Minimal Invasive Dentistry Research Articles

Comprehensive and esthetic rehabilitation for phobic patient “case report”

BackgroundOne of the main reasons for a patient to be referred for sedation in order to receive dental treatment is dental fear. Minimal Invasive Dentistry is caused by the ceramic material improvement along with luting composites ceramic and well secured to teeth. Modern society considers a lovely smile being the perfect image for beauty and great health. Case detailsA 24-year old phobic patient Male presented to the clinic, with a chief complaint of an unaesthetic smile. We end up by excellent management of phobic patient and complete comprehensive and esthetic treatment and the patient was highly satisfied with the results. ConclusionSuccessful management of a fearful patient during the first visit build good patient dentist relationship thus completing comprehensive dental treatment.

An investigation of general dental practitioners' understanding and perceptions of minimally invasive dentistry.

Objectives: This study investigated general dental practitioners' (GDPs) understanding and perceptions of minimally invasive dentistry (MID). This questionnaire-based survey looked at GDPs currently practising in the UK. / Methods: A total of 170 questionnaires were distributed. The questionnaire enquired about demographic information, postgraduate training in MID, number of years in clinical practice, the working environment, perceptions of the methods and rationale for their choice of restorative materials in clinical practice, and tested their knowledge of MID. / Results: Of the 170 distributed questionnaires, 87.6% (N = 149) were completed. The results showed that only 28% of the respondents scored all the basic MID knowledge questions correctly, illustrating a general lack of basic contemporary understanding of MID among the GDPs. Logistic regression analysis of the data revealed a true correlation between the knowledge in MID and the perception of knowing. The analysis also showed that knowledge in MID, application of G. V. Black's concepts and change in MID approach since qualification were significant (p <0.05). There were no significant relationships between the knowledge score on studied scenarios and country of education, working environment, caries risk assessment, effect of caries risk assessment on treatment planning, effect of caries risk assessment on choice of restorative material, dietary assessment and fluoride usage. / Conclusions: This study demonstrated that the knowledge of MID among UK GDPs is generally poor. There is a need for further education in the field of MID.

Knowledge, attitude and skills of dental practitioners of Puducherry on minimally invasive dentistry concepts: A questionnaire survey.

Background:Minimally invasive dentistry (MID) encompasses early caries diagnosis through caries risk assessment (CRA), early detection of incipient carious lesion including primary and secondary prevention based on scientific evidence that remineralization of demineralized enamel and dentin is possible if detected early. Although the dental curriculum focuses on the advantages of MID in tooth preservation, this science is not usually translated into practice.Aim:This study aimed to evaluate the knowledge, attitude, and skills of dental practitioners of Puducherry regarding the concepts of MID.Subjects and Methods:Data were collected through an online survey questionnaire based on awareness and practice of MID. Statistical evaluation was done on SPSS by Chi-square test.Results:A total of 126 dentists responded of which only 55% were trained in MID during their undergraduate and internship period, mainly through lectures (49.6%). Nearly 81% agreed that CRA should be conducted for all patients. Almost 42.7% had heard about International Caries Detection and Assessment System, but only 25.9% used a blunt explorer for caries detection. About 13.7% use magnification (loupes/microscope), but majority (84.7%) use radiographs. More than 70% were unaware of newer methods of caries detection. Statistically significant differences were found (P < 0.05) regarding qualification and experience about the effectiveness of Atraumatic Restorative Treatment and sandwich technique for treatment of caries in permanent teeth and high caries-risk children.Conclusion:Although there is knowledge about advantages of MID among dentists of Puducherry, it does not benefit patients, as many practitioners still follow the traditional principles of total caries removal.

