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Minimal intervention (MI) dentistry is a modern dental practice designed around the principal aim of preservation of as much of the natural tooth structure as possible. It uses a disease-centric philosophy that directs attention to first control and management of the disease that causes tooth decay—dental caries—and then to relief of the residual symptoms it has left behind—the decayed ...
Non-carious cervical lesions on an incisor belonging to Australopithecus africanus. Arrows show the location of the lesions. Non-carious cervical lesions (NCCLs) are a group of lesions that are characterised by a loss of hard dental tissue at the cementoenamel junction (CEJ) region at the neck of the tooth, without the action of microorganisms or inflammatory processes. [1]
Once a lesion has cavitated, especially if dentin is involved, remineralization is much more difficult and a dental restoration is usually indicated ("operative treatment"). Before a restoration can be placed, all of the decay must be removed otherwise it will continue to progress underneath the filling.
[1] [2] ECC is characterized by the presence of 1 or more decayed (non cavitated or cavitated lesions), missing (due to caries), or filled tooth surfaces in any primary tooth. [3] ECC has been shown to be a very common, transmissible bacterial infection , usually passed from the primary caregiver to the child.
These forms of tooth wear can further lead to a condition known as abfraction, [3] where by tooth tissue is 'fractured' due to stress lesions caused by extrinsic forces on the enamel. Tooth wear is a complex, multi-factorial problem and there is often difficulty identifying a single causative factor. [ 3 ]
In addition to periapical abscesses, periapical periodontitis can give rise to various related lesions, including periapical granulomas and cysts. [11] A periapical granuloma (also referred to as an 'apical granuloma' or 'radicular granuloma') is a mass of chronically inflamed granulation tissue that forms at the apex of the root of a nonvital ...
Tooth remineralization is the natural repair process for non-cavitated tooth lesions, [1] [2] in which calcium, phosphate and sometimes fluoride ions are deposited into crystal voids in demineralised enamel. Remineralization can contribute towards restoring strength and function within tooth structure. [3]
Lesions in proximity to the apex of a tooth, especially those associated with caries or periodontal disease, may have a greater chance of becoming infected. [3] Lastly, local infection within a COD lesion, often leading to necrosis of the area, is another risk factor for symptomatic COD.