Minimal Invasive Dentistry Research Articles

Minimal Invasive Dentistry: An Emerging Trend

When first introduced, the term Minimal Intervention Dentistry (MID) referred to use of smaller and more conservative cavity preparations. Today, concept is much broader, being a philosophy of care related to risk assessment of individual patients, early detection of oral disease, targeted preventively orientated strategies and limited surgical intervention appropriate to level of disease1-3. “Extension for prevention” which was previously taught has been changed to “Prevention of extension”.
 Though concept of MID has been stressed upon for more than a decade, but its uptake has not been global. MID should be the standard of care in modern dentistry, as it avoids over-zealous restorative interventions as well as supervised neglect. As dental profession worldwide grapples with challenges of dealing with high rates of dental diseases in socially disadvantaged and medically compromised patients, it is even more important to incorporate these concepts into practice to deal with challenge of management of oral diseases. This review focuses on the concept and techniques of minimal invasive dentistry as an emerging trend in paediatric dentistry.
 Keywords: paediatric dentistry, MID

Cognizance and Use of Minimally Invasive Dentistry Approach by General Dentists: An Overlooked Companion.

Background:Dental caries begins with the decalcification of the first nonorganic part, followed by the decay of the organic tooth matrix. Minimally invasive dentistry (MID) focuses on using the adhesive technique for restoration as these techniques allow minimum removal of healthy tooth structure.Objective:This study aimed to assess the attitude, knowledge, and behavior of the general dentists toward the use of MID and to evaluate if MID is considered as standard care measure among general dentists.Materials and Methods:This was a cross-section observational survey and included 285 practicing dentists. The survey questions were divided into two parts. The question related to the use of sharp explorer utilized response categories (1–5), with options of always, most of the time, often, sometimes, and never or rarely. The independent variables collected were age, gender, years of practice, clinical hours, type of practice, postgraduate education, and clinic environment. The data collected were tabulated and were statistically analyzed.Results:The results of the present study showed that MID meets the standard of care for the treatment of both primary teeth 85.96% (n = 245) as well as permanent teeth 78.24% (n = 223). ART, sandwich technique, in-office, and at-home topical fluoride application were considered active for treating dental caries. The use of sharp explorers, nonsharp explorers, radiographs, and magnification were considered common for caries detection.Conclusion:The more dentists who listened to about MID in the past responded that the MID concept is the standard of care for the treatment of primary and permanent teeth than dentists who have heard little or nothing about MID.

A biomimetic approach for class 1 restorations using stamp technique: A case report

Minimal invasive dentistry advocates the principle of minimal loss of tooth structure along with its harmonious relationship with the surrounding hard and soft tissues. Proper occlusion in the form of its cusp-fossa relationship is essential to achieve post any restoration. This minimizes any sort of post-procedural discomfort to the patient. Stamp technique is a viable, simple and accurate procedure for the restoration of class 1 carious lesion in an aesthethic and biomimetic manner.

Knowledge, Attitude and Practice Regarding Minimal Invasive Dentistry Among General Dental Practitioners in Tamil Nadu

Knowledge, Attitude and Practice Regarding Minimal Invasive Dentistry Among General Dental Practitioners in Tamil Nadu

Virtual Reality Support for Dental Treatment Premedication

The objective is to short review the current state of the art of virtual reality medical application in term of minimal invasive dentistry. An outline of the most important aspects of virtual reality has been created, and a subsequent literature search for articles related was conducted. The current state of the art of virtual reality includes a variety of applications, among others premedication, analgesics, anaesthetics plays an important role in informatics medicine. There is a growing consensus regarding the need to develop knowledge and possible introduce virtual reality as a non-pharmacological support for dental treatment.

