The Class II caries lesion. Part 1: Diagnosis and non-invasive management

Reductions in caries prevalence and a greater understanding of the caries process have meant that a more conservative, non-invasive approach to the treatment of early enamel lesions is possible. As the progression of approximal enamel lesions is generally slow, lesions that do not radiographically penetrate to the amelodentinal junction can be considered to have a good chance of being treated non-invasively. Both in vitro and in vivo experiments have shown that softened enamel surfaces can be rehardened and that fluoride applications enhance this remineralisation. For those accessible approximal lesions showing evidence of discrete disruption of the enamel surface an impregnation with resin may be effective. Although this type of approach to the management of the early carious lesion may not be equally successful in all patients, it will in many instances avoid the sequelae of recurrent decay, compromised gingival health, and inevitable failure associated with conventional approximal restorations.