Oriented and Ordered Biomimetic Remineralization of the Surface of Demineralized Dental Enamel Using HAP@ACP Nanoparticles Guided by Glycine

Achieving oriented and ordered remineralization on the surface of demineralized dental enamel, thereby restoring the satisfactory mechanical properties approaching those of sound enamel, is still a challenge for dentists. To mimic the natural biomineralization approach for enamel remineralization, the biological process of enamel development proteins, such as amelogenin, was simulated in this study. In this work, carboxymethyl chitosan (CMC) conjugated with alendronate (ALN) was applied to stabilize amorphous calcium phosphate (ACP) to form CMC/ACP nanoparticles. Sodium hypochlorite (NaClO) functioned as the protease which decompose amelogenin in vivo to degrade the CMC-ALN matrix and generate HAP@ACP core-shell nanoparticles. Finally, when guided by 10 mM glycine (Gly), HAP@ACP nanoparticles can arrange orderly and subsequently transform from an amorphous phase to well-ordered rod-like apatite crystals to achieve oriented and ordered biomimetic remineralization on acid-etched enamel surfaces. This biomimetic remineralization process is achieved through the oriented attachment (OA) of nanoparticles based on non-classical crystallization theory. These results indicate that finding and developing analogues of natural proteins such as amelogenin involved in the biomineralization by natural macromolecular polymers and imitating the process of biomineralization would be an effective strategy for enamel remineralization. Furthermore, this method represents a promising method for the management of early caries in minimal invasive dentistry (MID).

Comparison of efficacy of caries removal using polymer bur and chemomechanical caries removal agent: A clinical and microbiological assessment - An in vivo study

Conservative caries removal has become an integral part of minimally invasive dentistry (MID). Polymer burs and chemomechanical caries removal are two feasible methods of MID. The objective of this study was to assess and compare the efficacy of polymer bur and chemomechanical caries removal agent clinically and microbiologically for selective removal of infected dentin. A total of fifty primary second molars with occlusal decay involving dentin were selected from 25 patients aged between 5 and 9 years. They were randomly allocated to Group A (polymer bur group) and Group B (Carie-Care group) for caries removal. Completeness of caries excavation was assessed clinically with the application of caries detector dye. Dentinal samples were collected before and after caries removal and cultured in Luria-Bertani Agar, and total viable count was assessed. All the teeth after caries excavation were restored with Type 2 glass ionomer cement. The data obtained was tabulated and statistically analyzed using paired t-test and Chi-square test. There was a statistically significant reduction in the mean microbial count before and after treatment in polymer bur group and Carie-Care group. The reduction in mean microbial count was found significantly higher in polymer bur group compared to Carie-Care group. There was no significant association was observed between the two groups when efficacy was assessed clinically. Both polymer bur and Carie-Care were efficient caries removal agents when assessed clinically and microbiologically. Polymer bur was found to be more effective than Carie-Care when assessed microbiologically.

Acceptance of Minimally Invasive Dentistry Among US Dentists in Public Health Practices.

Little is known about use or acceptance of minimally invasive dentistry (MID) in the USA, particularly in public health settings. The purpose of this study was to assess opinions concerning MID among dentists in public-health practices. A cross-sectional study was conducted to assess the views of dentists in public-health practices concerning MID using an online survey instrument among National Network for Oral Health Access (NNOHA) and American Association of Community Dental Programs (AACDP) members. Specific questions focused on diagnostic and preventive techniques, and whether MID was considered to meet the standard of care in the US Results: Overall, 86% believed that MID met the standard of care for primary teeth, and 77% did so for permanent teeth. The majority of respondents also agreed that fluoride varnish prevents caries and atraumatic restorative techniques (ART) are an effective caries treatment for children and adults. According to logistic regression results, dentists who had continuing education courses in MID and agreed that ART was an effective treatment for adults were more likely to report that MID met the standard of care for permanent teeth. Subjects who believed that fluoride varnish was effective as caries prevention for children were more likely to view MID as meeting the standard of care for primary teeth. There appears to be a paradigm shift toward a MID philosophy, and most responding public health dentists believed that MID meets the standard of care for primary and permanent teeth in the US.

Minimal Invasive Dentistry- A Comprehensive Review

Minimal Invasive Dentistry- A Comprehensive Review

Knowledge and Attitude among General Dental Practitioners towards Minimally Invasive Dentistry in Riyadh and AlKharj.