A comparative evaluation of penetration depth and surface microhardness of Resin Infiltrant, CPP-ACPF and Novamin on enamel demineralization after banding: an in vitro study

Background The field of dentistry has been revolutionized by various concepts. Minimal invasive dentistry is the preferred treatment approach in the present era; therefore, various techniques have been advocated to arrest caries lesions at an early stage on the grounds of better understanding of the dynamic nature of dental caries. Thus, study was conducted to compare and evaluate the penetration depth and enamel microhardness of Resin Infiltrant, CPP-ACPF and Novamin on artificial demineralized enamel surface after orthodontic banding. Material and methods Eighty extracted sound premolars were banded. The bands were cemented with type 1 GIC and further divided into – Group I: Resin Infiltrant, Group II: CCP-ACPF, Group III: Novamin and Group IV: Control. The samples were incubated for 30 days and then thermocycled. A window of 4 mm × 4 mm was prepared on the buccal surface of samples and artificially demineralized for 4 weeks. A single application was made for Resin Infiltrant, while Novamin and CCP-ACPF were applied twice daily. These samples were otherwise immersed in artificial saliva, and this was protocol was observed for 14 days. For the evaluation of penetration depth, 10 samples from each group were bucco-lingually sectioned and immersed in methylene blue dye solution for 24 h and then evaluated under stereomicroscope. For the enamel surface microhardness, remaining 10 samples from each group were embedded in acrylic resin with outer buccal surface exposed and were tested by a using digital Micro-Vickers hardness tester. Results All groups showed a significant difference in the depth of dye penetration and surface microhardness compared to the control group. As compared to the other tested groups, Resin Infiltrant exhibited the highest significant reduction in demineralization and increased microhardness. Novamin had a deeper penetration and increase in microhardness as compared to CCP-ACPF. Conclusion Resin Infiltrant exhibited the highest potential to impede caries and constitutes a competent aerosol free micro-invasive strategy for combating non cavitated lesions approaching the outer layer dentine which are too advanced for remineralizing agents but do not necessarily require any drilling of tooth.

Relevance of minimal invasive dentistry during covid-19 pandemic

The outbreak of novel Coronavirus-Viral Disease-2019 (COVID-19) has spread rapidly across the globe and caused widespread public health and socio-economic concerns. Dental profession falls under very high risk category of virus transmission because of their close contact with the patient and production of aerosols during dental procedures. Therefore, to sustain dental practice, the dentists must find out different approaches which can minimize the risk of infection. One such approach is Minimal Invasive Dentistry (MID). This review aims to illustrate novel MID procedures as a possible alternative strategy to conventional dental treatment during this COVID-19 pandemic times.

Evaluation of the effect of a remineralising paste containing strontium doped nanohydroxyapatite with Non-Collagenous protein analogue - chitosan on the characteristics of partially demineralized dentin -An invitro study

Preservation of tooth structure by remineralisation of affected dentin can contribute greatly to the concept of minimal invasive dentistry. Remineralisation of dentin is a challenge due to the absence of seeding crystals. Biomimetic remineralising approach aids in restoring demineralised dentin close to that of normal dentin with the use of non-collagenous protein (NCP) analogues that stabilize the mineral phase of dentin resulting in intrafibrillar remineralisation. This study was done to assess the effect of a remineralising paste containing strontium doped nanohydroxyapatite (Sr-nHAp) with non-collagenous protein (NCP) analogue chitosan on the characteristics of partially demineralised dentin. Experimental pastes were formulated using 10 & 20% Strontium doped nano-hydroxyapatite (nHAp) with or without NCP analogue-chitosan. After characterization by x-ray diffraction, its remineralising efficacy on partially demineralised dentin was assessed through SEM-EDS analysis and nanoindentation and compared to that of demineralised and normal dentin. It was observed that 20% Sr-nHAp paste and the experimental formulations with Sr-nHAp and NCP analogue chitosan had the potential to remineralise the partially demineralised dentin specimens as observed by both increase in the mineral content noted in the SEM-EDS analysis and increased mechanical properties analysed by nanoindentation. Within the limitations of the study it was observed that Chitosan enhanced remineralisation potential of 10 & 20% Sr-nHAP and improved mechanical properties of partially demineralised dentin and hence has potential application as a remineralising agent and in vital pulp therapy procedures.

