New
A Clinical Guide to Advanced Minimum Intervention Restorative Dentistry,
Edition 1
By Avijit Banerjee, BDS MSc PhD LDS FDS (Rest Dent) FDS RCS (Eng) FHEA FICD
Publication Date:
01 Jun 2024
Description
As restorative dentistry shifts from a focus on core surgical procedures to the patient and their unique needs and values, this new book from acclaimed restorative dentistry expert Professor Avijit Banerjee is designed to support implementation of holistic patient care for long-term oral and dental health.
The Guide to Advanced Minimum Intervention Restorative Dentistry describes the entire clinical journey through the minimum intervention oral healthcare delivery framework, with an emphasis on long term, risk-related, prevention-based care. It presents a blend of clinical and scientific evidence-based clinical protocols to guide the practitioner through the four domains of minimum intervention oral care - identifying disease, prevention / control, minimally invasive operative interventions, and review / re-assessment / active surveillance.
Written in an engaging contemporary style and easy to navigate, this important book is suitable for all members of the team, from undergraduates to experienced primary care practitioners and specialists alike.
The Guide to Advanced Minimum Intervention Restorative Dentistry describes the entire clinical journey through the minimum intervention oral healthcare delivery framework, with an emphasis on long term, risk-related, prevention-based care. It presents a blend of clinical and scientific evidence-based clinical protocols to guide the practitioner through the four domains of minimum intervention oral care - identifying disease, prevention / control, minimally invasive operative interventions, and review / re-assessment / active surveillance.
Written in an engaging contemporary style and easy to navigate, this important book is suitable for all members of the team, from undergraduates to experienced primary care practitioners and specialists alike.
Key Features
- Suitable for all oral healthcare team members
- Written in a concise, easy-to-read style with tables, flowcharts, illustrations, clinical images and bulleted lists
- Blends clinical and scientific evidence, with clinical cases to support practice
- Well-illustrated clinical guide of step-by-step protocols for learning and practising minimally invasive operative care, progressed from the pioneering work of HM Pickard
- Includes practical dental disease prevention and control strategies
- Covers the latest dental biomaterials and operative technologies
- Contemporary approaches to dental caries management – selective caries removal, adhesion and sealed restorations
- Long term maintenance of functional tooth-restoration complex using the “5Rs¿ minimally invasive clinical protocols
- Self-assessment tasks and references throughout to support personal learning
About the author
By Avijit Banerjee, BDS MSc PhD LDS FDS (Rest Dent) FDS RCS (Eng) FHEA FICD, Professor of Cariology & Operative Dentistry/Hon Consultant, Restorative Dentistry, Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, UK.
