Non-Operative, Micro- and Minimally Invasive Methods for Caries Treatment—A Narrative Review

TL;DR

This paper reviews non-surgical and minimally invasive dental treatments for caries, focusing on preserving natural tooth structure and using advanced techniques for better patient outcomes.

Contribution

The paper provides a comprehensive overview of current non-operative and minimally invasive caries treatment methods, emphasizing biological preservation and technological advancements.

Findings

Fluoride therapy and CPP-ACP are effective for remineralization and early caries management.

Laser photoablation with erbium lasers allows precise cavity preparation with less thermal and mechanical stress.

Minimally invasive techniques improve patient comfort and reduce the need for anesthesia while preserving tooth vitality.

Abstract

The management of dental caries has evolved from the traditional mechanical approach of “extension for prevention” to a biologically oriented philosophy centered on preserving natural tooth structures. Minimally invasive dentistry (MID) emphasizes early detection, risk assessment, prevention, and conservative intervention based on the lesion’s activity and depth. This review outlines current evidence on non-operative, micro-invasive, and minimally invasive strategies, including fluoride therapy, remineralizing agents such as casein phosphopeptide–amorphous calcium phosphate (CPP-ACP), self-assembling peptides that promote biomimetic enamel repair, sealants, and resin infiltration. Minimally invasive operative methods employ advanced technologies for selective tissue removal—chemomechanical systems (Carisolv, Papacarie, Brix3000), sono-and airabrasion, and new-generation polymeric and ceramic burs (SmartBur, Cerabur) designed to preserve sound dentin. Laser photoablation, particularly with erbium lasers (Er:YAG, Er,Cr:YSGG), enables precise cavity preparation with minimal thermal and mechanical stress. These approaches enhance patient comfort, reduce anesthesia requirements, and maintain tooth vitality. Despite limitations related to cost, equipment, and operator sensitivity, MID represents not only a set of refined clinical techniques but also a comprehensive, evidence-based treatment philosophy founded on biological principles, structural preservation, and the promotion of long-term oral health.

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