The concept of minimal intervention dentistry has evolved as a consequence of our increased understanding of the caries process and the development of adhesive restorative materials. It is now recognised that demineralised but noncavitated enamel and dentine can be 'healed', and that 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 intervention dentistry, describes suggested techniques for a minimally invasive operative approach, and reviews clinical studies which have been carried out in this area.
The requirements for an ideal restorative material include adhesion to tooth structure (enamel and dentine) and an ability to withstand the traumas of occlusion. However, some level of an anticaries effect is also desirable. After a long history of glass-ionomer cement (GIC) development, an evidence base in support of the therapeutic effect of GIC, particularly with regard to its anticaries effect, is emerging. This evidence is increasingly presented through systematic reviews of clinical GIC application and, to a certain extent, relates to a caries-preventive effect of the material itself. However, the strength of evidence supporting other aspects of GIC, such as a higher remineralizing effect, fluoride uptake in hard tooth tissue and fluoride release of GIC, is limited. Nevertheless, the results of these in situ and laboratory trials provide valuable insights into factors that facilitate understanding of the clinical efficacy of GIC.Keywords: Glass-ionomer cement, caries, systematic review evidence.Abbreviations and acronyms: ART = Atraumatic Restorative Treatment; ASPA II = alumino-silicate polyacrylic acid; GIC = glass-ionomer cement; KHN = Knoop hardness number; RCT = randomized control trial; RR = restorative risk.
Background: According to the classification suggested by McLean, Wilson and Nicholson only three materials, currently marketed, fit the designation of resin modified glass-ionomers. These materials will undergo an acid/base setting reaction but also contain a limited quantity of a monomer that will polymerize as a result of irradiation. The quantity of polymer is limited to the extent that it will not interfere with the normal acid/base setting reaction and will therefore allow for the ion exchange adhesion with tooth structure that is typical of glass-ionomer. There is a third setting reaction incorporated to ensure remaining monomer, that is not affected by irradiation, will still polymerize. A series of experiments were carried out to determine the effect of the three types of setting reaction on the strength, depth of cure and translucency of these three materials. Methods: Specimens, both with and without irradiation, were subjected to a shear punch strength test. To determine the depth of cure brought about through irradiation, specimens were tested immediately after construction according to the test in ISO -4049 2000 (E). Translucency is clinically significant and will vary according to whether the material has been subjected to irradiation or cured through the acid/base reaction alone.
Results:The strength of all materials tested was higher in specimens subject to irradiation. The depth of cure was found to be both shade and irradiation time dependent. Irradiated specimens were found to be only marginally more translucent than those allowed to set without irradiation. Conclusions: It was concluded that, for cavities more than 3mm deep, these materials should be placed incrementally to allow for a full irradiation initiated cure.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.