Contemporary restorative ion-releasing materials: current status, interfacial properties and operative approaches.

Minimally invasive (MI) concepts in restorative dentistry in the year 2020 request from the practitioner not only a scientifically supported rationale for carious tissue removal/excavation and defect-oriented, biological cavity preparation, but also a deep understanding of how to ensure a biomechanically stable and durable restoration in different clinical situations by applying different restorative options. Bio-interactive materials play an increasingly relevant role, as they not only replace diseased or lost tissue, but also optimise tissue mineral recovery (among other properties) when used in restorative and preventive dentistry. Indeed, this is of certain interest in MI restorative dentistry, especially in those cases where gap formation jeopardises the integrity of the margins along resin composite restorations, causing penetration of bacteria and eventually promoting the formation of secondary caries. Recently, the interest in whether ion-releasing materials may reduce such biofilm penetration into margin gaps and reduce such a risk for development and propagation of secondary caries is growing significantly among clinicians and scientists. The aim of this article was to explore mechanisms involved in the process that allow mineral deposition at the interface between such materials and dentine, and to describe how conventional 'bioactive' restorative materials currently available on the market may benefit treatments in MI dentistry.

Minimal Invasive Dentistry: Literature Review

Minimally invasive procedures are the new paradigm in health care. Everything from heart bypasses to gall bladder, surgeries are being performed with these dynamic new techniques. Dentistry is joining this exciting revolution as well. Minimally invasive dentistry adopts a philosophy that integrates prevention, remineralisation and minimal intervention for the placement and replacement of restorations. Minimally invasive dentistry reaches the treatment objective using the least invasive surgical approach, with the removal of the minimal amount of healthy tissues. This paper reviews in brief the concept of minimal intervention in dentistry.

Self Assembling Peptide P11-4 for Enamel Remineralization: A Biomimetic Approach

Treatment of caries through conventional modalities involves an invasive approach of excavation of the carious lesion followed by a restoration. This compromises on the strength and integrity of the tooth structure. Minimal invasive dentistry aims at early detection of the carious lesion and their remineralization. Self assembling peptides find its application in the medical field due to its ability to form a scaffold through a process of hierarchical organization into nano structures. Self-assembling peptide P11-4 is a novel technology for enamel remineralization through a biomimetic approach. The technology simulates normal enamel histogenesis. It induces de novo precipitation of hydroxyapatite crystals by forming a three dimensional scaffold matrix. The formation of the scaffold involves the conversion of the peptide from a low viscosity fluid to a nematic gel under low pH conditions. This scaffold matrix further attracts calcium ions and leads to formation of hydroxyapatite crystals. Being minimally invasive, it helps in preserving the strength and integrity of the tooth structure. The aim of the article is to review the technology of self assembling peptides for enamel regeneration and its potential as a material for successful treatment of early carious lesions through a minimally invasive approach.

English

English

Debridement Efficiency Of Different Irrigating Protocols In Truss Cavity Access Preparation

Minimal invasive dentistry and endodontic technological revolution used in endodontic treatment enable the application of conservative endodontic access(CEC)cavity to minimize tooth structure removal.This study examined the cleanliness of CEC.Methods:Eighty sound extracted upper first premolar divided into 4groups (n=20)according to the irrigation protocol G1:Conventional method with Irriflex irrigating needle;G2: ENDOVAC negative pressure irrigation system;G3: PUI with ED62 irrigation ultrasonic tip;G4: Er,Cr:YSGG Laser SWEEPS Mode. CEC done under high magnification.After instrumentation with M3ProGold rotary file to size 35/0.04 taper and irriganted, specimens examined under SEM, and cleanliness of pulp chamber and root canal walls at coronal,middle,apical third was measured. Data were measured, tabulated and statistically analyzed by ANOVA and t-student test (P

Pediatric Dentists' Educational Experiences, Attitudes, and Professional Behavior Concerning Resin Infiltration: Implications for Dental Education.

