<p>Conservative Composite Resin Restoration for Proximal Caries – Two Case Reports</p>

Abstract

The paradigms of contemporary caries management have shifted to minimal intervention dentistry. Conservative restorative procedures are recommended to replace the complete removal of all carious tissues in the management of dental caries. This article reports two clinical cases of conservative restorations of proximal caries. Different conservative cavity designs and restorative techniques were performed in the two cases. Proximal caries in posterior teeth were prepared using the box-only preparation technique or the proximal tunnel preparation technique. The cavities were restored directly with resin composites. The advantages of using the box-only preparation with fissure sealant included the maximum conservation of tooth hard tissues and the prevention of unnecessary tissue removal in the occlusal surface. The tunnel preparation preserved the marginal ridge and protected the restored tooth from fracture. The filling of composites into the tunnel demonstrated a better marginal adaptation than other restorative materials. These two techniques allowed for the preservation of more healthy dental hard tissue compared with traditional techniques. Potential problems in the restoration included the high incidence of the inappropriate removal of dental hard tissue, damage of the vital pulp and the microleakage due to the polymerization shrinkage. The solutions to minimize the risk of these problems in the operative procedures were discussed.

Tunnel Restoration: A Minimally Invasive Dentistry Practice

“…Three essential conditions should be attained in the operation process to achieve the proper visualization for preventing inadequate enamel/dentin removal in the cavity preparation: (i) a clear operation field, (ii) strict moisture control and (iii) suitable magnification. 38 A clear operation field should be obtained before the operative intervention. Removing supra-/sub-gingival plaque, debris and calculus are essential.…”

“… 11 In addition, to ensure that the lesion is cavitated and to improve visual access, it is useful to separate teeth by placing an orthodontic elastic separator for a week to develop a small interproximal space. 38 Moisture control via applying a rubber dam is helpful for restoration with high quality. In addition, using magnifying loupes helped reduce marginal overhangs by up to 40%.…”

“…72 Therefore, experienced operators adopting new technologies, such as a magnifying loupe, and bonding, and using durable materials (composite resin, silver amalgam) may indicate higher success rates of tunnel restorations. 38,66,69…”

Minimally invasive treatment of dental caries, an update

“…This form of treatment uses the kinetic energy of abrasive grains in a stream of compressed gas (usually air) [33] . Its action consists of launching abrasive particles of aluminum oxide at high velocity, having a de-galling effect on the hard structures of the tooth and producing a temperature rise [34] . It is a technique used for small cavities [35] .…”

“…The pressure range is between 40-160 psi and the particle size ranges from 27 to 50 um. The larger the particle size, the more abrasive [34] . Aluminum oxide is characterized by being chemically stable, non-toxic, and water-coupled [36] .…”