minimal intervention ddentistry

8/13/2019 Minimal Intervention Ddentistry

1/12

International Dental Journal (2000) 50, 112

2000 FDI/World Dental Press0020-6539/00/01001-12

Minimal intervention dentistry areview*

FDI Commission Project 1-97

Martin J. TyasMelbourne, Australia

Kenneth J. Anusavice

Gainesville, USAJo E. FrenckenNijmegen, The Netherlands

Graham J. MountAdelaide, Australia

The concept of minimal intervention dentistry has evolved as a conse-quence of our increased understanding of the caries process and thedevelopment of adhesive restorative materials. It is now recognised thatdemineralised but noncavitated enamel and dentine can be healed, andthat the surgical approach to the treatment of a caries lesion along with

extension for prevention as proposed by G V Black is no longer tenable.This paper gives an overview of the concepts of minimal interventiondentistry, describes suggested techniques for a minimally invasive opera-tive approach, and reviews clinical studies which have been carried out inthis area.

Key words: Dental caries, cavity design, adhesive restorative materials

*Project initiated and report approved by FDI Commission

Correspondence to: Professor Martin J. Tyas, School of Dental Science, The Universityof Melbourne, 711 Elizabeth Street, Melbourne 3000, Australia.


2/12

2

International Dental Journal (2000) Vol. 50/No.1

Biological approach to earlylesions


3/12

3

Tyas et al.: Minimal intervention dentistry a review

The concept of minimalintervention dentistry

Adhesive restorative materials

Glass-ionomer (polyalkenoate)cements28


4/12


4

Resin composites/dentinebonding agents35

Lamination (sandwich)technique

Cavity designs


5/12


5

Table 1 Classification of cavities41

Cavity SizeCavity Site Size 1 Size 2 Size 3 Size 4 Minimal Moderate Enlarged Extensive

Site 1 Pits and fissures 1.1 1.2 1.3 1.4Site 2 Approximal surfaces 2.1 2.2 2.3 2.4

Site 3 Cervical region 3.1 3.2 3.3 3.4


6/12


6

Survival of restorations placedusing minimal interventiontechniques

Table 2 Survival results of preventive resin restorations (PRR)in permanent teeth. N = number at last evaluation.

Source Duration N Survival %

Kilpatrick et al., 199689 1.5 66 97King et al.,199690 1.5 532 98Granath et al., 199291 2 87 96

Roth & Conroy 199292

2.3 100 96Simonsen, 198047 3 232 99Welbury et al., 199050 5 150 95Houpt et al., 199451 9 79 75Mertz-Fairhurst et al., 199837 10 85 87

Preventive resin restorations

Survival of preventive resinrestorations

Atraumatic RestorativeTreatment (ART) restorations


7/12

Survival of ART restorations

Table 3 Survival of single-surface ART restorations in the permanent dentition. N =number at last evaluation

Source Period Patient age N Survival (per cent)1y 2y 3y

Panthumvanit et al., 199658 199194 758 144 93 83 71Mallow et al., 199857 199396 1217 39 78 59

Frencken et al., 1998a46

199396 1316 197 93 89 85Frencken et al., 1998b93 199497 1316 206 99 94 88Ho et al., 199956 199597 adults 100 98 93

Table 4 Survival results of total tunnel restorations inpermanent teeth. N = number at last evaluation

Source Duration (y) N Survival %

Svanberg, 199260 3 11 91Strand et al., 199662 3 161 46Lumle & Fisher, 199559 5 33 79Hasselrot, 199761 7 121 39

Tunnel and internal'restorations

Survival of tunnel and internalrestorations


7


8/12

Minibox restorations

Survival of mini-box restorations

Summary of clinical studies

Table 5 Survival results of mini-box restorations. N = number at lastevaluation

Source Duration N Survival %

Kreulen et al., 199568 2.2 64 100Andersson-Wenckert et al., 199566 3 9 75Kreulen et al., 199869 5 67 100

Nordbo et al., 199867

7.2 36 70

Repair of defective restorations

Amalgam

Resin composite


8


9/12

Repair vs replacement

Conclusion


9


10/12

Acknowledgements

References


10


11/12


11


12/12


12

minimal intervention ddentistry

Documents