringcavityinstrumentation,andthiswasmoreprevalentinlargecavitiesandincavitieswiththefloorclosetothepulp.HobdellM,PetersenPE,ClarksonJ,JohnsonN.Globalgoalsfororalhealth2020.InternationalDentalJournal.2003Oct;53(5):285-8.•定义•影响ART应用的因素•ART的发展趋势•对ART的评价知识点Thankyou!