Use of new minimum intervention dentistry technologies in caries management.

Preservation of natural tooth structure requires early detection of the carious lesion and is associated with comprehensive patient dental care. Processes aiming to detect carious lesions in the initial stage with optimum efficiency employ a variety of technologies such as magnifying loupes, transillumination, light and laser fluorescence (QLF® and DIAGNOdent® ) and autofluorescence (Soprolife® and VistaCam®), electric current/impedance (CarieScan(®) ), tomographic imaging and image processing. Most fluorescent caries detection tools can discriminate between healthy and carious dental tissue, demonstrating different levels of sensitivity and specificity. Based on the fluorescence principle, an LED camera (Soprolife® ) was developed (Sopro-Acteon, La Ciotat, France) which combined magnification, fluorescence, picture acquisition and an innovative therapeutic concept called light-induced fluorescence evaluator for diagnosis and treatment (LIFEDT). This article is rounded off by a Soprolife® illustration about minimally or even non-invasive dental techniques, distinguishing those that preserve or reinforce the enamel and enamel-dentine structures without any preparation (MIT1- minimally invasive therapy 1) from those that require minimum preparation of the dental tissues (MIT2 - minimally invasive therapy 2) using several clinical cases as examples. MIT1 encompasses all the dental techniques aimed at disinfection, remineralizing, reversing and sealing the caries process and MIT2 involves a series of specific tools, including microburs, air abrasion devices, sonic and ultrasonic inserts and photo-activated disinfection to achieve minimal preparation of the tooth. With respect to minimally invasive treatment and prevention, the use of lasers is discussed. Furthermore, while most practices operate under a surgical model, Caries Management by Risk Assessment (CaMBRA) encourages a medical model of disease prevention and management to control the manifestation of the disease, or keep the oral environment in a state of balance between pathological and preventive factors. Early detection and diagnosis and prediction of lesion activity are of great interest and may change traditional operative procedures substantially. Fluorescence tools with high levels of magnification and observational capacity should guide clinicians towards a more preventive and minimally invasive treatment strategy.

Quantitative evaluation by glucose diffusion of microleakage in aged calcium silicate-based open-sandwich restorations.

This study compared the in vitro marginal integrity of open-sandwich restorations based on aged calcium silicate cement versus resin-modified glass ionomer cement. Class II cavities were prepared on 30 extracted human third molars. These teeth were randomly assigned to two groups (n = 10) to compare a new hydraulic calcium silicate cement designed for restorative dentistry (Biodentine, Septodont, Saint Maur des Fossés, France) with a resin-modified glass ionomer cement (Ionolux, Voco, Cuxhaven, Germany) in open-sandwich restorations covered with a light-cured composite. Positive (n = 5) and negative (n = 5) controls were included. The teeth simultaneously underwent thermocycling and mechanocycling using a fatigue cycling machine (1,440 cycles, 5-55°C; 86,400 cycles, 50 N/cm(2)). The specimens were then stored in phosphate-buffered saline to simulate aging. After 1 year, the teeth were submitted to glucose diffusion, and the resulting data were analyzed with a nonparametric Mann-Whitney test. The Biodentine group and the Ionolux group presented glucose concentrations of 0.074 ± 0.035 g/L and 0.080 ± 0.032 g/L, respectively. No statistically significant differences were detected between the two groups. Therefore, the calcium silicate-based material performs as well as the resin-modified glass ionomer cement in open-sandwich restorations.