Ultraconservative approaches for

non cavitated caries management

Aims
The aim of this presentation is to discuss
the efficacy of current nonsurgical
treatments for non-cavitated carious
lesions in permanent teeth.
Surgical intervention in carious lesions
which can be managed by more
conservative approaches is an archaic
concept which leads to a vicious cycle of
debridement and restoration which was
likely to be repeated, tooth extraction
was the most reliable method of
treatment for carious lesions
The fear of dentists is well documented
in all forms of media
Newer approaches to treating caries in
its early stages which eliminates the use
of dental drills makes it more acceptable
for many patients

Materials and methods

A search of peer-reviewed dental
literature from Pub Med and MEDLINE
databases was conducted and
limited to dental journals. Key words
included remineralization and resin
infiltration. Titles, abstracts and full
articles were reviewed and
evaluated.

Result

Remineralizing agents
The main remineralizing agents are
CPP-ACP and CPP-ACFP, with major
attention for the CPP-ACP which is a
nanocomplex thought to provide a
reservoir of calcium and phosphate
ions to maintain a state of supersaturation with respect to tooth
enamel and buffer plaque pH.

Caries infiltration with low viscosity

resin
The aim of resin infiltration is to soak up the porous
lesion body with a low-viscosity resin (infiltrant) that
is subsequently hardened with blue light. Thereby,
diffusion pathways for cariogenic acids are blocked,
and lesions are sealed and the progression is
arrested.
Also it prevents scattering of light from the air filled
pores reducing the opacity of the lesion and
improving the esthetics.
The fact that it requires no drilling is so appealing
to the patients that ICON was featured in Readers
digest, popular science and on fox news.

 It has certain advantages over the

remineralizing approach that the
appearance of even deep lesions can
be improved and the esthetic
improvement is visible immediately.
Also it sacrifices negligible amount of
surface enamel by etching and
polishing compared to enamel
microabrasion and traditional
restorative procedures.

CONCLUSIONS
In the last 100 years, dentistry has shown a
great change in the approaches adopted to
treat carious lesions. The effectiveness of
nonsurgical methods to treat enamel lesions is
fully recognized, and these methods can be
used by clinicians worldwide.
Dental professionals can now treat a potential
problem at the point of discovery until it
becomes a bigger problem. This therefore
bridges the gap between prevention and
restoration.