Table of Contents
Foreword, v
Preface, vi
1 Dental Hard Tissue Pathologies, 1
1.1 Dental Caries, 1
1.1.1 What Is It?, 1
1.1.2 Terminology, 1
1.1.3 Caries: The Process and the Lesion, 2
1.1.3.1 The Caries Process: Dental Plaque
Biofilm, 2
1.1.3.2 The Carious Lesion: Dental Hard
Tissues, 3
1.1.4 Aetiology of the Caries Process, 3
1.1.5 Speed and Severity of the Caries
Process, 5
1.1.5.1 Definitions, 7
1.1.6 The Carious Lesion, 7
1.1.6.1 Within Enamel, 8
1.1.6.2 At the Enamel–Dentine
Junction (EDJ)/Amelo-dentinal
Junction, 10
1.1.6.3 Within Dentine, 10
1.1.7 Carious Pulp Exposure, 12
1.1.8 Dentine–Pulp Complex Reactions, 12
1.1.8.1 Translucent Dentine, 12
1.1.8.2 Tertiary Dentine, 13
1.1.8.3 Pulp Inflammation, 14
1.2 Toothwear, 15
1.3 Dental Trauma, 16
1.3.1 Aetiology, 17
1.4 Developmental Defects, 17
1.5 Causes of Tooth Discolouration, 17
SECTION 1 Minimum Intervention
Oral Care (MIOC) –
Clinical Domain 1
2 MIOC Domain 1: Identifying Clinical Problems, 27
2.1 Introduction: Minimum Intervention Oral
Care and Minimally Invasive Dentistry, 27
2.2 Detection/Identification, 32
2.3 Taking a Verbal History, 33
2.4 Physical Examination, 33
2.4.1 General Examination, 33
2.4.2 Oral Examination, 33
2.4.3 Dental Charting, 36
2.4.4 Tooth Notation, 36
2.5 Caries Detection, 36
2.5.1 Caries Detection Indices, 38
2.5.2 Susceptible Surfaces, 41
2.5.3 Investigations, 44
2.5.3.1 Radiographs, 44
2.5.3.2 Pulp Sensibility Tests, 45
2.5.3.3 Percussion Tests, 49
2.5.4 Lesion Activity, 49
2.5.5 Diet Analysis, 51
2.5.6 Caries Detection Technologies, 54
2.6 Toothwear: Clinical Detection, 55
2.6.1 Targeted Verbal History, 55
2.6.2 Clinical Presentations of Toothwear, 55
2.6.3 Summary of the Clinical Manifestations
of Toothwear, 57
2.7 Dental Trauma: Clinical Detection, 59
2.8 Developmental Defects: Clinical Detection, 60
3 MIOC Domain 1: Diagnosis, Prognosis and
Personalised Care Planning, 65
3.1 Introduction, 65
3.1.1 Definitions, 65
3.2 Diagnosing Dental Pain, ‘Toothache’, 66
3.2.1 Acute Pulpitis, 66
3.2.2 Acute Periapical Periodontitis, 66
3.2.3 Acute Periapical Abscess, 69
3.2.4 Acute Periodontal (Lateral) Abscess, 69
3.2.5 Chronic Pulpitis, 69
3.2.6 Chronic Periapical Periodontitis, 69
3.2.7 Exposed Dentine Sensitivity, 70
3.2.8 Interproximal Food-Packing, 70
3.2.9 Cracked Cusp/Tooth Syndrome, 72
3.3 Caries Risk/Susceptibility
Assessment (CRSA), 72
3.4 Diagnosing Toothwear, 75
3.5 Diagnosing Dental Trauma and
Developmental Defects, 76
3.6 Prognostic Indicators, 76
3.7 Formulating a Risk-Related, Personalised
Care Plan, 76
3.7.1 Why Is a Personalised Care Plan
(PCP) Necessary?, 76
3.7.2 Structuring a Personalised Care Plan, 77
SECTION 2 Minimum Intervention
Oral Care (MIOC) –
Clinical Domain 2
4 MIOC Domain 2: Disease Control and Lesion
Prevention, 83
4.1 Introduction, 83
4.1.1 Disease Control, 83
4.1.2 Lesion Prevention, 83
4.2 Caries Control and Lesion Prevention, 83
4.2.1 Categorising Caries Activity and Risk/
