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Ultraconservative approaches for

non cavitated caries management

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Aims•  The aim of this presentation is to discuss

the ecacy of current nonsurgicaltreatments for non-cavitated cariouslesions in permanent teeth.

• Surgical intervention in carious lesionswhich can be managed by moreconservative approaches is an archaicconcept which leads to a vicious cycle ofdebridement and restoration which waslikely to be repeated, tooth etractionwas the most reliable method oftreatment for carious lesions

•

 The fear of dentists is well documentedin all forms of media

• !ewer approaches to treating caries inits early stages which eliminates the useof dental drills makes it more acceptable

for many patients

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"aterials and methods

• A search of peer-reviewed dentalliterature from #ub "ed and "$%&'!$databases was conducted and

limited to dental (ournals. )ey wordsincluded reminerali*ation and resinin+ltration. Titles, abstracts and full

articles were reviewed andevaluated.

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esult

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eminerali*ing agents

•  The main reminerali*ing agents are##-A# and ##-A#, with ma(orattention for the ##-A# which is ananocomple thought to provide areservoir of calcium and phosphateions to maintain a state of super-

saturation with respect to toothenamel and bu/er pla0ue p1.

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aries in+ltration with low viscosity

resin

•  The aim of resin in+ltration is to soak up the porouslesion body with a low-viscosity resin 2in+ltrant3 thatis subse0uently hardened with blue light. Thereby,di/usion pathways for cariogenic acids are blocked,

and lesions are sealed and the progression isarrested.

• Also it prevents scattering of light from the air +lledpores reducing the opacity of the lesion and

improving the esthetics.•  The fact that it re0uires no 4drilling5 is so appealing

to the patients that '6! was featured in eader5sdigest, popular science and on fo news.

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• 't has certain advantages over thereminerali*ing approach that theappearance of even deep lesions can

be improved and the estheticimprovement is visible immediately.

• Also it sacri+ces negligible amount of

surface enamel by etching andpolishing compared to enamelmicroabrasion and traditional

restorative procedures.

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6!&US'6!S

• 'n the last 788 years, dentistry has shown agreat change in the approaches adopted totreat carious lesions. The e/ectiveness ofnonsurgical methods to treat enamel lesions isfully recogni*ed, and these methods can beused by clinicians worldwide.

• %ental professionals can now treat a potential

problem at the point of discovery until itbecomes a bigger problem. This thereforebridges the gap between prevention andrestoration.