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Minimally Invasive, Comprehensive Treatment in Everyday Dentistry

Categories: Restorative Dentistry

Author(s): Dr. Erick Gutierrez

Date: 02-18-2021 09:27:40 am

The term “minimally invasive” has been used in dentistry for decades. And while economic factors or lack of confidence can impede clinicians from fully making the switch to minimally invasive dentistry, most of us would agree that enamel and periodontal preservation are paramount in achieving a lifetime of optimal oral health.

Modern bonding systems and materials have transitioned minimally invasive dentistry from concept to reality—but can this protocol work for simple, everyday cases as well as comprehensive ones? And is the minimally invasive approach truly healthier for the patient? The answer to both questions: Absolutely.

The Catalyst to Comprehensive Care
Thanks to the omnipresent power of Facebook and Instagram, patients are becoming more aware of what common dental issues look like—for example, inflamed gums from subgingival margins. Social media has become a catalyst for consumers seeking less-invasive options.

In this regard, minimally invasive dentistry acts as a vessel, helping patients understand the stakes and accept comprehensive care. And by offering more choices, both in the areas of prevention and treatment, clinicians can increase the possibility of case acceptance. With a growing consumer demand comes the tremendous opportunity for practice growth.

So, how can you start applying a minimally invasive approach to not just the everyday cases, but all clinical scenarios? The good news is that managing comprehensive cases, such as full-mouth rehabilitations, with minimally invasive techniques doesn’t require expensive equipment. The only thing a clinician needs is a good understanding of sound occlusal and adhesive principles combined with restorative material knowledge.

Case in Point
A patient who presents with excessive incisal wear on the lower anterior teeth and fracture lines will most likely have a lack of anterior guidance or a deep bite and parafunctional habits. A conventional treatment approach would be to recommend a nightguard to prevent further wear of the teeth. But comprehensive dentistry goes a step further to correct the deep bite and set up a functional relationship for anterior guidance by using clear aligner therapy.

Once the deep bite is corrected, if anterior guidance is still inadequate, veneers or bonding can be recommended. A good bonding technique can brace the fracture lines and restore worn enamel, while re-establishing anterior guidance to strengthen weakened teeth and decrease destructive forces on those teeth. Most dentists avoid doing crowns on lower anterior teeth at all costs due to the aggressive size of the preparation. Fortunately, there’s no need to do crowns on such teeth. By understanding the principles of a healthy stable occlusion, the neuromusculature can be better managed to minimize loading forces.

With the proper occlusal principles, bonding techniques, and dental materials, minimally invasive dentistry options can be incorporated seamlessly into any practice. And by leaving the supragingival margins of the restorations as is, we can also decrease the frequency of chronic gingival inflammation. It’s that simple.
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