The document discusses the principles and techniques of minimal invasive dentistry for diagnosing and treating dental caries, including identifying patients' caries risk factors, using remineralization methods to prevent or control non-cavitated caries, and employing restorative techniques that minimize removal of healthy tooth structure. It outlines the goals of preserving tooth structure, stopping disease progression, and restoring function with minimal intervention. The approach focuses on changing the disease process through dietary and lifestyle modifications rather than solely operative treatment.

2. The Challenge in the treatment
according to the Concept of
Minimal Invasive Dentistry
Dr.Tahani R.Jamal
Consultant in Advanced
Restorative Dentistry
University Medical Center
Identify
Prevention
Treatment
&
control
Cariology

4. CONTENTS
Introduction
2. Timeline Of Minimal Invasive Dentistry.
3. Golden Triangle Of Minimal Invasive Dentistry
4. Plan Of Minimal Invasive Dentistry
5. Goals Of Minimal Invasive Dentistry
6. Concept Of Minimal Invasive Dentistry
I. Caries Diagnosis Ii. Caries Removal Or Early
Restoration Iii. Caries Control . cariogram
interpretation .CAMBRA
7. Advantages Of Minimal Invasive Dentistry
8. Conclusion.
9. References.

5. Every thing you do to the
tooth has consequence ;
short term or long ,its
cascade of events
determines the survival
of the tooth .

7. INTRODUCTION
The goal of MID is to stop the disease process and then to
restore lost tooth structure and function, maximizing the
healing potential of the tooth.
How MID preparations the waves of the future?!

8. process of removing only minimal
carious tooth structure and
attempting to re- mineralize and
restore the remaining tooth
structure

11. Dental caries :
Microbial disease of the
calcified tissues of the
teeth characterized by
demineralization of the
inorganic portion and
destruction of organic
substance of the teeth

12. Dental Caries The is chronic, transmissible and infectious disease remain the most
prevalent health condition across the globe affecting millions of subjects. The goal of
minimal invasive dentistry of caries to preserve healthy tooth tissue throughout life. it
includes preventing disease from occurring and intercepting its progress, but also
removing and replacing with as little tissue loss as possible when operative treatment
is needed for caries prevention ,the focus on dietary recommendations, the use of
fluoride and mechanical tooth cleaning.

13. The disease of dental caries is not just
demineralization, but a process of repeated
demineralization cycles caused by an imbalance
in the ecological and chemical equilibrium of
the biofilm /tooth interface (the ecological
plaque hypothesis).
Dietary and lifestyle patterns, especially
carbohydrate frequency, water intake and
smoking, play an important role in changing the
biofilm ecology and pathogenicity.

14. Three critical factors required to achieve success clinically when using a minimally
invasive operative caries management strategy (MI OCMS):
1-The histology of the dental substrate being treated.
2-Consideration of operative techniques available to excavate caries minimally.
3-The chemistry/handling of the adhesive materials used to restore the cavity.

15. "Minimal Invasive
(MI) Dentistry”
Theterm "Minimal Invasive (MI) Dentistry" canbest be defined as the management of
caries with a biological approach, ratherthan with a traditional (surgical) operative
dentistry approach.
this is nowcarried out in the most conservative mannerwith minimal destructionof
tooth structure.Thisnew approach to caries management changesthe emphasis from
diagnosing carious lesions as cavities (and a repeating cycle of restorations), to one of
diagnosing the oral ecological imbalance and effectingbiological changesin the biofilm.

16. New Minimal Invasive Dentistry
approach can be organized into
three main categories
Recognize
which means identify
patient caries risk.
Remineralize
which means prevent caries
and reverse non-cavitated
caries Despite.
Repair
which means control caries
activity, maximize healing
and repair the damage.
caries is
not stopped by placing a
restoration.

18. Caries Diagnosis
Caries risk assessment
Early detection of caries
•Patient history
•Clinical examination
•Nutritional analysis
•Salivary analysis.

19. 19
Pre treatment Maxillary view
Post treatment Maxillary view

20. 20
Pre treatment mandibular view
Post treatment mandibular view

22. 22
Test Normal value Results
Salivary Flow
Rate
Unstimulated
( U.S.S.F.R.)
0,25 – 0,35 ml/mitue
5ml/15
min=.3 ml
Stimulated
(S.S.F.R.)
1-3 ml/minute 1ml/minute
Buffering Capacity (B.C.)
( U.S.F.R.) = 4,25 – 4,75
(S.S.F.R.) = 5,75 – 6,5
low
Bacterial
Tests
Streptococcus
Mutans Counts
(S.M.C.)
Low < 105
Medium 105 - 106
High > 106
High
Lactobacillus
Counts (L.C)
Low < 105
Medium to High 105 - 106
High > 106
High
CARIES ACTIVITY TEST:

23. Diet Analysis
&
Dietary Advice
- She eats cariogenic snack(sweets) between
meals such as chocolates
- Low amounts of fruits and vegetables.
- Prebed meal is cariogenic.
-Reduce sugar and carbohydrates intake.
- Increase fruits and vegetables.
- Reduce snacks between meals.
- Chewing Gum very helpful ,if intakes after meals that
contain sugar or between meals.
- In case of snacks ,safe food are better to eat as nuts
,cheese, vegetables and fruits.
Caries risk assessment

24. CARIES DIAGNOSIS

25. Page 25
•High amount of sugar intake.
•Frequent sugar attacks.
•poor plaque control.
•high mutants streptococci
counts.
Caries balance
Attacking factors
Resistance factors
•Normal saliva flow rate.
•saliva buffering capacity
Demineralization
(Active caries)
Attacking factors Resistance factors
Caries activity

26. Dr.Tahani 26
Cariogram

27. The Cariogram indicates a Very high risk for caries. Urgent actions are needed.
-The Diet situation with respect to both content of fermentable carbohydrates and
frequency of eating is a clear problem.
-Increase amount of water & vegetables intake to dilute viscous saliva
-The Bacterial situation with respect to both plaque amount and Mutans streptococci
level has a heavy impact.
-Improved oral hygiene, Repeated professional tooth cleaning is advised.
Chlorhexidine gel treatment session is recommended.
-Fluoride program in addition to the fluoride toothpaste is encouraged.