Minimally Invasive Dentistry (MID) emphasizes conservative caries management strategies resulting in less destruction of tooth structure, a deviation of the traditional GV Black's restorative principles. However, there seems to be either deficiency in knowledge or little intention by general dental practitioners to adopt these principles. The aim of this study was to assess the knowledge and attitude among general dental practitioners towards minimally invasive dentistry in Riyadh and AlKharj cities of Saudi Arabia. Self-administered structured questionnaires were handed to general dental practitioners (GDPs) in the cities of Riyadh and AlKharj in Saudi Arabia. Several questions, including Likert-type scale response categories (1-5), were used. The questions assessed the respondents' levels of agreement regarding diagnostic, preventive and restorative techniques such as use of caries risk assessment, use of high fluoride tooth paste, Atraumatic Restorative Treatment and tunnel preparations. Out of 200 respondents, 161 GDPs with overall response rate of 80.5% completed the questionnaires. The GDPs showed significantly different approach with regards to the use of sharp explorer for caries detection (p = 0.014). Almost 60% of the participants had received no special education regarding minimally invasive procedures. Moreover, GDPs who had received MID training showed significantly better knowledge and attitude in adopting minimally invasive techniques for both diagnosis and treatment of dental caries. Although GDPs possess knowledge about the benefits of MID; however, study showed deficiencies in their attitudes towards caries detection methods and application of minimally invasive dentistry procedures.

Minimally Invasive Dentistry Approach Benefits of Using Laser

The preservation of healthy human body and function for every patient should be the goal of all health practitioners. Dentistry is not an exception to this philosophy. The loss of human tooth structure should be regarded as a serious injury and never to be considered lightly, therefore it is imperative to provide the most comprehensive and conservative care to all teeth. In past few decades, the improvements of scientific method and technology has led to a better understanding of oral micro flora and dental materials resulted in the shifting of caries management method from G.V. Black’s “Extension for prevention” to the modern “Minimally invasive” approach in dentistry. The minimally invasive approach to dental caries encompasses the science of detection, diagnosis and treatment on the microscopic level. The approach also establishes a proper doctor-patient relationship thus empowering and educating the patient to take responsibility for their own dental health. It has been widely accepted that the restorative materials and preparation designs are not the cure for caries. The dentist must recognize that the caries is a bacterial disease and the elimination of disease should be the priority before initiating any restorations. The proper sequence of caries management should be the introduction of preventive strategies such as oral hygiene instructions, remineralisation regiments, and risk assessments followed by minimal surgical interventions. Using the laser technology in the aspect of surgical intervention has many clinical advantages. Some of the clinical benefits include its selectivity for carious tissue, reduction of needs for local anaesthesia, decontamination effect of preparation surfaces, minimal thermal stimulus to pulp chamber, increase surface adhesion for composite materials, and other soft tissue applications. A critical evaluation of disadvantages on laser should also be considered when implementing its use in the clinical practice. The combination of caries prevention program, disease control, risk assessment and laser technology application on the surgical intervention significantly reduce the long term restorative needs thus preserve more healthy natural tooth structures, which complimenting the concept of minimally invasive dentistry. This presentation summarized various articles within the past 15 years regarding to topics of minimal invasive dentistry and laser technology usage in dentistry.

Clinical Evaluation of Caries Removal in Primary Teeth Using Carie-care and SmartPrep Burs: An In vivo Study

Background: Ultra conservative caries removal now has become an integral part of Minimal Invasive Dentistry. The main objective of deep caries removal is to conserve the tooth structure as well to maintain the integrity of pulpal health. Aim: To evaluate clinically the efficiency of caries removal using Carie-Care compared to the SmartPrep burs for complete caries excavation. Materials and Methods: Split mouth study was done in 64 children where caries excavation was done using Carie-Care on one side and Smart burs on the other side. The parameters assessed were complete caries excavation, pain reaction, need for local anesthesia and mean time required. Results: The differences between complete caries excavation, pain reaction and need for local anesthesia using both the techniques were statistically insignificant. Whereas the time taken for caries removal using Carie-Care was significantly less than Smart burs (P = 0.001). Conclusion: Both the techniques can be used effectively for caries excavation in primary teeth.

A new ceramics approach for contact lens

Nowadays the field of dentistry is focusing into a new aesthetic area in the light of an minimal invasive dentistry approach. Aesthetic treatments with dental porcelain veneers without any preparation (ceramic contact lenses) have gained popularity in recent years. Thus, the need for constant improvement and knowledge of innovative techniques and ceramics is fundamental. This article point out about the essential criteria to promote a clinical succeed of the technique over the years.

Treatment planning concepts for the ageing patient.

