Minimal Invasive Dentistry
The concept ‘Minimally Invasive Dentistry’ is a modern dental practice designed around the principal aim of maximal preservation of healthy dental structures. Within cariology, this concept includes the use of all available information and techniques ranging from accurate diagnosis of caries, caries risk assessment and prevention, to technical procedures in repairing restorations. The approach uses similar principles for prevention of future caries, and is intended to be a complete management solution for tooth decay.
Decay is the process or result of demineralization (softening) of an area of dental tissue, creating a decayed lesion on the tooth. The process of restoring decay begins with an analysis of the decayed lesions together with their location and severity, with particular regard to the state of reversibility.
Where decay is reversible, it is referred to as non-cavitated decay, where healing is possible by the hardening process of remineralization. Where a cavity has formed from excessive demineralization, the decay has reached the point of no return where the tooth structure has been lost and the decay is permanent and non- reversible. In this situation of cavitated decay, the cavity will have to be filled to restore the tooth.
- Minimal intervention dentistry is focused on filling only cavitated regions, leaving non-cavitated decay to be remineralizer, thus restoring the tooth while removing as little of the tooth structure as possible,
enhancing the strength and aesthetics of the restoration. Classifications of the location and severity of decay are made in order to establish guidelines for suitable treatment methods.
The following techniques are used in minimally
Invasive cavity preparation:
- Mechanical high/low speed rotary systems.
- Chemo mechanical cavity preparation systems.
- Air abrasion
- Ultrasonics and Sono abrasion.
- Atraumatic Restorative Treatment (ART).
- Ozone therapy
- Laser application
- Antibacterial Photodynamic Therapy (APDT).
Various techniques exists for remineralization, varying from simple application of fluoride to using special substances for filling materials that interact with the tooth to aid the process from within. Glass Ionomer Cements (GICs) have been shown to undergo ion exchange with the surrounding tooth structure, and also engage in fluoride feeding.