Minimal treatment of the carious lesion

The development of reliable adhesive technology in the oral cavity has opened the way to an entirely new approach to the treatment of active carious lesions. The initial lesion, prior to complete penetration of the enamel, can often be controlled with remineralization techniques. However, once the dentine is breached, surgical intervention is required. With modern instrumentation, including fibre-optic lighting and magnification with binocular loupes, a more surgical approach has been developed, allowing removal of caries with very limited destruction of sound tooth structure. Experience over the last 5 years has led to the development of a classification of cavity designs as well as a reliable method of instrumentation and restoration based on the use of glass-ionomer cement and composite resin. The remineralization available through the glass-ionomer cements and the adhesion developed with both the cement and composite resin allows for maintenance of the original strength of the tooth along with a high resistance to further breakdown. The classification of cavity design is presented as well as a detailed description of the suggested instrumentation for the development of the cavities.