There is an ageing imperative in Australia as in many other industrialized nations, and these populations are extremely heterogeneous. In young adults, the factors which influence decision making for oral health care are whether the patient has the will, the time or the finances to pay for care, while for clinicians, the decisions are whether they have the skill and the resources to carry out the treatment plan. For older adults, the decision making includes all of the previous identified factors, but they are now complicated by the patient's medical and medication problems, the side effects of the medications they are taking, their cognitive status as well as the cumulative effects of a lifetime of physiological, traumatic and iatrogenic effects on the dentition and the oral cavity. The decision-making process which has evolved has been called many names, from cost-effective care to minimal invasive dentistry to rational dental care. Fundamentally, they are similar. Rational dental care has been defined as the process of decision making, which develops a treatment plan that is in the best interest of the patient after evaluating all of the modifying factors. This article will discuss the various concepts, and the strengths and weaknesses of some of these systems. It will also illustrate some of the clinical problems as there is very little evidence-based data to support any of these concepts. However, treatment planning is still an art, which can only be carried out for an individual and not a group, and the result must serve the needs of the patient and enhance the quality of his or her life.

Biomimetic remineralization of demineralized dentine using scaffold of CMC/ACP nanocomplexes in an in vitro tooth model of deep caries.

Currently, it is still a tough task for dentists to remineralize dentine in deep caries. The aim of this study was to remineralize demineralized dentine in a tooth model of deep caries using nanocomplexes of carboxymethyl chitosan/amorphous calcium phosphate (CMC/ACP) based on mimicking the stabilizing effect of dentine matrix protein 1 (DMP1) on ACP in the biomineralization of dentine. The experimental results indicate that CMC can stabilize ACP to form nanocomplexes of CMC/ACP, which is able to be processed into scaffolds by lyophilization. In the single-layer collagen model, ACP nanoparticles are released from scaffolds of CMC/ACP nanocomplexes dissolved and then infiltrate into collagen fibrils via the gap zones (40 nm) to accomplish intrafibrillar mineralization of collagen. With this method, the completely demineralized dentine was partially remineralized in the tooth mode. This is a bottom-up remineralizing strategy based on non-classical crystallization theory. Since nanocomplexes of CMC/ACP show a promising effect of remineralization on demineralized dentine via biomimetic strategy, thereby preserving dentinal tissue to the maximum extent possible, it would be a potential indirect pulp capping (IPC) material for the management of deep caries during vital pulp therapy based on the concept of minimally invasive dentistry (MID).

Incipient caries lesions: from concept to actual treatment approaches

The concepts introduced by the Minimally Invasive Dentistry (MID) allowed the rising of new conservative treatment and assessment system for caries lesions’ classification. In this context, the approaches of the incipient caries lesions surpass the use of only traditional restorative techniques. The aim of this study was to review the new caries classifications criteria (ICDAS and CAST), the importance of the early diagnosis of caries lesions and the clinical procedures for treatment in MID.

A comparative in vitro efficacy of conventional rotatory and chemomechanical caries removal: Influence on cariogenic flora, microhardness, and residual composition.

Background:Chemomechanical caries removal system is part of the minimal invasive dentistry; the aim of the study was to compare the amount of bacteria after caries removal with chemomechanical system and conventional rotatory instruments and to test the Vickers microhardness and micro-RAMAN analysis of residual dentin after excavation.Materials and Methods:Molars were induced for demineralization, confirmed with DIAGNOdent; Streptococcus mutans were inoculated into the cavities and filled. Caries removal was performed with rotatory instruments and chemomechanical system; surviving bacteria were cultured for 24 and 48 hours at 37°C. Vickers microhardness and micro-RAMAN analysis were tested after excavation. Data were analyzed with Wilcoxon, continuity correction, odds ratio, ANOVA post hoc Tukey test, and Spearman correlation.Results:Demineralization was significantly detectable at 240 hours of incubation; conventional rotatory instruments and chemomechanical caries removal were effective in 19.4%-22.6% and 25.8%-32.3%, respectively. Vickers microhardness of chemomechanical system was higher (P < 0.0001) than conventional rotatory instruments and comparable to healthy dentin. Micro-RAMAN analysis showed that healthy dentin is correlated to chemomechanical system (R2 = 0.683, P < 0.00001) and drilling with burs (R2 = 0.139, P < 0.00001).Conclusion:The chemomechanical system is effective for caries elimination, comparable to conventional rotatory instruments; the remaining Vickers microhardness and composition surface tissue are similar to healthy dentin.

