title: Minimal intervention dentistry: part 7. Minimally invasive operative caries management: rationale and techniques.
abstract: When patients present with cavities causing pain, poor aesthetics and/or functional problems restorations will need to be placed. Minimally invasive caries excavation strategies can be deployed depending on the patient's caries risk, lesion-pulp proximity and vitality, the extent of remaining supra-gingival tooth structure and clinical factors (for example, moisture control, access). Excavation instruments, including burs/handpieces, hand excavators, chemo-mechanical agents and/or air-abrasives limiting caries removal selectively to the more superficial caries-infected dentine and partial removal of caries-affected dentine when required, help create smaller cavities with healthy enamel/dentine margins. Using adhesive restorative materials the operator can, if handling with care, optimise the histological substrate coupled with the applied chemistry of the material so helping to form a durable peripheral seal and bond to aid retention of the restoration as well as arresting the carious process within the remaining tooth structure. Achieving a smooth tooth-restoration interface clinically to aid the cooperative, motivated patient in biofilm removal is an essential pre-requisite to prevent further secondary caries.
authors: King's College London Dental Institute, Guy's Dental Hospital, London Bridge, London, SE1 9RT. avijit.banerjee@kcl.ac.uk
authors: A
authors: A
authors: Banerjee
mesh_terms: D057087:Dental Atraumatic Restorative Treatment; D003731:Dental Caries / Q000473:pathology / Q000517:prevention & control / Q000628:therapy; D003737:Dental Cavity Preparation / Q000295:instrumentation* / Q000379:methods; D003738:Dental Cements / Q000737:chemistry / Q000627:therapeutic use; D003793:Dental Restoration, Permanent / Q000379:methods*; D006801:Humans; D010895:Pit and Fissure Sealants / Q000737:chemistry / Q000627:therapeutic use
chemical_list: D003738:Dental Cements; D010895:Pit and Fissure Sealants