Indirect and Direct Restorative Protocols - Caulk

› PRINCIPLES & PRACTICES
Instrumentation and Bur Selection
for Minimally Invasive
Tooth Preparation
› Abstract:
Significant improvements in the oral
health of the worldwide population and
increasing patient interest in aesthetic
dentistry have resulted in an emphasis
on minimally invasive treatment
options. Conservative treatment of
diseased tooth structures is a valuable
part of a modern and comprehensive
approach to the management of
the dentition. This presentation
will discuss preparation design and
instrumentation required to deliver
minimally invasive dental treatment,
highlighting key considerations and
illustrating design requirements.
Minimally invasive
dentistry is in part
a byproduct of
clinicians’ greater
understanding of
the cavitation process and the therapeutic
benefits of adhesive dentistry.
The ultimate objective of minimally
invasive dentistry is the preservation
of tooth structure for strength and
long-term function. Innovative diagnostic
devices such as Midwest Caries
I.D. (DENTSPLY Professional,
York, PA) and other means of caries
detection have supported the transition
to minimally invasive dentistry,
thus better enabling the practitioner
to conservatively respond to the oral
health needs of today’s patient. Management
of patients with dental caries
involves careful treatment planning
as well as the selection of appropriate
instrumentation during restorative
care (Figure 1). Proper maintenance
and home care are also important in
managing the caries-prone patient.
If an area is suspected to have caries
involvement, detection—either
through conventional methods (eg,
radiographs, explorers) or technological
means such as with Midwest
Caries I.D.—is important as the
clinician attempts to prevent the
caries process from progressing. Any
such exploration should be as conservative
as possible and confined to
tooth enamel.
When preparing for exploration
or direct restoration of initial caries,
access should be performed using
Figure 1. Tapered, round-end burs (ie, Midwest ® Esthetic Finishing
Bur, DENTSPLY Professional, York, PA) are well suited for conservative
preparation along the buccal grooves of the tooth.
Figure 2. Use of a 1/4 small round carbide (Esthetic Finishing Burs,
DENTSPLY Professional, York, PA) allows conservative access to caries.
Preservation of tooth structure is the key to conservative dentistry.
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