Minimally invasive dentistry through chemical caries removal

Abstract

Introduction: Minumally invasive dentistry encopasses techniques focused on the maximum preservation of dental structures. Within this framework, chemical caries removal using papain-based products allow for the removal of infected dentin while preserving affected dentin. This alternative enables minimal or no use of rotary instruments, or even omits them entirely, reducing undesirable thermal and pressure effects during caries removal in teeth affect by molar-incisor hypomineralization (MIH), which improves patient behavior management. Clinical case: Several cases of chemical caries removal in hipomineralized molars are presented, with informed consent obtained from parents/guardians. Local anesthesia was administered in the area of the molar to ne treated (2% lidocaíne): Absolute isolation was applied to prevent the product from contacting the mucosa and to facilite the adhesion technique of the composite material. If the caries was not exposed, rotary instruments were used to access it and allow product placement. The product was applied in the cavity for the time indicated by the manifacturer. Caries removal was performed using blunt curettes or gentle sweeping motions. Once the caries was eliminated, the resulting cavity was rinsed and restored using the acid-etching+adhesive+flowable/hybrid composite technique, followed by checking the patient¨´´s occlusion. Conclusion: Enzymatic removal is an excellent option for molars with MIH.