Minimally invasive dentistry (MID) is receiving increased attention. Resin infiltration (RI) is one micro-invasive technique for treating initial caries by sealing white spot lesions on tooth surfaces. The aims of this study were to assess pediatric dentists' RI-related educational experiences, attitudes, and professional behavior and to determine if their educational experiences were significantly related to their professional attitudes and behavior regarding RI. This cross-sectional study used an online survey to collect data from members of the American Academy of Pediatric Dentistry (AAPD) in March-April 2017. Of the 2,367 AAPD members invited to participate, 43 emails could not be delivered, and 273 surveys were completed, for a response rate of 11.8%. While only 9% of the 273 respondents reported that their classroom-based dental education had informed them about RI and only 1% that it had prepared them well to use RI with pediatric patients, higher percentages said they had been informed/prepared well by their classroom-based (24%) and clinical residency education (12%). The majority wanted to learn more about RI (71%) and would like to take a related CE course (59%). The respondents' average RI-related attitudes were positive (on five-point scale with 1=worst attitude: Mean=3.84). Regarding use of RI, 28% of respondents said they used RI sometimes and 4% often/very often, with 64% considering implementing RI in their clinics. Graduation year did not correlate with RI attitudes and use. However, the more education about RI the respondents had received during their residency (r=0.20; p<0.01) and in professional development after graduation (r=0.34; p<0.001), the more they used RI in their own work. This study found that the pediatric dentists' RI-related education was positively correlated with their professional behavior. Increasing predoctoral, resident, and continuing professional education about RI should therefore be considered.

Restorative Direct Management of Cavitated Proximal Carious Lesions of Permanent Molars using Elastic Separators in Children and Adolescents

Purpose: The purpose of this study was to assess the longevity of direct amalgam and composite restorations placed on the mesial surface of permanent molars after separation with elastic separators. Design: One hundred and seventy seven (177) restorations placed on the mesial surfaces of first and second permanent molars in 140 patients aged 10-25 years-old (median age 12.2 years) were followed for a period of 1 to 12 years (median time 4.3 years). Eighty four (84) amalgam and 93 composite resin restorations were placed randomly on carious lesions that were detected by bite-wing x-rays at the dentino-enamel junction and verified as cavitated after tooth separation. Restorations were evaluated clinically according to the modified Ryge criteria. Flexible parametric proportional-hazards and proportional-odds models for censored survival data was used to analyze the data, with application to prognostic modelling and estimation of treatment effects at 95% CI. Results: Of the 177 restorations, 13 (7.2%) failed in a median time to failure of 8.8 years. There was no statistically significant difference on the cumulative median time to failures between amalgam and composite while statistically significant difference was found between patients that were using fluoride mouthrinse or not (p<0.048) and if there was bleeding detected at the interproximal area of the restoration or not (p<0.001). Conclusions: Restorative management of cavitated proximal carious surfaces of permanent teeth with amalgam or composite resin, using elastic separators, seems to be a very good and promising alternative technique in the context of the minimal invasive dentistry in children and adolescents.

