Minimally Invasive Treatment
Minimally Invasive Treatment Uppermost in our minds should be how to be the least invasive as possible. How to keep any stress to a minimum to all of those involved clinically and patient wise. We are now in a position that we must implement the principles of MID. Once we have confirmed that treatment is required we should consider the following. What can I do to sort it out? Can I do a better job than previously had been done? What measures need to be taken to reduce re-treatment? And even more so now we must look very closely at assessing whether it is possible to treat without the use of the drill. Could we rely upon a combination of the A.R.T. technique and the newer biometric materials as well as ‘older’ GIC materials as those from GC and other fine dental companies? Atraumatic restorative treatment (ART) is, as you know, an alternative treatment for caries removal with sharp hand instruments only. Therefore, no electricity or anaesthesia is required and pain being kept to a minimum as opposed to that experienced in conventional cavity preparation. This has often been the treatment of choice with children. Micro-invasive burs from Komet and their ceramic burs, which remove soft caries with minimal thermal stimulation brought about by conventional metal burs. The ceramic burs are what I would class as a “smart bur” as they are very sharp and remove soft caries with ease, but when striking harder/sound tooth structure the operator is aware of this and this enables them to stop, thus resulting in less removal of sound tooth. I have found that they supersede the use of hand instruments. They are fully autoclavable and for use in slow handpieces. CariSolv is an older Swedish product has sound evidence for the removal of affected dentine.It selectively softens necrotic tissue in affected dentine and preserves healthy tissue. This is then removed with the ART technique or ceramic burs.
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