The Journal
EDITORIAL
MICRO-INVASIVE DENTISTRY
Proximal dental lesions, limited to dentine, are traditionally treated by invasive
(drill and fill) means. Non-invasive alternatives (e.g. fluoride varnish, flossing) might
avoid substance loss but their effectiveness depends on patients' adherence.
Recently, micro-invasive approaches for treating proximal caries lesions have been
tried. These interventions install a barrier either on top (sealing) or within (infiltrating)
the lesion.
Micro-invasive treatment seems more efficacious to arrest early (non-cavitated)
proximal carious lesions than non-invasive treatment (NI). Uncertainty remains as to
the efficacy of sealing versus infiltration and the robustness of the evidence.
The available evidence shows that micro-invasive treatment of proximal caries
lesions arrests non-cavitated enamel and initial dentinal lesions (limited to outer third of
dentine, based on radiograph) and is significantly more effective than non-invasive
professional treatment (e.g. fluoride varnish) or advice (e.g. to floss). We can be
moderately confident that further research is unlikely to substantially change the
estimate of effect. Different methods and materials currently available for micro-
invasive treatments are sealing via resin sealants, (polyurethane) patches/tapes, glass
ionomer cements (GIC) or resin infiltration.
Practitioners should strive to perform micro-invasive treatment instead of NI for
early proximal lesions. The decision between sealing or infiltration should be guided by
practical concerns beyond efficacy.
Dr. Amrit Raj Bahl
Editor-in-Chief
2
Vol. 14 No. 2
May-August 2018