Think small, see big and remove little

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MID (minimally invasive dentistry) has been a buzzword for some time. It is now so important to respect the hard tissues and the principles are well known. The problem is that many dentists do not have the necessary equipment to help them carry this out.

Firstly, to keep things as small as possible flawless vision is necessary. This can only be achieved with the use of loupes and loupe-attached lighting. We are fooling ourselves if we think that we are minimally restoring without magnification. The principle has to be: ‘think small, see big and remove little’.

Flawless vision

When aiming to minimise the amount of tooth loss during cavity preparation, it is essential to have the ability to enlarge the visibility of the clinical field so it can be clearly seen. By using high-quality loupes, dentists can work with a greater degree of precision whilst making diagnosis and treatment safer, more reliable and faster.

The minimum level of magnification for MID is 2.8x, but some dentists prefer to use 3.3x loupes or even higher, up to 5.7x.

Sometimes with MID, a cavity will be approached from a difficult angle in order to preserve tooth structure. Loupe-mounted lighting is as important and beneficial as the accompanying loupes, as without suitable illumination it can be very difficult to see, especially when using a mirror. Without both, we can easily adopt bad posture in trying to get the light and our vision in the same place. What could have been very difficult and stressful becomes routine with the right aids to vision.

There is an extensive range of loupes and lights on the market for specific MID requirements, with products combining excellent optics and good ergonomic design. Loupes manufactured using lightweight and durable titanium frames, which can accommodate all prescriptions and declination angles whilst providing the benefits of an improved working posture, are the most suitable to seek out. Combine them with LED lighting to provide shadow-free illumination and you’ll achieve higher visibility of the observed field.

Air abrasion and microetching techniques

Much MID relies on adhesion and a perfectly clean surface is mandatory. The best way to achieve this is by air abrasion using aluminium oxide powder. The micro-texturing that this produces helps to increase the adhesion. The air abrasion can be achieved by using a microetcher or an air abrasion unit such as PrepStart, which has the added advantage of being able to cut hard tissue as well as clean. Tiny fissure preparations are attainable as well as tunnel preps that can be prepared without any vibration that could lead to fracture of the marginal ridge.

Air abrasion with PrepStart is also very useful for the removal of stains around composites, within just a few seconds the stain can be removed, the surface of the composite cleaned and a new layer of composite be placed over.

It takes a lot more skill to keep it small, so make sure that you have the right equipment to be able to bring this benefit to your patients.

To discover how you, your practice and your patients can benefit from some of the solutions mentioned in this feature, click here and we’ll be in touch with our recommended solutions.

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