Susceptibility Status, 83
4.2.2 Behaviour Change/Modification:
The COM-B Model, 84
4.2.3 Standard/Self Care: Low-Risk,
Caries-Controlled, Disease-Inactive
Patient, 87
4.2.3.1 Plaque Biofilm Control, 87
4.2.3.2 Fluoride, 90
4.2.3.3 Diet, 90
4.2.4 Active Care: High-Risk, Caries-
Uncontrolled, Disease-Active Patient, 91
4.2.4.1 Decontamination Procedures, 91
4.2.4.2 Antimicrobial Agents, 91
4.2.4.3 Remineralisation, 92
4.3 Toothwear Control and Lesion Prevention, 99
4.3.1 Process, 99
4.3.2 Lesions, 99
SECTION 3 Minimum Intervention
Oral Care (MIOC) –
Clinical Domain 3
5 MIOC Domain 3: Minimally Invasive Operative
Dentistry, 105
5.1 Clinical Management Guidelines, 106
5.2 The Dental Surgery, Clinic or Office, 107
5.2.1 Positioning the Clinician,
Patient and Nurse, 107
5.2.2 Lighting, 108
5.2.3 Zoning, 108
5.3 Infection Prevention and Control/Personal
Protective Equipment, 109
5.3.1 Decontamination and Sterilisation
Procedures, 109
5.4 Patient Safety and Risk Management, 111
5.4.1 Management of Minor Injuries, 111
5.5 Dental Aesthetics, 112
5.5.1 Colour Perception, 113
5.5.2 Clinical Tips for Shade Selection, 114
5.5.3 MI Management of Tooth
Discolouration, 116
5.6 Magnification, 118
5.6.1 Clinical Photography, 121
5.7 Moisture Control, 122
5.7.1 Why? 122
5.7.2 Techniques, 122
5.7.3 Rubber (Dental) Dam Placement:
Practical Steps, 123
5.8 Instrumentation in Minimally Invasive
Operative Dentistry, 128
5.8.1 Hand Instruments, 128
5.8.2 Rotary Instruments, 131
5.8.3 Using Hand/Rotary Instruments:
Clinical Tips, 134
5.8.4 Dental Air-abrasion, 137
5.8.5 Chemo-mechanical Carious Tissue
Removal, 137
5.8.6 Other Instrumentation
Technologies, 138
5.9 “MI” Operative Management of the
Cavitated Carious Lesion, 139
5.9.1 Rationale, 139
5.9.2 Minimally Invasive Dentistry (MID), 140
5.9.2.1 Assessing Clinical Cavitation of a
Carious Lesion, 141
5.9.3 Enamel Preparation, 142
5.9.4 Carious Dentine Removal, 145
5.9.4.1 Peripheral Caries Management
(EDJ), 146
5.9.4.2 Caries Overlying the Pulp, 147
5.9.4.3 Discriminating Between the
Histological Zones of Carious
Dentine, 149
5.9.4.4 ‘Stepwise Excavation’ and
Atraumatic Restorative
Technique, 149
5.9.5 Cavity Modifications, 151
5.10 Pulp Protection, 151
5.10.1 Rationale, 151
5.10.2 Terminology, 153
5.10.3 Materials, 153
5.11 Dental Matrices, 155
5.11.1 Clinical Tips, 156
5.11.2 Silicone Matrices, Stents and Splints, 156
5.11.3 ‘Stamp’ Matrix Technique, 157
5.12 Temporary/Provisional Restorations, 160
5.12.1 Definitions, 160
5.12.2 Clinical Tips, 160
5.13 Principles of Dental Occlusion, 160
5.13.1 Definitions, 160
5.13.2 Terminology, 161
5.13.3 Occlusal Registration Techniques, 161
5.13.4 Clinical Tips, 162
6 MIOC Domain 3: MI Operative Management of the
Badly Broken Down Tooth, 166
6.1 Causes of Broken Down Teeth, 166
6.2 Clinical Assessment of Broken Down
Teeth, 166
6.2.1 Why Restore the Broken Down (or any)
Tooth?, 166
6.2.2 Is the Broken Down Tooth Restorable
Clinically?, 167
6.3 Intra-coronal Core Restoration, 170
6.3.1 Direct Core Retention, 170
