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At least 865 records · Page 48Linked to original sources
PubMed2006

Minimally invasive dentistry: a review and update.

The term "Minimal Invasive (MI) Dentistry" can best be defined as the management of caries with a biological approach, rather than with a traditional (surgical) operative dentistry approach. Where operative dentistry is required, this is now carried out in the most conservative manner with minimal destruction of tooth structure. This new approach to caries management changes the emphasis from diagnosing carious lesions as cavities (and a repeating cycle of restorations), to one of diagnosing the oral ecological imbalance and effecting biological changes in the biofilm. The goal of MI is to stop the disease process and then to restore lost tooth structure and function, maximizing the healing potential of the tooth. The thought process which underpins this new minimal invasive approach can be organized into three main categories: (1) Recognize, which means identify patient caries risk, (2) Remineralize, which means prevent caries and reverse non-cavitated caries, and (3) Repair, which means control caries activity, maximize healing and repair the damage. The disease of dental caries is not just demineralization, but a process of repeated demineralization cycles caused by an imbalance in the ecological and chemical equilibrium of the biofilm /tooth interface (the ecological plaque hypothesis). Dietary and lifestyle patterns, especially carbohydrate frequency, water intake and smoking, play an important role in changing the biofilm ecology and pathogenicity. Tools for chairside assessment of saliva and plaque, allow risk to be assessed and patient compliance monitored. The remineralizing properties of saliva can be enhanced using materials which release biologically available calcium, phosphate and fluoride ions (CPP-ACP and CPP-ACFP). Use of biocides can also alter the pathogenic properties of plaque. Use of these MI treatment protocols, can repair early lesions and improve patient understanding and compliance. This review article introduces some of the key concepts and practical aspects of minimally invasive dentistry.

Caseins↗
PubMed2002

[Effect of sodium chloride treatment on remineralization of human root dentine caries in vitro].

OBJECTIVE: To investigate the influence of soluble phosphoprotein removal from artificial dentin caries lesions by pretreatment of NaCl on subsequent remineralization. METHODS: Human root dentin samples were demineralized in an acidic gel (pH = 4.4) at 37 degrees C for 48 hours. Samples were pretreated with 0.5 mol/L NaCl solution and 0.5 mol/L disodium EDTA solution respectively. The histomorphologic changes of root caries surface were examined by scannings electronic microscope. Mineral profiles were assessed by means of microradiography. RESULTS: No histomorphologic changes were present on root caries surface after treated with 0.5 mol/L NaCl solution, while many opened dentin tubules were seen after treated with 0.5 mol/L disodium EDTA solution. The remineralization results showed that pretreatment with 0.5 mol/L NaCl solution increased more remineralization than pretreated with 0.5 mol/L disodium EDTA solution. CONCLUSION: 0.5 mol/L NaCl solution has no damage on the root caries surface. The in vitro results suggested that removal of soluble phosphoprotein from dentin lesions is an interesting approach to enhance remineralization.

Dental Caries↗
PubMed1994

Characteristics of a fluoride-releasing elastomeric chain.

The physical properties and fluoride releasing capabilities of a recently introduced fluoride-containing elastomeric chain (Fluor-I-Chain) have been evaluated and compared to those of a standard gray elastomeric chain. When stored in solution, there was a progressive loss of the force delivered by both types of chains. In particular, they both required increased displacement to achieve force levels of 150g and 300g but the fluoride chain required significantly more displacement to achieve the same force level. When maintained at a constant distraction of 100%, Fluor-I-Chain was unable to deliver a force within the optimal range for tooth movement after one week. In contrast, the force delivery level of the standard gray chain remained adequate over the entire three-week test period. Fluoride was released by the fluoride-containing chain over a three-week period at a level that could inhibit demineralization and promote remineralization.

Analysis of Variance↗
PubMed1980

In vivo remineralization using a sustained topical fluoride delivery system.

The efficacy of a new remineralization system was determined in vivo by maintaining a low concentration of approximately 1 ppm fluoride for 48 hrs against a demineralized human tooth. Human subjects were selected who wore removable partial dentures containing two or more of the demineralized teeth with film system. The findings indicate levels of fluoride uptake to 500 ppm at 50 micron depths in experimental sites.