30. MECHANISM OF ACTION Antiplaque action of chlorhexidine
1. Prevents pellicle formation by blocking acidic groups on
salivary glycoproteins thereby reducing glycoprotein
adsorption on to the tooth surface
2. Prevents adsorption of bacterial cell wall on to the tooth
surface
3. Prevents binding of mature plaques.
CHX, an antimicrobial agent that can suppress the
growth of mutans streptococci, has been considered as
having the potential to prevent dental caries

34. Tools for chairside assessment of saliva and
plaque, allow risk to be assessed and patient
compliance monitored. The remineralizing
properties of saliva can be enhanced using
materials which release biologically available
calcium, phosphate and fluoride ions (CPP-ACP and
CPP-ACFP). Use of biocides can also alter the
pathogenic properties of plaque. Use of these MI
treatment protocols, can repair early lesions and
improve patient understanding and compliance.

36. This guide were
originally published in the
January 2019
issue of the Journal of the
California Dental
Association.
CAMBRA protocols facilitate
integration of caries
management by risk
assessment into everyday
practice.
In many dental practices through out the world, the CAMBRA philosophy
the practice routine and embodied by the entire patient care team, including
front desk staff and dentists.
has been completely incorporated into
dental assistants and hygienists,
The CAMBRA concept provides the dental professional with scientific, evidence-based solutions with which to
approach treatment of dental caries disease. understanding of the caries balance, the process of
demineralization and remineralization of tooth structure, caries risk assessment, and the different levels of
caries risk.

38. The CAMBRA system
has been shown to
be highly predictive

41. Key oral health
behaviors
-Regular daily tooth-brushing with a fluoride containing toothpaste.
-Increased exposure to fluoride, including regular use of mouthwash.
-Interdental cleaning.
-Reduction in the frequency of sugar containing foodstuffs, particularly
sugar containing snacks between meals.
-Regular attendance at the dentist (at least once every two years or more
often on the basis of their risk of developing oral disease).

42. Caries
Detection
Visual and tactile examination
• Mirror & probe
• Tooth separation Radiographic method
• IOPA • Bite wing
Conventional Method Early detection of caries
•Fiber optic transillumination
•Digital fiber optic transillumination
•Quantitative light induced fluorescence
•Laser fluorescence - DIAGNODENT •Electrical
conductance measurement
•Ultrasonic imaging
•Endoscope
•Videoscope Recent Advances
Fiber Optic Transillumination(FOTI)
DIFOTI
laserfluorescence/ Diagnodent. Quantitative light-
induced fluorescence.
Caries Detecting Dyes
Calcein Zyglo zl- Fuschin Acid red system 9- Amino
acridine

47. http://oralhealth.ro/volumes/2015/volume-6/Paper-
856.pdf

49. https://theminimalplan.com/mindmap-planning-project-management

51. Today!!!

52. When people act with arrogant complacency (hubris)
towards the earth, we suffer. When we ignore others’
pleas for help, people suffer and the earth suffers. On
the other side, when people act with care and
responsibility, suffering is erased. The Titanic is every
person’s story and it is the story of people interacting
with nature. It is a tragic reminder that mindlessness
sinks us, and yet it’s possible to rise above the odds and
express a higher form of humanity.
The Titanic is
the story of
human
struggle, and
yet it’s also
the story of
overcoming
struggle

53. Reference
References • Tyas MJ, Anusavice KJ, Frencken JE,Mount GJ. Minimal intervention dentistry-a review. FDI Commission Project 1-97.
Int Dent J. 2000;50:1–12. • Vimal k sikri. Textbook of operative dentistry.2nd edition. • Ramya raghu, clinical operative dentistry,
principles and practice. • Graham j mount, an atlas of glass ionomer cements. A clinicians guide. • White JM, Stephan EW,
Rationale and treatment approach in minimally invasive dentistry. J Am Dent Assoc. 2000;131: 13s- 19s. • Mount GJ, Hume WR. A
new cavity classification. Australian Dental Journal.1998;43(3):153-159.
. • Roberson TM, Lundeen TF. Sturdvent’s Art & Science of Operative Dentistry, 4th edition, Cariology: The Lesion,
Etiology,Prevention, and Control; 2002. • Walsh LJ. The current status of laser application in dentistry. Aust Dent J 2003;48:146-. •
A.Banerjee . Minimal intervention dentistry: part 7. Minimally invasive operative caries management: rationale and
techniques. BRITISH DENTAL JOURNAL VOLUME 214 NO. 3 FEB 9 2013. • Shefally Garg. Minimal Invasive Dentistry- A Comprehensive
Review BJMMR, 17(5): 1-9, 2016; Article no.BJMMR.27526. • Avijit Banerjee The contemporary practice of minimally invasive
dentistry FACULTY DENTAL JOURNAL April 2015 • Volume 6 • Issue 2 • Simonsen RJ. Preventive resin restorations (PRR) and
Sealants In Light Of Current Evidence: DCNA. 2005;49:815-823.Did you like the resources on this template? Get them for free at
our other websites.

54. THANKS!
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