6. INTRODUCTION
For more than a century, since the creation of
belt-driven handpieces, dentists have been
removing caries based on the concept of drill,
remove, and restore. The remaining dentin is an
essential feature for long-term pulpal health.
Translated, this realization clearly means that
removing excess dentinal tooth structure and
encroaching on the pulpal tissue directly
correlate to potential negative pulpal outcomes.
7. The different concepts in caries removal
1-Ozone therapy
2-Air abrasion technique
3-Chemomechanical caries removal
4-Smart bur
5-Stepwise excavation
6-Use of laser in tooth preparation
7-Use of ultrasonic in tooth preparation
8. Ozone therapy
Ozone is a gas made up of three
molecules of oxygen. When it is applied
to bacteria and other organisms, the
Ozone completely destroys them.
It is used in dentistry by utilizing a special
delivery system.
The portable apparatus includes a source of
oxidizing gas and a dental hand piece for delivering
the gas/water to the target tooth at a concentration
of 2100 ppm.
9.
10. A cup attached to the hand piece is provided
for receiving the gas and exposing a selected
area of the tooth to the gas action.
The ozone gas is refreshed in this disposable
cup at a rate of 615cc/minute changing the
volume of gas inside the cup over 300 times
every second.
The cup forms a seal around the lesion being
treated so that ozone cannot leak into the oral
cavity.
11.
12. Air abrasion technique*
•The use of air abrasion
techniques in dentistry
allows the removal of
decayed tissue without
the removal of the
healthy tooth
substance.
*Reis-schmidt T. Air abrasion cavity-preparation system provide cutting-edge option in
restorative dentistery :dent prod report 1998;32(12);57-60,108-9
13.
14. • The apparatus involves minute abrasive
particles which are too small to be seen by the
naked eye carried to the target tooth by a
stream of air gently and precisely acting to
remove away the decayed tooth structure
• It is recommended for treatment of children,
pregnant women and other medically
compromised patients.
15.
16. Chemomechanical caries removal
Chemomechanical caries provides painless
and efficient removal of carious dentin and no
administration of local anaesthesia.
17. This techniques is based on altering the
secondary and /or quaternary structure of
collagen in carious dentin by chlorination
of the collagen.
The hydrogen bonding in the collagen is
disrupted rendering it more friable and
easier to remove by scrapping the carious
fragments away.
18. Smartprep
(Smart bur)
The SMARTPREP Instrument is a medical grade
polymer that safely and effectively remove decayed
dentin, leaving healthy dentin intact.
The polymer instrument is self-limiting and will not
cut sound dentin unless applied with great force, and
then it will only wear away, rather than cut the
healthy dentin.
19.
20.
21. laser in tooth preparation
Lasers are used to
remove decay within
a tooth and prepare
the surrounding
enamel for receipt of
the filling. Lasers are
also used to "cure" or
harden a filling.
22. Ultrasonics in tooth preparation
The use of ultrasonic
tips has become an
alternative for cavity
preparation. However,
there are concerns
about this type of
device, particularly with
respect to intrapulpal
temperatures and cavity
preparation time.
23. Refrences
Nisha Garg, Amit Garg.Textbook of
Operative Dentistry. Second
Edition.2013;ch.5,ch.6
Bjorndal L. in deep cavities stepwise
excavation of caries can preserve the
pulp.Evid based dent.2011;12(3):68.
