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.
Aim. To compare and contrast by three-dimensional finite element analysis the biomechanical performance of deep mesio-occlusal-distal cavities of mandibular molars reinforced by different sizes of horizontal fiber posts. Materials and Methods. The finite element (FE) stress analysis was performed with the ANSYS, a commercial finite element method package. Based on the evidence-based scientific data and on the mechanical properties of materials, i.e., Young’s modulus and Poisson ratio, the model of a mandible and mandibular first molar was replicated. The mandibular molar models replicating the clinical scenarios were simulated, designed, and built, assuming all materials to be homogenous, isotropic, and linearly elastic as follows: Model 1 control: the model of an intact first mandibular molar. Model 2: the prepared cavity mesio-occlusal-distal is replicated by the subtraction Boolean method. The remaining thickness of dentin is 1 mm. Model 3: these were rehabilitated by three different diameters of two horizontal fiber posts. Model 3A: fiber post diameter 1 mm, Model 3B: 1.5 mm and Model 3C: 2 mm. The dimensions of the cavity, the intercuspal distance between buccal walls and lingual walls, and the distance of placement of the post from occlusal reference points were all kept constant for all three subgroups of Model 3. The cavities of Model 3 were restored with Filtek bulk-fill posterior composite. After meshing the models, loads were defined on the buccal and lingual distal cusps with a constant value of 600 N and at an angle of 45°. Results. The results of finite element analysis are expressed as stresses, i.e., tensile compressive, shear, or a combination known as von Mises stresses. The overall von Mises stresses were as follows: Model 1:154.83 Mpa; Model 2: 376.877 Mpa; Model 3A: 160.221 Mpa; Model 3B: 159.488 Mpa; Model 3C: 147.231 Mpa. Statistical analysis of the compiled data was carried out. It was seen that there was a significant difference in stress values from the intact tooth Model 1 and cavity Model 2 ( p < 0.05 ) with means values of 53.1 and 139.22, respectively. The means of all subgroups were comparable but there was a statistically significant difference between Model 3, i.e., 3A (67.74), Model 3B (60.47), Model 3C (53.70), and Model 2. Model 1 and Model 3C had comparable mean values. Conclusion. Rehabilitation of deep mesio-occlusal-distal cavities of molars with intact buccal and lingual walls with the aid of a horizontal post of any diameter has a similar stress distribution to an intact tooth. However, the biomechanical performance of a 2 mm horizontal post was exacting of the natural tooth. Horizontal posts can be included in expanding our restorative option for rehabilitating grossly mutilated teeth.
Over the past few decades, technological advances in endodontics have taken quantum leaps from conventional hand files to rotary system and from direct vision to magnification. The clarity and details are achieved by magnification devices such as orascope, dental loupes, and dental operating microscope. The details are very clear and revealing so that the endodontists can achieve precision in diagnosis, treatment procedures, and final assessment of procedure performed. Magnification technique is undergoing continuous advancements, allowing a better precision and quality standard. Microdentistry with its expanding possibility and increased clinical implication has now set a higher standard in patient care and in success rate of treatment procedures.
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