6.3.2 C-Factor, 170
6.4 Clinical Operative Tips, 171
6.5 Design Principles for Indirect
Restorations, 172
6.5.1 Design Features, 173
7 MIOC Domain 3: Restorative Materials Used in
Minimally Invasive Operative Dentistry, 176
7.1 Introduction, 177
7.2 Dental Resin Composites, 177
7.2.1 History, 177
7.2.2 Chemistry, 177
7.2.2.1 Resin Matrix, 177
7.2.2.2 Filler Particles, 178
7.2.2.3 Other Chemical Constituents, 180
7.2.2.4 Polymerisation Reaction, 181
7.2.3 The Tooth–Resin Composite Interface, 182
7.2.3.1 The Resin Composite–Enamel
Interface, 183
7.2.3.2 Resin Composite – Dentine
Interface: Dentine Bonding
Agents/Dental Adhesives, 184
7.2.4 Classification of Dental Adhesives, 186
7.2.4.1 Type 1: Three-Bottle or Three-Step
Bonding Systems, 186
7.2.4.2 Type 2: Two-Bottle or Two-Step,
‘Total Etch’ or ‘Etch and Rinse’
Adhesives, 187
7.2.4.3 Type 3: Weaker Self-Etching
Primers, 187
7.2.4.4 Types 4 and 5: Self-Etching All-in-
One/Universal Systems, 189
7.2.5 Clinical Issues With Dentine Bonding
Agents/Dental Adhesives, 189
7.2.6 Developments, 190
7.2.6.1 Reducing Shrinkage Stress and
Strain, 190
7.2.6.2 Dentine Bonding Agents, 190
7.2.6.3 ‘Self-Adhesive Composite’, 190
7.3 Glass-Ionomer Cement, 190
7.3.1 History, 190
7.3.2 Chemistry, 190
7.3.3 The Tooth–GIC Interface, 191
7.3.3.1 Enamel, 191
7.3.3.2 Dentine–Collagen, 191
7.3.3.3 Dentine–Tubules, 191
7.3.3.4 Surface Conditioning, 191
7.3.4 GIC Surface Protection , 191
7.3.5 Clinical Uses of GIC Relating to
Its Properties, 194
7.3.6 Developments, 195
7.4 Resin-Modified Glass-Ionomer Cement
and Polyacid-Modified Resin Composite
(Compomer), 195
7.4.1 Chemistry, 196
7.4.1.1 RM-GICs, 196
7.4.1.2 Polyacid-Modified Composites, 196
7.4.2 Clinical Indications, 196
7.5 Dental Amalgam, 197
7.5.1 Chemistry, 197
7.5.2 Physical Properties, 198
7.5.3 Bonded and Sealed Amalgams, 198
7.5.3.1 Bonded Amalgams, 199
7.5.3.2 Sealed Amalgams, 199
7.5.4 Contemporary Indications for the
Use of Dental Amalgam, 199
7.6 Temporary and Provisional (Intermediate)
Restorative Materials, 199
7.6.1 Characteristics, 199
7.6.2 Chemistry, 200
7.7 Calcium Silicate Cements, 200
7.7.1 History, 200
7.7.2 Chemistry and Interactions With the
Tooth, 200
7.7.3 Clinical Applications, 201
7.8 Materials and Techniques for Restoring the
Endodontically Treated Tooth, 203
7.8.1 Root Canal Posts, 203
7.8.2 Root Canal Post Cementation, 203
8 MIOC Domain 3: Minimally Invasive Operative
Dentistry (MID), a Step-by-Step Clinical Guide, 206
8.1 Introduction, 206
8.1.1 Cavity/Restoration Classification, 206
8.1.2 Restoration Procedures, 207
8.2 Preventive Fissure Sealant, 208
8.3 Therapeutic Sealant Restoration/Preventive
Resin Restoration: Type 3 Adhesive, 211
8.4 Posterior Occlusal Resin Composite
Restoration (Class I): Type 3 Adhesive, 216
8.5 Posterior Proximal Restoration (Class II), 221
8.5.1 Type 2 Adhesive, ‘Moist Bonding’, 221
8.5.2 Type 3 Adhesive, 225
8.6 Class III Anterior Restoration:
Type 2 Adhesive, 232
8.7 Anterior Incisal Edge/Labial Veneer
Composite (Class IV): Type 3 Adhesive (With
