Minimalistic Approach for Conservative Restorations
The traditional restorative treatment of a carious decay implies traumatic preparation. Cleaning the softened demineralized dentin using manual or mechanical methods leads to geometrical preparation of cavities displaying flat surfaces (cervical and/or pulpal), at right angles from each other. Taking advantage from the geometry of the cavity, horizontal and plane surfaces contribute to preparation of cavities according to GV. Black’s principles (1908). Ultimately, the cavity is filled with a biocompatible material. All these successive steps refer to old concepts, as they were developed in textbook or in manuals published in the previous century.
The recent evolution of the preparation of cavities, adhesive properties of resin-containing cements or glass ionomers, and the biological properties of adhesive-containing materials leads to improve adhesion and promote atraumatic restorative treatment (ART). This is based on clinical decisions linked to caries risk assessment (CRA). The aims of minimal invasive therapy are oriented toward the reduction or evolution of carious lesion. These methods are focusing on the enhancement of methods of prevention, keeping the teeth functional for the whole life. These methods constitutes a whole set of investigations, avoiding unnecessary preventive measurements. Minimal approaches associate enamel and dentine carious lesions, linking the various stages of the lesion to the depth of the dentin decay.
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