Hard dental tissue minimal-invasive preparation using contemporary polymer rotating instruments and laser

Abstract

Goal of contemporary dentistry is to decrease the patient's discomfort during treatment. Dentists aim to achieve maximum with the newly developed dental materials as well as with new cavity preparation techniques in the shortest time span. Since the development of the first constructed borer (drilling machine) for caries removal, the preparation techniques have considerably changed. The progress of dental materials as well as the cavity preparation techniques has led us to contemporary carbide tungsten and diamond borers that are used with obligatory water cooling. The innovation within this field represents newly developed polymer borers that can detect the difference between carious lesions and healthy tooth structure. In this way the cavity preparation may be performed without damaging dental healthy tissue. This is possible owing to their hardness which is lower than the hardness of intact dentin. Polymer borer preparation is painless with less vibration, while the increase in temperature is negligible. Lasers have been used in clinical dentistry since 1980s so it can be said that they represent a new technology. The function of lasers is based on ablation which requires water. Erbium lasers have shown the highest potential with their ability to produce effective ablation of hard dental tissues. Laser application in dentistry requires special training as well as some protective measures. Laser advantages, compared to traditional preparation techniques, involve the absence of vibration, painless preparation, possibility of preparation without anesthetic and easier patient's adjustment to dental intervention which is of importance, especially in pediatric dentistry.

Savremena stomatologija teži ka što manjoj traumatizaciji pacijenta prilikom rada uz maksimalni učinak. Savremeni materijali uz nove vidove preparacije kaviteta pružaju mogućnost sanacije karijesnih lezija u najkraćem vremenskom roku. Vidovi preparacije kaviteta su se znatno promenili otkako je uvedeno prvo mašinski napravljeno svrdlo za uklanjanje karijesa. Tehnološki napredak materijala za ispune i načina preparacije doveli su do savremenih karbidnih i dijamantskih svrdla koja se koriste uz obavezno vodeno hlađenje. Inovaciju na polju rotirajućih instrumenata predstavljaju polimerna 'pametna' svrdla, koja uklanjaju karijesnu leziju bez mogućnosti povređivanja i uklanjanja zdrave zubne strukture. Ovo je moguće zahvaljujući čvrstoći koju poseduju, koja je manja od čvrstoće zdravog dentina. Zahvaljujući prirodi materijala od kojih su izrađena, ova svrdla omogućuju bezbolniji rad uz manje vibracija i slabije zagrevanje zubne supstance. Laseri su relativno novo tehnološko sredstvo u stomatologiji, a njihova klinička upotreba počela je osamdesetih godina dvadesetog veka. Laseri funkcionišu po principu ablacije, za šta je neophodno prisustvo vode. Najveći potencijal među ispitivanim laserima pokazali su erbijumski laseri, kojima je moguće uraditi efikasnu ablaciju čvrstih zubnih tkiva. Za korišćenje lasera u stomatologiji neophodni su posebna obuka i odgovarajuće mere zaštite. Prednosti lasera u poređenju sa drugim metodama preparacije čvrstih zubnih tkiva su nepostojanje vibracija, bezbolan rad, mogućnost rada bez anestezije i lakše prilagođavanje pacijenta stomatološkim intervencijama, što je veoma značajno u dečjoj stomatologiji.