Enamel Pre-etch), 235
8.8 Buccal Cervical Resin Composite
Restorations (Class V): Type 2 Adhesive, 240
8.9 Posterior ‘Bonded’ Amalgam
Restoration, 243
8.10 ‘Nayyar Core’ Restoration, 246
8.11 Direct Fibre-Post/Resin Composite Core
Restoration, 247
8.12 Dentine Bonding Agents/Adhesives: A Stepby-
Step Practical Guide for Use, 248
8.13 Checking the Final Restoration, 249
8.14 Patient Instructions, 249
SECTION 4 Minimum Intervention
Oral Care (MIOC) –
Clinical Domain 4
9 MIOC Domain 4: Clinical Re-assessment,
Recall and Maintenance of the Tooth-Restoration
Complex, 253
9.1 Active Surveillance of the Patient/Course of
Disease, 253
9.1.1 Risk-related Re-assessment, 253
9.1.2 Re-assessment Checklist, 254
9.1.3 Monitoring Toothwear, 254
9.2 Restoration Failure, 256
9.2.1 Aetiology, 256
9.2.2 Choice of Restorative Material, 257
9.2.3 How May Restorations Be Assessed?, 259
9.2.4 How Long Should Restorations Last?, 259
9.3 Tooth Failure, 264
9.4 Managing the Failing Tooth-Restoration
Complex: The ‘5Rs’, 264
9.4.1 Dental Amalgam, 267
9.4.2 Resin Composites/GIC, 270
10 MIOC Implementation: Personalised Care
Management Pathways, 273
10.1 MIOC Framework: Summary, 273
10.1.1 Phased Courses of Treatment, 273
10.2 Care Management Pathways: Clinical
Scenarios, 277
10.2.1 How Would You Manage the
Following High-Risk Adult?, 278
10.2.2 How Would You Manage the
Following High-Risk Child?, 282
10.2.3 How Would You Manage the Following
High-Risk Older Adult Patient?, 285
10.2.4 How Would You Manage the Following
Low-Risk Adult Patient?, 288
Index, 290
Preface, vi
1 Dental Hard Tissue Pathologies, 1
1.1 Dental Caries, 1
1.1.1 What Is It?, 1
1.1.2 Terminology, 1
1.1.3 Caries: The Process and the Lesion, 2
1.1.3.1 The Caries Process: Dental Plaque
Biofilm, 2
1.1.3.2 The Carious Lesion: Dental Hard
Tissues, 3
1.1.4 Aetiology of the Caries Process, 3
1.1.5 Speed and Severity of the Caries
Process, 5
1.1.5.1 Definitions, 7
1.1.6 The Carious Lesion, 7
1.1.6.1 Within Enamel, 8
1.1.6.2 At the Enamel–Dentine
Junction (EDJ)/Amelo-dentinal
Junction, 10
1.1.6.3 Within Dentine, 10
1.1.7 Carious Pulp Exposure, 12
1.1.8 Dentine–Pulp Complex Reactions, 12
1.1.8.1 Translucent Dentine, 12
1.1.8.2 Tertiary Dentine, 13
1.1.8.3 Pulp Inflammation, 14
1.2 Toothwear, 15
1.3 Dental Trauma, 16
1.3.1 Aetiology, 17
1.4 Developmental Defects, 17
1.5 Causes of Tooth Discolouration, 17
SECTION 1 Minimum Intervention
Oral Care (MIOC) –
Clinical Domain 1
2 MIOC Domain 1: Identifying Clinical Problems, 27
2.1 Introduction: Minimum Intervention Oral
Care and Minimally Invasive Dentistry, 27
2.2 Detection/Identification, 32
2.3 Taking a Verbal History, 33
2.4 Physical Examination, 33
2.4.1 General Examination, 33
2.4.2 Oral Examination, 33
2.4.3 Dental Charting, 36
2.4.4 Tooth Notation, 36
2.5 Caries Detection, 36
2.5.1 Caries Detection Indices, 38
2.5.2 Susceptible Surfaces, 41
2.5.3 Investigations, 44
2.5.3.1 Radiographs, 44
2.5.3.2 Pulp Sensibility Tests, 45
2.5.3.3 Percussion Tests, 49
2.5.4 Lesion Activity, 49
2.5.5 Diet Analysis, 51
