The concept of minimal intervention operative dentistry is being accepted and taught in more places all the time. Simply for emphasis the basic principals are repeated here because it is essential that the reader understands the significance of the recognition of caries as a bacterial disease. Once this is established then the entire approach to its treatment needs to be modified. One highly significant aspect of treatment relates to the surgical preparation of the cavity, which is required to eliminate the more advanced lesion where the smooth tooth surface has been breached. Whilst the cavities will be considerably smaller than those designed by GV Black they will certainly not be easier to design and prepare. Conservation of tooth structure is of prime importance and to achieve this there needs to be a high level of visibility and an excellent tactile sense to avoid over-preparation and excess tooth loss. Preparation techniques are discussed in some detail including rotary cutting instruments, lasers and air abrasion techniques.
This case is related to a 25 years old healthy female patient. Her past medical history excluded diabetes and hypertension. She was oriented to the dental office by our referral orthodontist to find a prosthetic replacement solution to the gap consequential to the orthodontic treatment. The open space of 3.5 mm was localized at the first lower right premolar.