• Treatment of caries without a drill: the pros and cons

    At the heart of fears before dental treatment lies the fear of pain caused by drilling. Elimination of this problem is one of the most urgent tasks of modern dentistry.

    Removal of affected dental tissues is possible without traditional drilling. There are two main methods - physical( laser) and biochemical( enzymatic).We will consider which method of caries treatment without a drill is modern, and the safest.

    Laser preparation

    The essence of treatment of hard tissues of a tooth by laser radiation consists in exposure to electromagnetic radiation with a wavelength of 2.78 μm. Enamel and dentin, like all tissues of the human body, contain water, which undergoes intense heating and almost instantly boils.

    The resulting steam literally breaks the surrounding tissues, which crumble in the area of ​​contact with the working tool. The heating zone is very small, which does not allow deep heating of the tooth. To prevent overheating of the treated surface and evacuation of the infected dust, additional water cooling is used.
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    Laser treatment has a number of advantages:

    1. 1) Surface treatment is completely painless and is not accompanied by unpleasant sensations, including vibration.
    2. 2) Simultaneously with the mechanical treatment of solid tissues, they are completely sterilized, because intense electromagnetic radiation is harmful to all kinds of microorganisms.
    3. 3) The treated surface at the microscopic level does not look perfectly even, but rough, which contributes to better contact with the filling materials.
    To the relative disadvantages of laser treatment of teeth can be attributed a large cost of equipment and increased requirements for the qualification of medical personnel. In addition, virtually with every treatment still does not do without a conventional drill - you need to refine the shape of the cavity, grinding the enamel edge and finishing the fit and polishing the seal.

    Treatment of caries using proteolytic enzymes

    One of the recent beliefs is the hope for the possibility of treatment of caries by applying a "cotton wool with medicine."Such information is based on work related to the use of enzymes.

    The structure of dental tissues is not uniform. In addition to the predominant inorganic substances, there is also an organic, protein matrix, around which the solid tissues themselves are built. Having lost this protein structure, enamel and dentin become more fragile. Therefore, it is proposed to treat the inner surface of the carious defect with proteolytic enzymes for the purpose of final destruction of tissues that are disrupted in the process of caries development.

    However, the remaining structures of the tooth's hard tissues will still need mechanical removal. This can be done by scraping with a hand tool( excavator), but the quality of work will be much inferior to the traditional treatment of the drill. This method can be used, for example, in the treatment of shallow caries in temporary teeth in the event that the child because of severe fear does not allow the use of conventional preparation.

    To obvious drawbacks of this method of treatment should be attributed:

    1. 1) The inability to give the carious cavity optimal shape, which contributes to better fixing of the filling material.
    2. 2) There is a high probability of recurrence, recurrent caries on the seal-to-tooth line. This is due to the fact that without smoothing the edges of the cavity with a fine abrasive tool, it is impossible to achieve a good edge fit of the seal.
    3. 3) The final processing of the seal still has to be carried out by a drill.
    Treatment of tooth defects without the use of a drill is possible in principle. However, these methods are still very imperfect for today. The best confirmation of this is the widespread predominance of traditional methods using mechanical processing.

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