2.5.6 Caries Detection Technologies, 54
2.6 Toothwear: Clinical Detection, 55
2.6.1 Targeted Verbal History, 55
2.6.2 Clinical Presentations of Toothwear, 55
2.6.3 Summary of the Clinical Manifestations
of Toothwear, 57
2.7 Dental Trauma: Clinical Detection, 59
2.8 Developmental Defects: Clinical Detection, 60
3 MIOC Domain 1: Diagnosis, Prognosis and
Personalised Care Planning, 65
3.1 Introduction, 65
3.1.1 Definitions, 65
3.2 Diagnosing Dental Pain, ‘Toothache’, 66
3.2.1 Acute Pulpitis, 66
3.2.2 Acute Periapical Periodontitis, 66
3.2.3 Acute Periapical Abscess, 69
3.2.4 Acute Periodontal (Lateral) Abscess, 69
3.2.5 Chronic Pulpitis, 69
3.2.6 Chronic Periapical Periodontitis, 69
3.2.7 Exposed Dentine Sensitivity, 70
3.2.8 Interproximal Food-Packing, 70
3.2.9 Cracked Cusp/Tooth Syndrome, 72
3.3 Caries Risk/Susceptibility
Assessment (CRSA), 72
3.4 Diagnosing Toothwear, 75
3.5 Diagnosing Dental Trauma and
Developmental Defects, 76
3.6 Prognostic Indicators, 76
3.7 Formulating a Risk-Related, Personalised
Care Plan, 76
3.7.1 Why Is a Personalised Care Plan
(PCP) Necessary?, 76
3.7.2 Structuring a Personalised Care Plan, 77
SECTION 2 Minimum Intervention
Oral Care (MIOC) –
Clinical Domain 2
4 MIOC Domain 2: Disease Control and Lesion
Prevention, 83
4.1 Introduction, 83
4.1.1 Disease Control, 83
4.1.2 Lesion Prevention, 83
4.2 Caries Control and Lesion Prevention, 83
4.2.1 Categorising Caries Activity and Risk/
Susceptibility Status, 83
4.2.2 Behaviour Change/Modification:
The COM-B Model, 84
4.2.3 Standard/Self Care: Low-Risk,
Caries-Controlled, Disease-Inactive
Patient, 87
4.2.3.1 Plaque Biofilm Control, 87
4.2.3.2 Fluoride, 90
4.2.3.3 Diet, 90
4.2.4 Active Care: High-Risk, Caries-
Uncontrolled, Disease-Active Patient, 91
4.2.4.1 Decontamination Procedures, 91
4.2.4.2 Antimicrobial Agents, 91
4.2.4.3 Remineralisation, 92
4.3 Toothwear Control and Lesion Prevention, 99
4.3.1 Process, 99
4.3.2 Lesions, 99
SECTION 3 Minimum Intervention
Oral Care (MIOC) –
Clinical Domain 3
5 MIOC Domain 3: Minimally Invasive Operative
Dentistry, 105
5.1 Clinical Management Guidelines, 106
5.2 The Dental Surgery, Clinic or Office, 107
5.2.1 Positioning the Clinician,
Patient and Nurse, 107
5.2.2 Lighting, 108
5.2.3 Zoning, 108
5.3 Infection Prevention and Control/Personal
Protective Equipment, 109
5.3.1 Decontamination and Sterilisation
Procedures, 109
5.4 Patient Safety and Risk Management, 111
5.4.1 Management of Minor Injuries, 111
5.5 Dental Aesthetics, 112
5.5.1 Colour Perception, 113
5.5.2 Clinical Tips for Shade Selection, 114
5.5.3 MI Management of Tooth
Discolouration, 116
5.6 Magnification, 118
5.6.1 Clinical Photography, 121
5.7 Moisture Control, 122
5.7.1 Why? 122
5.7.2 Techniques, 122
5.7.3 Rubber (Dental) Dam Placement:
Practical Steps, 123
5.8 Instrumentation in Minimally Invasive
Operative Dentistry, 128
5.8.1 Hand Instruments, 128
5.8.2 Rotary Instruments, 131
5.8.3 Using Hand/Rotary Instruments:
Clinical Tips, 134
5.8.4 Dental Air-abrasion, 137
5.8.5 Chemo-mechanical Carious Tissue
Removal, 137
