MINIMALLY INVASIVE DENTISTRY
COMPARISON OF DIFFERENT METHODS OF EXCAVATION CONTROL FOR MINIMALLY INVASIVE CARIES TREATMENT
Nadezhda Georgieva Mitova 1a *, Maya Rashkova 1b, Galina Zhegova 1c, Todor Uzunov 2c, Dimitar Kosturkov 3d, Nikolay Ishkitiev 4e
1
Department of Pediatrics Dentistry, Faculty of Dental Medicine, Medical University-Sofia, Bulgaria
2
Department of Prosthetic Dentistry, Faculty of Dental Medicine, Medical University-Sofia, Bulgaria
3
Department of Conservative Dental Medicine, Faculty of Dental Medicine, Medical University-Sofia, Bulgaria
4
Department of Medical Chemistry and Biochemistry Faculty of Medicine, Medical University-Sofia, Bulgaria a
DDS, Assistant Professor b
DDS, PhD, Professor c
DDS, PhD, Associate d
DDS, PhD Student e
DDS, PhD, Assistant Professor
Cite this article: Mitova NG, Rashkova M, Zhegova G, Uzunov T, Kosturkov D, Ishkitiev N. Comparison of different methods of excavation control for minimally invasive caries treatment. Stoma Edu J. 2016; 3( 1): 98-106.
ABSTRACT
Received: March 6, 2016 Received in revised form: March 15, 2015
Accepted: May 3, 2016 Published online: April 21, 2016
Introduction: The change in the color of dentine, registered by visual and tactile control methods is an objective method for the assessment of demineralization of the in-depth carious process. The aim of the research is that, by means of an in vitro experiment, to study the changes in the in-depth color of dentine, during mechanical caries excavation, comparing two control methods, the visual and tactile and also by fluorescence. Methodology: The subjects of the study were 32 extracted teeth, with dentine occlusal or proximal carious lesions similar in size( D3), excavated down to the healthy or affected dentine, controlled with two methods- visual and tactile( by Bjørndal) and fluorescent. Pictures were taken from the tooth samples and the resulting images were subject to a software color analysis with the use of the Hue, Saturation and Brightness color system. Results: Visual and tactile controlled mechanical excavation down to the healthy dentine results in the dentine at the bottom of the excavation having the same characteristics as the healthy dentine, which indicates that the method is sufficiently objective but there is a risk of over-excavation. After applying the fluorescently controlled method and the fluorescence disappears after the excavation, the dentine at the bottom of the excavation has a much darker coloration than the healthy dentine. Conclusion: The fluorescent method of control gives us the opportunity to leave non-infected, demineralized dentine at the bottom of the cavity and should be the preferred method in the light of minimally invasive treatment of dentinal caries. Keywords: dentin, excavation, fluorescence, minimally invasive caries treatment.
1. Introduction
In recent years the treatment with minimal intervention has been the subject of studies in all fields of modern medicine. With regard to deep dentinal carious lesions, dental science focuses on researching and developing new methods related to the choice of technique of excavation, control during excavation and stimuli for internal remineralisation. 1, 2, 3, 4 The goal is to prevent or detect the disease in its early stage, modern diagnostic and treatment procedures with minimal intervention for the maximum preservation of dental structures to be used. The minimally invasive excavation in the treatment of deep dentinal caries requires a controlled, selective and sparing approach. Various techniques for selective excavation only of irreversibly damaged dentine have been developed. 3, 5, 6, 7 The concepts for step excavation have been created. Control during excavation is getting to be an important condition for a selective removal only of irreversibly damaged dentine and preservation of that which minimally infected is and that has preserved remineralizing
* Corresponding author: Assistant Professor Nadezhda Georgieva Mitova, DDS, Department of Pediatrics Dentistry, Faculty of Dental Medicine, University-Sofia 1, Georgy Sofijski blvd., BG-1431 Sofia, Bulgaria Tel / Fax: + 359 886 216 886, e-mail: nadia _ bm @ abv. bg
98 STOMA. EDUJ( 2016) 3( 1)