This lecture will describe on first part the global medical approach of minimally invasive dentistry including the different concepts like CAMBRA or MITP and their daily clinical applications. On second part we will focus our thoughts about the advantages and drawbacks of the different diagnosis and treatment tools (Diagnodent™, Canary system™, PAD™ device…) now available and in particular the development of a new intraoral fluorescence device to be used in relation with the diagnosis and treatment of carious lesions. This device is called SoproLIFE™ and comes with its own clinical concept: LIFEDT (Light Induced Fluorescence Evaluator for Diagnosis and Treatment) and its principle lies in the analysis of variations of the fluorescence of a clinically suspicious carious area in comparison to the fluorescence of a healthy area on the same tooth.

On third part after a very short description of numerous researches and developments conducted, in order to better grasp and understand the fundamentals of fluorescence variation on the dentin, the lecture will be dedicated to the presentation of multiple, rather easy clinical applications, from diagnosis to minimally invasive treatment as a whole. Distinctions will be done between Minimally Invasive Technique type 1(MIT1)⁷ (Fig 1) which preserve or reinforce the enamel and enamel-dentine structures from those that require minimum preparation of the dental tissues (MIT2)⁷ (Fig 2). Thanks to its magnification power and fluorescence information , SoproLIFE™ proves to be equally useful in the case of sealant technique like ICON™ infiltration, slot preparation or very complex restorative clinical cases. The discussion will rounded off by illustrations of how the natural tooth structure and aesthetics are preserved in most case thanks to the minimally invasive approach.

Figure 1. After drying with a 99% alcohol solution, application of the resin infiltrant ICON™, Application time 3 mins; followed by multisite photopolymerisation (Bluephase light, Vivadent, 1200 mW, 3 x 20 s)

Figure 2. Ultrasonic semi-circular insert (Excavus insert, EX3 half-ball diamond tip) within the slot preparation. The marginal ridge was preserved. (Soprolife camera, daylight mode).

References

1. Elodie Terrer , Sarraquigne C, Koubi S, Weisrock G, Mazuir A, Tassery H. A New Concept in Restorative Dentistry: LIFEDT - Light Induced Fluorescence for Diagnosis and Treatment. Part 1: Diagnosis and Treatment of Initial Occlusal Caries J Contemp Dent Pract. 2009 1;10(6):86-94.
2. MI Compendium of systematic reviews. Minimum Intervention (MI) in Dentistry. www.mi-compendium.org. Edition 1.4: 1-188.
3. Mickenautsch S. Adopting minimum intervention in dentistry: diffusion, bias and the role of scientific evidence. Int Dent SA 2009; 11:16-26.
4. Mickenautsch S. Systematic reviews, systematic error and the acquisition of clinical knowledge BMC Med Res Methodol 2010; 10:53.
5. Elodie Terrer , Sarraquigne C, Koubi S, Weisrock G, Mazuir A, Tassery H. A New Concept in Restorative Dentistry: LIFEDT - Light Induced Fluorescence for Diagnosis and Treatment. Part II: Treatment of dentinal caries. J Contemp Dent Pract. 2010 1;11(1):95-102.
6. Koubi S, Raskin A, Dejou J, About I, Tassery H, Camps J, Proust JP. Effect of dual cure composite as dentin substitute on the marginal integrity of Class II open-sandwich restorations. Oper Dent. 2010 ;35(2):165-71.
7. Weisrock G, Terrer E, Couderc G, Koubi S, Levallois B, Manton D, Tassery H. Natural aesthetic restorations and minimally invasive dentistry. JMID 2011; 4 (2) (accepted, in press)