5.8.6 Other Instrumentation
Technologies, 138
5.9 “MI” Operative Management of the
Cavitated Carious Lesion, 139
5.9.1 Rationale, 139
5.9.2 Minimally Invasive Dentistry (MID), 140
5.9.2.1 Assessing Clinical Cavitation of a
Carious Lesion, 141
5.9.3 Enamel Preparation, 142
5.9.4 Carious Dentine Removal, 145
5.9.4.1 Peripheral Caries Management
(EDJ), 146
5.9.4.2 Caries Overlying the Pulp, 147
5.9.4.3 Discriminating Between the
Histological Zones of Carious
Dentine, 149
5.9.4.4 ‘Stepwise Excavation’ and
Atraumatic Restorative
Technique, 149
5.9.5 Cavity Modifications, 151
5.10 Pulp Protection, 151
5.10.1 Rationale, 151
5.10.2 Terminology, 153
5.10.3 Materials, 153
5.11 Dental Matrices, 155
5.11.1 Clinical Tips, 156
5.11.2 Silicone Matrices, Stents and Splints, 156
5.11.3 ‘Stamp’ Matrix Technique, 157
5.12 Temporary/Provisional Restorations, 160
5.12.1 Definitions, 160
5.12.2 Clinical Tips, 160
5.13 Principles of Dental Occlusion, 160
5.13.1 Definitions, 160
5.13.2 Terminology, 161
5.13.3 Occlusal Registration Techniques, 161
5.13.4 Clinical Tips, 162
6 MIOC Domain 3: MI Operative Management of the
Badly Broken Down Tooth, 166
6.1 Causes of Broken Down Teeth, 166
6.2 Clinical Assessment of Broken Down
Teeth, 166
6.2.1 Why Restore the Broken Down (or any)
Tooth?, 166
6.2.2 Is the Broken Down Tooth Restorable
Clinically?, 167
6.3 Intra-coronal Core Restoration, 170
6.3.1 Direct Core Retention, 170
6.3.2 C-Factor, 170
6.4 Clinical Operative Tips, 171
6.5 Design Principles for Indirect
Restorations, 172
6.5.1 Design Features, 173
7 MIOC Domain 3: Restorative Materials Used in
Minimally Invasive Operative Dentistry, 176
7.1 Introduction, 177
7.2 Dental Resin Composites, 177
7.2.1 History, 177
7.2.2 Chemistry, 177
7.2.2.1 Resin Matrix, 177
7.2.2.2 Filler Particles, 178
7.2.2.3 Other Chemical Constituents, 180
7.2.2.4 Polymerisation Reaction, 181
7.2.3 The Tooth–Resin Composite Interface, 182
7.2.3.1 The Resin Composite–Enamel
Interface, 183
7.2.3.2 Resin Composite – Dentine
Interface: Dentine Bonding
Agents/Dental Adhesives, 184
7.2.4 Classification of Dental Adhesives, 186
7.2.4.1 Type 1: Three-Bottle or Three-Step
Bonding Systems, 186
7.2.4.2 Type 2: Two-Bottle or Two-Step,
‘Total Etch’ or ‘Etch and Rinse’
Adhesives, 187
7.2.4.3 Type 3: Weaker Self-Etching
Primers, 187
7.2.4.4 Types 4 and 5: Self-Etching All-in-
One/Universal Systems, 189
7.2.5 Clinical Issues With Dentine Bonding
Agents/Dental Adhesives, 189
7.2.6 Developments, 190
7.2.6.1 Reducing Shrinkage Stress and
Strain, 190
7.2.6.2 Dentine Bonding Agents, 190
7.2.6.3 ‘Self-Adhesive Composite’, 190
7.3 Glass-Ionomer Cement, 190
7.3.1 History, 190
7.3.2 Chemistry, 190
7.3.3 The Tooth–GIC Interface, 191
7.3.3.1 Enamel, 191
7.3.3.2 Dentine–Collagen, 191
7.3.3.3 Dentine–Tubules, 191
7.3.3.4 Surface Conditioning, 191
7.3.4 GIC Surface Protection , 191
7.3.5 Clinical Uses of GIC Relating to
Its Properties, 194
7.3.6 Developments, 195
7.4 Resin-Modified Glass-Ionomer Cement
and Polyacid-Modified Resin Composite
(Compomer), 195
7.4.1 Chemistry, 196
