Minimal Invasive

Dentistry

Dr. Rabab Salama

•Minimally invasive dentistry is a concept involving

early to advanced carious lesions and their minimal

treatment or retreatment.

•“Extension for prevention” has given way to the new

paradigm of minimally invasive dentistry which

includes the following concepts:

• Determination of caries risk assessment

• Early diagnosis of caries (early caries detection).

• Reduction in cariogenic bacteria, either chemically or

mechanically, to reduce and prevent future carious lesions.

• Control of caries as an infective communicable disease.

• Remineralization techniques for early lesions.

• When tooth restoration is necessary, using minimal restorative

intervention of cavitated lesions.

• Repairing rather than replacing defective restorations.

The four core principles of MID

•Recognition – early identification and assessment of potential caries

risk factors through lifestyle analysis, saliva testing and using plaque
diagnostic tests;
•Reduction – to eliminate or minimize caries risk factors by altering
diet and lifestyle habits and increasing the pH of the oral environment;
•Regeneration – to arrest and reverse incipient
lesions, using appropriate topical agents including
fluorides and casein amorphous calcium
phosphates (ACP)

•Repair – when cavitation is present and surgical

intervention is required, conservative caries
removal is carried out to maximize the repair
potential of the tooth and retain tooth structure.
Minimally-invasive treatment in dentistry
was pioneered in

1.1970s by application of silver diamine fluoride

2.1978 by Preventive resin restoration (PRR)

3.1980s by Atraumatic restorative treatment (ART)

4.1990s by Chemo-mechanical caries removal concepts

 Recent Cavity
Classification Systems
Site 1 Size 1
Site 1 Size 2
Site 1 Size 3
Site 1 Size 4
Site 2 size 1

• Tunnel
• Minibox / slot
• Proximal approach
Tunnel
Minibox / Slot
Proximal Approach
Site 2 Size 2
Site 2 Size 3
Site 2 Size 4
Site 3 Size 1
 Site 3 Size 2

Restoration done with GIC

Site 3 Size 3

Modified glass – ionomer

Site 3 Size 4
MID technique

• Mechanical Rotary High/Low-Speed Bur

• Atraumatic restoration
• Air abrasion
• Air Polishing
• Laser
• Chemo mechanical agent
• Pit and fissure sealant
• Ozone Technology
 ATRAUMATIC RESTORATIVE TREATMENT
(ART)

• It is also known as “Alternative Restorative Treatment”.

• ART is launched by the World Health Organization on

7th April, 1994 (World Health Day).
• The essential instrument used for ART
are:
1. Mouth mirror
2. Explorer
3. Pair of tweezers
4. Dental hatchet
5. Small, medium sized spoon excavators
6. Glass slab
7. Spatula
8. Carver
• The materials used are:
1. Gloves
2. Cotton rolls and pellets
3. Glass ionomer restorative material
4. Dentin conditioner
5. Petroleum jelly
6. Wedges
7. Plastic strips and water
 Procedure for ART

1. preoperative 3. cavity after caries removal

2. excavation of caries 4. cavity conditioning

5- Dispensing of GIC 7- Insertion of GIC

6- Mixing of GIC 8- Restored cavity

 Air abrasion

• It is a method of tooth structure

removal that is considered to
be an effective alternative to
the standard dental drill.

AIR ABRASIVE SYSTEM

 Advantages
üPainless
üLocal anesthesia is rarely needed
üUsed with a small lesion
üNo vibration or pressure to cause
microfractures that weaken tooth
üNo production of heat to damage
the dental pulp
ü lesser sound tooth structure is
removed.
 Chemico-mechanical removal of caries

• An alternative to the conventional

mechanical removal of caries is
chemo mechanical method.

• The need for local anesthesia is

reduced or eliminated as there is
little pain during the procedure.
 Chemico-mechanical removal of caries
• It is an effective alternative for
caries removal because it brings
together Atraumatic
characteristics and bactericide /
bacteriostatic action.
• The chemicals used can be in the
form of liquid (caridex) or gel
(carisolv).
• Papacarie’s bactericidal, bacteriostatic and anti-
inflammatory characteristics. Papain comes from the
latex of the leaves and fruits of the green adult papaya
Resin Infiltration (Icon)
THANK YOU