Impact of Brix 3000 and conventional restorative treatment on pain reaction during caries removal among group of children in Baghdad city

Background: Pain and the usage of local anesthetic agents are still real problem in pediatric dentistry, for these reasons, the use of minimal invasive dentistry (MID) in regard to the patient comfort is important especially for children, anxious and uncooperative patients. Chemomechanical caries removal (CMCR) methods involve the selective removal of the carious dentine hence it avoided the painful removal of the sound dentine and the anxiety resulted due to the vibration of the hand piece which is also decreased thus it appears to be more acceptable and comfortable to the patient. Aims of this study: This study was conducted among group of children to assess and compare the anxiety rating scale (during and after treatment) between the use of a recent chemomechanical caries removal method (by using Brix 3000) and the use of rotary instruments (using the ceramic bur). Materials and methods: Thirty pediatric patients aged between 8-12years, with bilateral occlusal carious permanent molars (extending into dentin) were selected for this study. Carious lesions were removed using Brix 3000 (CMCR) on one side and rotary instruments on the contra lateral side. Both cavities were restored with light cured composite filling. Anxiety scores were determined using Frankle rating scale (1962) during and after the period of caries removal. Results: The anxiety rating scale during the period of treatment showed the percentage of the negative behavior in the CMCR method was less than the percentage of the ceramic bur reverse the positive and definitely positive, which means that the new CMCR agent (Brix 3000) was more comfortable than the conventional rotary instrument (ceramic bur), that reduced the need for local anesthesia and the use of the drill. While after the treatment there is no big difference in the acceptance of the patients in two groups. Conclusion: Brix 3000 gel as a CMCR is an effective alternative method for caries removal, which appears to be more comfortable for the patients and more conservative

The transition from amalgam to other restorative materials in the U.S. predoctoral pediatric dentistry clinics.

Increased concerns about the safety of amalgam restorations in children have resulted in many dental schools emphasizing the teaching of alternative dental materials. This study investigated the current teaching of different dental materials for use in posterior teeth in the United States predoctoral pediatric dentistry programs. In 2011, the authors invited the chairs of the predoctoral pediatric dentistry departments in all accredited dental schools at that time (N = 57) to participate in an internet‐based survey. Descriptive statistics were calculated to describe the frequency of using different restorative materials. Regression models were developed to explore the factors related to the use of dental restorations in predoctoral pediatric clinics. Among the 44 dental schools that responded (77% response rate), 74% used amalgam, and 93% used composite in primary posterior teeth. Glass ionomer was used by 61% of the schools in primary posterior teeth. Placing amalgam in primary posterior teeth was associated with programs that treated more 3–5‐year‐old patients (β = .302, p < .043), whereas the use of glass ionomer was associated with having students serving at off‐site satellite dental clinics (β = .015, p < .012). In general, having departments with chairs who had positive attitudes towards Minimal Invasive Dentistry (MID) used composite (β = .091, p < .0001) and glass ionomer (β = 103, p < .0001) more frequently and were less likely to use amalgam (β = −.077, p < .005) in primary posterior teeth. Although teaching MID concepts in predoctoral pediatric clinics in dental schools is increasing, the use of amalgam in posterior primary and permanent teeth is still widely practiced.

Minimal invasive microscopic tooth preparation based on endodontic, periodontal and functional health

Tooth preparation is the primary and core operation technique for dental esthetic restoration treatment, due to its effect of providing restoration space, bonding interfaces and marginal lines for dental rehabilitation after tooth tissue reduction. The concept of microscopic minimal invasive dentistry put forward the issue of conducting high-quality tooth preparation, conserve tooth-structure, protect vital pulp and periodontal tissue simultaneously. This study reviewed the concepts, physiology background, design and minimal invasive microscopic tooth preparation, and in the meantime, individualized strategies and the two core elements of tooth preparation (quantity and shape) are listed.

Oral homeostasis, kill the microbiome or not?

The objective is to short review the current state of the art of dental antimicrobial agents in term of minimal invasive restorative dentistry. An outline of the most important aspects of dental antimicrobial agents was created, and a subsequent literature search for articles related was conducted. The current state of the art of antimicrobial agents includes a variety of species with broad ranges of properties. There is no agreement as to the choice of substances and concentration, however, there is a growing consensus regarding the need to use antimicrobial agents as additions into dental restorative materials’ compound in patients with high intensity of active caries disease.

Minimal Invasive Dentistry

Minimal Invasive Dentistry