Orthodontie et finitions cosmétiques composites : approche ultra-conservatrice de la restauration du sourire

Thanks to alignment, bleaching and bonding, cosmetic dentistry is rising. The cases presented in this article are treated through minimal invasive dentistry linked to orthodontics.

Preventive and Minimal Invasive Dentistry in Adult Patients

Preventive and Minimal Invasive Dentistry in Adult Patients

Reorientating dental curricula to reflect a minimally invasive dentistry approach for patient‐centred management

Minimally invasive dentistry (MID), together with patient-centred care (PCC), can be considered central to patient management. These approaches have been incorporated in the structure of various dental curricula and indeed formally assessed. However, there is limited evidence that students have an integrated skill-set and are able to apply these skills when providing direct patient care within the clinical setting. Assessment of students' application of core clinical skills has identified numerous deficiencies that need to be addressed. The revised Bachelor of Dental Surgery curriculum at the School of Dentistry, The University of Adelaide, provides an example of how MID, underpinned by PCC, can be presented throughout a dental curriculum. Essentially, MID and PCC are not considered as separate subjects but as a patient management approach that is 'woven into the whole fabric' of the curriculum. The programme relies on the development of empathic communication skills that enable students to obtain key patient information, including their patients' values, beliefs, needs, preferences and expectations, thereby allowing management to be tailor-made. As a result, patients are empowered to be a part of the oral health care team. The Adelaide undergraduate dental curriculum consists of one clinical stream called Dental Science and Practice (DSP), that promotes the application of student knowledge, skills and behaviours in the clinical setting. Vertical and horizontal integration, aligned with an integrated approach to assessment, drives the learning throughout the programme. Clearly-defined outcomes are introduced by Integrated Learning Activities (ILAs) that provide a focus for associated learning activities (e.g. class meetings, tutorials, simulation laboratories, etc). The aim of this approach to learning and teaching is to ensure the required learning outcomes are achieved. It also requires coordinated teaching teams including trained external tutors who clearly understand all aspects of MID and PCC within the curriculum structure.

The concepts of minimally invasive dentistry and its impact on clinical practice: a survey with a group of Brazilian professionals

This cross-sectional study aimed to assess the knowledge and attitudes of 123 Brazilian dentists in relation to the concepts and practice of minimally invasive dentistry (MID). Data were collected through a questionnaire developed and validated by experts. Statistical analysis was performed using an spss program and Pearson's chi-square test. Most participants had up to 10years experience after graduation (69.9%), were specialised (60.2%) and worked in public and private service (43.1%). Regarding current concepts of dental caries, 87.0% were unaware and 65.9% answered that the treatment involves only the restorative phase. In relation to caries lesion arrest, 39.8% replied that it depended on the total removal of carious tissue. Most of them were aware of MID procedures (82.1%) but 49.6% did not follow them in daily practice. From these participants, 48.4% did not believe in the technique or did not know how to perform it. Decisions on partial or total removal of carious dentine, behaviour in relation to the procedures (permanent or temporary) and the practice of MID were not influenced by how long since the professionals had graduated or become specialised. It can be concluded that scientific evidence reaches most of the professionals, but does not benefit all patients, as many practitioners still follow the principles of total removal of carious tissue. Teaching should include making professionals fully aware of the carious process and encourage them to fully adopt the techniques and attitudes of MID.

Carisolv- An Innovative Method of Caries Removal

The use of minimal invasive dentistry and attention to patient comfort is of utmost importance especially for the school children and anxious and uncooperative patients. This demanded the newer patient friendly technique in dentistry amongst which is the Chemo mechanical caries removal (CMCR). CMCR involves the selective caries removal of carious dentine. As only the carious dentine is removed the painful removal of sound dentine is avoided and the anxiety due to the vibration of the handpiece is also reduced thus it appears to be more comfortable to the patient. CMCR although more prolonged procedure, is effective in caries removal. Thus CMCR is an effective alternate method for caries removal; it is more conservative and appears to be more comfortable for the patients.