Delayed-Action Preparations↗
PubMed2005

Optimal Er:YAG laser energy for preventing enamel demineralization.

OBJECTIVES: The purpose of this study was to identify the optimal laser energy range of Er:YAG laser irradiation for laser-induced caries prevention (LICP). METHODS: Twenty-one human non-carious molars were selected. The teeth were covered with nail varnish, except two 4 mm x 1 mm windows on both the buccal and lingual surfaces. The windows were randomly assigned to groups A, B, C and D, receiving no irradiation, 100, 200 and 300 mJ irradiation, respectively. The pulse width 10 pps (pulse per second) with a 1.0 mm spot size was used. After the laser treatment, each tooth was cut into two halves longitudinally. Then a two-day pH-cycling was performed, with an 18-hour demineralization followed by a 6-hour remineralization. Sections of 120 +/- 20 microm in thickness were obtained from each window. Lesion depth was measured using polarized light microscope coupled with an image analysis software. One-way ANOVA and post-hoc Tukey tests were used for evaluation of treatment effects. RESULTS: The laser treatments of 100 and 200 mJ have demonstrated significant protection of enamel demineralization (p = 0.01 and 0.001, respectively), but not the treatment with 300 mJ (p = 0.106). A smaller lesion depth was observed for the 200 mJ group (97.1 microm) than that of the 100 mJ group (105.6 microm). Compared with the control, a lesion reduction of 32.78 and 26.93% for the 200 mJ group and the 100 mJ group were obtained, respectively. CONCLUSION: Caries prevention may be achieved by using Er:YAG laser treatment if the optimal range of laser parameters for LICP can be employed.

Aluminum↗
PubMed1981

Rapid maxillary expansion and external root resorption in man: a scanning electron microscope study.

The effects of rapid maxillary expansion on the external root structure of thirteen appliance-attached and five unattached maxillary first premolars from nine patients have been investigated with the scanning electron microscope (SEM). Topographic features of cementum and dentine resorption, as well as initial and subsequent remineralization changes, are described in detail. All anchor premolars exhibited root resorption, which was mostly confined to the buccal surface. Generally, the longer an anchor tooth remained in fixed retention, the more extensive the buccal root resorption. In contrast, the unattached maxillary first premolars and the opposing mandibular first premolars showed no evidence of resorption. Active resorption was the dominant process in anchor premolars extracted almost immediately after rapid expansion. Subsequently, repair became the predominant process, but continuing resorption was apparent even after 9 months of retention. Repair of root defects occurred by the deposition of cellular cementum which revealed little evidence of principal periodontal fiber reattachment within the advancing mineral front. The resorption pattern identified in the scanning electron microscope was not detected by in vivo radiographic examination. The significance of the findings is discussed.

Activator Appliances↗
PubMed1991

Reaction paper: the use of topical and systemic fluorides in the present era.

Systemic fluoride may enhance the resistance of the tooth by way of (1) an alteration in tooth morphology, and (2) a conversion of the hydroxyapatitic mineral to a fluoridated state with an attendant reduction in solubility and an enhancement of the remineralization phase of the caries process. It has been reported by a number of investigators, although it is not universally accepted, that the posterior teeth from fluoridated areas have a distinct morphology that is less susceptible to caries attack. Fluorapatite and hydroxyapatite do not differ appreciably with respect to the amount of mineral that dissolves at a specified concentration of acid. However, if solubility is considered as a function of pH at equilibrium, i.e., the final pH after the dissolution products have entered the solvent--a model more akin to the in vivo situation--hydroxyapatite is the conspicuously more soluble of the two minerals. In this connection, epidemiologic data suggest that children with unusually high levels of surface enamel fluoride have little or no caries. This observation is consistent with the finding that the solubility of solid apatite solutions with varying degrees of fluoride substitution was inversely related to fluoride content, with minimal solubility at 0.5 substitution, a value observed in natural teeth at the very outermost surface of the enamel. Evidence of a preeruptive effect of fluoride has also been shown in field studies in which subjects had reduced levels of caries with fluoride exposure in childhood only.

Administration, Oral↗