Minimal Intervention Preventive Treatment
PROTECT & PREVENT
Managing dentine hypersensitivity with MI Varnish
Case 1: 49 year-old female patient presented with concerns regarding gum recession and some sensitivity in her lower molar teeth when brushing. MI Varnish application was completed and sensitivity was markedly reduced.
Courtesy Prof. Ian Meyers
Case 2: 63 year-old female patient reporting sensitivity with clinical signs of dental erosion caused by high consumption of fruits. MI Varnish™ application is repeated every 4 months for reducing sensitivity and protecting exposed root surfaces.
Courtesy Prof. Matteo Basso
Case 3: 73 year-old female polypharmacy patient presented with a complaint of a very dry mouth and hypersensitivity in many of her teeth, particularly around the gum line of the teeth. The exposed root surfaces were coated with MI Varnish™ to provide some immediate relief from the sensitivity and assist with the ongoing desensitization of these exposed dentine surfaces. The patient was advised to use a combination of GC Dry Mouth Gel followed by GC Tooth Mousse Plus® twice daily after brushing, with particular attention to this protocol when going to bed at night.
Courtesy Prof. Ian Meyers
Protecting exposed root surfaces with GC Fuji® VII/VII EP
A patient presents with an exposed root surface on a canine; Dr. Graeme Milicich.
The plaque was gently removed.
GC Fuji® VII EP White applied.
Completed GC Fuji® VII EP root surface protection.
CAVITY CONDITIONER applied for 10 sec.
Application of EQUIA® Forte Coat (light-cured 20 sec).
“For the first time, dentists can give the older patients effective treatment that will protect exposed root surfaces. The technique is non-invasive, painless and does not rely on compliance.” Ngo, Knight
Root surface caries in an 82 year-old dry mouth patient; Dr. Andrew Brostek
Hand-instrumentation was used for removal of soft caries. CAVITY CONDITIONER was applied for 10 sec.
After rinsing and gently drying the cavity, GC Fuji®VII EP was applied to coat the root surface. COCOA BUTTER was applied immediately after.
TREAT & CONTROL
Managing erosion, poor oral hygiene and exposed roots
Prof. Matteo Basso
A 78 year-old lady presented for treatment with evidence of erosion combined with mechanical abrasion from normal masticatory function. Gold overlays which were placed 35 years ago (4 in each quadrant on premolars and molars) continue to function effectively. GC Tri Plaque ID Gel™ was used to identify areas where the plaque has not been cleaned off. The areas that appear light blue are of most concern, as this is where an acid-producing cariogenic biofilm has developed (image 3). Cervical lesions were restored with EQUIA® Forte as the shape of those lesions facilitated plaque deposit. MI Varnish™ was applied to reinforce thin enamel layers and to protect the margins of the overlays. MI Varnish™ will be reapplied at every recall appointment to help elevate calcium, phosphate and fluoride levels at and around high risk sites.
CAVITY CONDITIONER was used (10 sec.).
GC Tri Plaque ID Gel™ applied.
Areas that are light blue indicate a high risk biofilm.
EQUIA® Forte Fil (A3) was placed.
MI Varnish™ was applied to reinforce thin enamel layers.
MI Varnish™ was applied to protect the margins of the overlays.
Stabilising the mouth of a dental phobic patient
Dr E. Stephen Vouliotis
A 67 year-old female psychologist, previously diagnosed with dental phobic and high caries risk, presented for treatment of a carious lesion on tooth 23. She has been a regular patient since 2001. According to her medical history, she had survived an aneurysm with no loss of body function. More recently she was diagnosed with breast cancer and was treated with surgery and chemotherapy – she has fully recovered and is cancer free. However, her oral environment had suffered, consequently becoming very dry. Her home care includes GC Tooth Mouse Plus® and GC Dry Mouth Gel. She continues to attend the practice regularly for examination and application of MI Varnish™.
Caries lesion on tooth 23 cervical.
After the removal of decayed tissue, CAVITY CONDITIONER was used (10 sec.) to remove surface debris.
Tooth cavity was washed and gently dried.
A clear cervical matrix was positioned in place.
GC Fuji® II LC was placed in one single increment.
Pressure was applied on the clear matrix and GC Fuji® II LC was light-cured for 20 sec.
Polishing cup under water spray was used.
Managing active caries at partial denture clasp
Dr E. Stephen Vouliotis
A patient with active caries presented with lesions at the clasp-tooth contact areas of his partial denture. GC Fuji®IX gp EXTRA is an excellent option for restoring the distal lesion on tooth 14 and protecting surrounding tooth structures. Another excellent option is GC Fuji® BULK which is less aesthetic but more acid resistant so ideal for restoring and protecting in very high risk patients. After diagnosis was established, a patient-specific prevention strategy was implemented to encourage new oral hygiene habits with additional supplements (e.g. nightly application of GC Tooth Mousse Plus®) to drive their oral environment towards one favouring remineralisation.
Partial denture wearing is a predictor for root surface caries. Hence, “partial denture wearers should be the target of intensive preventive efforts”.Thomson, 2004
Partial denture in place.
Lesion on tooth 14.
CAVITY CONDITIONER was applied (10 sec.) followed by GC Fuji® IX gp EXTRA shade A3.
After contour and finish, apply EQUIA® Forte Coat (light-cured 20 sec).
Cases extracted from the South East Asia edition of The Silver Wave booklet.