cosmetic dentistry_ beauty & science International

06 I I special _ MiCD _Minimallyinvasivedentistry(MiD),alsoknown as minimal intervention dentistry and preservative dentistry,isapracticemindsetandphilosophy.There is no escape from MiD in clinical practice. All clini- cians practice MiD periodically whether consciously orunconsciously.Asapracticephilosophy,thereare principles of being, knowledge and/or conduct. Although MiD relates to most oral diseases and aspects of dentistry, its application to caries is prob- ably the most evolved. Carious lesions that are de- mineralised and non-cavitated are now “healed” in- steadofsurgicallyremoved.Tyasetal.1 ,aspartofaFDI Commission-initiated project, provided an overview of the principles and concepts of MiD, suggested techniquesandpresentedtheresultsofclinicalstud- ies as they pertain to dental caries. The principles of MiD in relation to caries management are: _remineralisation of early lesions; _reduction in cariogenic bacteria, in order to elimi- nate the risk of future demineralisation and cavi- tation; _minimum surgical intervention of cavitated le- sions; _repair rather than replacement of defective restorations; and _disease control. Basedonthesefoundationaltenets,genericMiD principlescanbeproposedforalloraldiseases.They are: _early detection and diagnosis of disease (D); _control of contributing (predisposing, precipitat- ing and/or perpetuating) factors (C); _curativeandleastinvasivemanagementofdisease or pathological effects (M); and _assessment and monitoring of intervention out- come (O). These tenets are not only applicable to dental caries, but also to aesthetic problems causing pa- tients “dis-ease”. Dental aesthetic problems, like other diseases, can be caused by genetic or devel- opmental anomalies, infection agents (e.g. caries and periodontal disease) and/or environmental factors (malnutrition, diet, stress, trauma, etc.) and include: _discoloured teeth; _poorly shaped teeth; _broken or worn teeth; _ugly fillings (secondary to dental caries); _spaces between teeth; _crooked teeth; and _missing teeth. cosmeticdentistry 3_2011 Minimallyinvasivecosmetic dentistry:Whenlessismore! Author_ Assoc Prof Adrian U.J. Yap, Singapore Table I_MiCD treatment options for managing various aesthetic problems. Non-invasive options Minimally invasive options Smile training Aesthetic recontouring of teeth/gums Remineralisation of white spot lesions Direct restoration with micro-preparation, air abrasion and laser Take-home and in-office bleaching Direct or indirect veneers Direct veneers without tooth preparation Inlays, onlays and partial veneer crowns Bonded pontics Adhesive bridges Bruxism guards Dentures Sectional orthodontics Mini-implants Orthodontics Table I