7.4.1.1 RM-GICs, 196
7.4.1.2 Polyacid-Modified Composites, 196
7.4.2 Clinical Indications, 196
7.5 Dental Amalgam, 197
7.5.1 Chemistry, 197
7.5.2 Physical Properties, 198
7.5.3 Bonded and Sealed Amalgams, 198
7.5.3.1 Bonded Amalgams, 199
7.5.3.2 Sealed Amalgams, 199
7.5.4 Contemporary Indications for the
Use of Dental Amalgam, 199
7.6 Temporary and Provisional (Intermediate)
Restorative Materials, 199
7.6.1 Characteristics, 199
7.6.2 Chemistry, 200
7.7 Calcium Silicate Cements, 200
7.7.1 History, 200
7.7.2 Chemistry and Interactions With the
Tooth, 200
7.7.3 Clinical Applications, 201
7.8 Materials and Techniques for Restoring the
Endodontically Treated Tooth, 203
7.8.1 Root Canal Posts, 203
7.8.2 Root Canal Post Cementation, 203
8 MIOC Domain 3: Minimally Invasive Operative
Dentistry (MID), a Step-by-Step Clinical Guide, 206
8.1 Introduction, 206
8.1.1 Cavity/Restoration Classification, 206
8.1.2 Restoration Procedures, 207
8.2 Preventive Fissure Sealant, 208
8.3 Therapeutic Sealant Restoration/Preventive
Resin Restoration: Type 3 Adhesive, 211
8.4 Posterior Occlusal Resin Composite
Restoration (Class I): Type 3 Adhesive, 216
8.5 Posterior Proximal Restoration (Class II), 221
8.5.1 Type 2 Adhesive, ‘Moist Bonding’, 221
8.5.2 Type 3 Adhesive, 225
8.6 Class III Anterior Restoration:
Type 2 Adhesive, 232
8.7 Anterior Incisal Edge/Labial Veneer
Composite (Class IV): Type 3 Adhesive (With
Enamel Pre-etch), 235
8.8 Buccal Cervical Resin Composite
Restorations (Class V): Type 2 Adhesive, 240
8.9 Posterior ‘Bonded’ Amalgam
Restoration, 243
8.10 ‘Nayyar Core’ Restoration, 246
8.11 Direct Fibre-Post/Resin Composite Core
Restoration, 247
8.12 Dentine Bonding Agents/Adhesives: A Stepby-
Step Practical Guide for Use, 248
8.13 Checking the Final Restoration, 249
8.14 Patient Instructions, 249
SECTION 4 Minimum Intervention
Oral Care (MIOC) –
Clinical Domain 4
9 MIOC Domain 4: Clinical Re-assessment,
Recall and Maintenance of the Tooth-Restoration
Complex, 253
9.1 Active Surveillance of the Patient/Course of
Disease, 253
9.1.1 Risk-related Re-assessment, 253
9.1.2 Re-assessment Checklist, 254
9.1.3 Monitoring Toothwear, 254
9.2 Restoration Failure, 256
9.2.1 Aetiology, 256
9.2.2 Choice of Restorative Material, 257
9.2.3 How May Restorations Be Assessed?, 259
9.2.4 How Long Should Restorations Last?, 259
9.3 Tooth Failure, 264
9.4 Managing the Failing Tooth-Restoration
Complex: The ‘5Rs’, 264
9.4.1 Dental Amalgam, 267
9.4.2 Resin Composites/GIC, 270
10 MIOC Implementation: Personalised Care
Management Pathways, 273
10.1 MIOC Framework: Summary, 273
10.1.1 Phased Courses of Treatment, 273
10.2 Care Management Pathways: Clinical
Scenarios, 277
10.2.1 How Would You Manage the
Following High-Risk Adult?, 278
10.2.2 How Would You Manage the
Following High-Risk Child?, 282
10.2.3 How Would You Manage the Following
High-Risk Older Adult Patient?, 285
10.2.4 How Would You Manage the Following
Low-Risk Adult Patient?, 288
Index, 290
Book details
ISBN:
9780443109713
Page Count: 308
Retail Price
:
£59.99
