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Resin Infiltration of Incipient Caries with Icon: A Patient-Friendly Approach to Caries Control
Jonesboro, AR, private practitioner W. Johnston Rowe, Jr., DDS, AAACD, is encouraged by a new understanding of dental disease that is changing treatment.“For years we thought we were treating the disease causing tooth decay as we restored damaged tooth structure. We understand now that we were not treating the disease’s cause—ie, bacteria—but were merely managing its symptoms,” he asserts.
“Ongoing research in the area of cariology has allowed us to better understand the caries process, which involves bacteria attaching themselves to tooth structure, establishing colonies, and forming protective biofilm through the utilization of simple sugars,” he continues. “It is clear that the caries process is driven by the presence of simple sugars within the diet; we also know that the pH level of the mouth, at any given time, is directly affected by the presence of cariogenic bacteria.”
To address the organisms causing carious lesions, Rowe says, new remineralization products and restorative procedures are designed; this results in the preservation of tooth structure, which in the past was sacrificed for the purpose of mechanical debridement and restoration. “Through the understanding of bacteria, researchers have been able to develop new and more effective remineralization strategies utilizing fluoride, ACP, CPP-ACP, and bioactive glass materials. These materials, not available a decade ago, have proved to be useful tools in addressing the slowing of the caries process and the rebuilding of tooth structure,” he maintains.
DMG America has introduced a resin infiltrant, an effective new concept in the restoration of demineralized tooth structure. “The introduction of the resin infiltration technique utilizing DMG America’s Icon® system," Rowe says, "has provided dentists with a new tool that is effective in preserving tooth structure while disrupting the caries process.” Designed to treat incipient caries, rather than waiting for the need to initiate more invasive approaches—ie, drilling and filling—he says that Icon fills, reinforces, and stabilizes demineralized enamel without drilling or sacrificing healthy tooth structure.
In this way, Rowe explains, resin infiltration of the carious lesion bridges the gap between chemical remineralization efforts and aggressive mechanical restoration. Citing additional benefits, he says, “Resin infiltration eliminates the need to anesthetize a patient to restore a lesion, and it only requires one office visit, thus eliminating the frustrations of return visits and need for patient compliance. Because the active cavity is treated completely in one visit, it increases the percentage of success in restoration and sets the stage for subsequent potential remineralization.” Rowe observes that approaches such as resin infiltration with Icon to slow or reverse the caries process are especially important because their success does not depend on stringent patient compliance and/or numerous repetitive applications of medicaments over time. “Despite the best efforts of dental professionals and patients, too often, the caries process continues, resulting in the need to employ aggressive mechanical restoration. In many cases, utilization of Class II restorations leads to the removal of a significant amount of healthy tooth structure relative to a significantly smaller amount of decayed tooth structure purely to access the carious lesion.”
Rowe, who uses Icon in his own practice, says DMG America provides in-office continuing education for clinicians who are interested in learning more about resin infiltration as a viable means of treating incipient caries lesions. “It provides clear guidelines for determining proper treatment selection, including criteria based on lesion type, lesion depth, and surface quality. The capabilities and limitations of treating incipiencies through the caries infiltration process are also addressed,” he says.
Rowe is optimistic that caries control will continue to improve using integrated approaches. “Appropriate protocols of periodontal therapy, hygiene instruction, chemical remineralization, resin infiltration, and conventional mechanical restoration of carious lesions, each where appropriate, all work together in clinical practice to provide effective treatment of caries as a disease.”
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