SKENARIO 4

PENUMPATAN TANPA PENGGUNAAN BUR

Drg Hayyu adalah seorang drg muda yang sedang menjalani internship di puskesmas
Kendari. Daerah tsb sangat terpencil. Melihat angka kunjungan pasien yg menunjukkan psien
anak anak dan dewasa yang datang ke poliklinik gigi hampir semua gigi gerahamnya terdapat
gigi berlubang. Maka dari itu, untuk menekan angka karies, drg Hayyu menjalankan suatu
program mengajak kader dan tokoh masyarakat yang telah dilatih untuk melakukan kegiatan
promosi kesehatan berupa penyuluhan setiap 1 bulan sekali dan screening pada saat posyandu
rutin. Paien yang memerlukan tindakan berupa penumpatan dirujuk ke puskesmas untuk
dilakukan penumpatan, karena poli gigi di puskesmas tsb peralatan sangat terbatas serta
sering terjadi pemadaman listrik yang lama shg penumpatan gigi karies dilakukan dengan alat
sedrehana.

STEP 1

STEP 2

1. What is atraumatic restorative treatment?

2. What are the purpose of ART?
3. What are the advantages and disadvantages ART?
4. What are the indication and contraindication of ART?
5. What are tools and material that use in ART?
6. How the steps of ART?
7. How to be choose ideal material for ART?
8. What are the cause of failure ART?

STEP 3
1. What is atraumatic restorative treatment?
Clinical procedur without use of tooth bur
Restorative treatment for managing caries lession with hand instrument only
Preventive procedure
Restoration of tooth cavity with adhesive patch material
Clinical procedure that restore the tooth cavity that use hand instrument and
adhesive material
2. What are the purpose of ART?
Restorative treatment for caries lession and preventive
To restore the tooth function
To decrese anxiety of patient because that treatment not use the burs
3. What are the advantages and disadvantages of ART?

Advantages :

Not needed electricity

Not painfull
 The cost relative cheap
Minimize the use of local anesthesion
Make it easier for people that not cover by health service
Fluoride release material
Easy to repair if there is disability patient
Using simple instrument

Disadvantages:

Make fatigues operator because use the hand instrument

4. What are the indication and contraindication of ART?
Indication
There is cavity on the tooth within pulp involvement
The cavity can be reached with hand instrument
Caries superficial
For the area not support by the electricity

Contraindication

Caries interproximal area

Open dental pulp
There is fistule and abcess in the area of the tooth
There are hidden caries cavity that cannot be reached with hand instrument
Tooth have been painful for along time
5. What are tools and material that use in ART?
instrument :
OD instrument
Hand instrument (hatchet, enamel acces cauter, excavator)
Mixing slab and spatula
Brush
Carver instrument
Cheek retractor
Plastic instrument

Materials :

GIC
Dentin conditioner
Articulating paper
Glooves and mask
Cotton pelet
Cotton roll
Varnish
Pumish
6. How the steps of ART?
Brush the teeth with pumice
Rinse with water
Dry with cotton pellet
Isolation the area with cotton roll
Measure the dept of caries with explorer
Widening the cavity with enamel acces cauter
Clear the invfectious tissue with excavator
Rinse with water, and dry with cotton pelet
Aplication the dentin conditioner 15 scnd
Rinse with water, dry with cotton pelet
Manipulation of GIC (powder : liquid = 1:1)
Aplication of GIC
Carving
Aplication varnish
Cek occlusion
7. What is the ideal criteria of material for ART?
Biocompatible with the tissue
Release fluoride
Not toxic
Not iritative
Form stabil bond to enamel and dentin
The material have same color with the tooth
Not larut in mouth
8. What are the cause of failure ART?
There is caries that still exist in the enamel or dentin
Contamination of saliva and blood to the tooth
Skills of operator
Patients cooperative
Failure from manipulation of GIC
The temperature level of GIC
The cavity not full filled with GIC
Condition the cavity after preaparation is not enough
Dentin conditioner that not adequat

STEP 4

STEP 5

1. Pengertian, jenis, indikasi dan kontraindikasi, usia, steps

2. Instrumentarium for ART
3. Treatment planning for ART (purpose, treatment, sampai prognosis)
4. Instruction post ART