List of Contributors ix Foreword xi Preface xiii About the Companion Website xiv 1 Introduction to Minimally Invasive Dentistry: History of Minimally Invasive Dentistry and Key Concepts 1 Aylin Baysan and Kenneth Eaton Key Topics 1 Learning Objectives 1 Introduction 1 The Epidemiology of Dental Caries Worldwide 2 The Epidemiology of Periodontitis Worldwide 4 The Epidemiology of Tooth Wear 5 The Epidemiology of Tooth Loss 5 The Concept of Minimally Invasive Dentistry (MID) 7 Principles of Minimally Invasive Dentistry (MID) with Advantages and Disadvantages 7 The History of Minimally Invasive Dentistry (MID) 8 Summary 8 Further Reading 9 References 9 2 Where Are We with the Evidence for Minimally Invasive Dentistry? 11 Derek Richards and Valeria Marinho Key Topics 11 Learning Objectives 11 Introduction 11 Clinical Experiences and Patient Values 12 Evidence 12 Clinical Experience 13 Patients Values 13 The Evidence-based Approach 13 Asking Answerable Questions 14 Searching for the Best Evidence 14 Evidence-based Computerised Decision Support Systems 15 Evidence-based Guidelines 15 Systematic Reviews 15 Individual Studies 16 Critical Appraisal 16 Applying the Evidence 17 Evaluating the Outcome 17 High Quality Evidence in Relation to MID 17 Cochrane Reviews on the Effects of Minimal Intervention Approaches in Caries Management 18 The Main Findings/Conclusions from Each Review Were 19 Cochrane Reviews on the Effects of Other MID Approaches (Consequences of Dental Caries) 21 Summary 22 Further Reading 22 References 23 3 Molecular Dentistry: Role of Salivary Proteins in Dental Hard Tissue Protection 25 Paul Anderson Key Topics 25 Learning Objectives 25 Introduction 25 Protein Control of Enamel Formation 26 The Inorganic Chemistry of Dental Hard Tissue Mineral Loss 27 The Role of the Organic Proteins of Saliva in Enamel Mineral Preservation 30 Biomineralisation and Bio-demineralisation/remineralisation 31 The Potential Roles of Protein Engineered Salivas in Minimally Invasive Dentistry 32 Overall Conclusion 33 References 33 4 Dental Caries Risk Assessment and Early Caries Detection 35 Bennett T. Amaechi Key Topics 35 Learning Objectives 35 Introduction 35 What Is Caries Risk Assessment and Its Benefits? 37 The Components and Uses of Caries Risk Assessment Tools 38 The Caries Risk Likelihood Matrix 45 Identification of Factors Predictive of Risk 46 Caries Detection, Activity Assessment, Staging, and Diagnosis in Caries Risk Assessment 47 Visual Caries Detection 47 Detecting Early Lesions on Buccal, Lingual and Root Surfaces 49 Detecting Early Caries in Pits and Fissures on Tooth Surface 51 Detecting Lesions on Tooth Proximal Surfaces 52 Detecting Early Caries around Restorations 53 Assessing Caries Lesion Activity 53 Staging of the Caries Process 54 Radiographic Detection of Early Caries 56 Diagnosis of Dental Caries 57 Clinical Application of Caries Risk Assessment 57 Summary 57 Further Reading 58 References 58 5 Management of Dental Caries: Minimally Invasive Dentistry vs. Conventional Strategies 65 John Featherstone Key Topics 65 Learning Objectives 65 Introduction 65 Clinical Challenges to Manage Dental Caries 66 Caries Risk Assessment and the Process 67 Disease Indicators 68 Biological and Environmental Risk Factors 70 Protective Factors 70 Determining the Caries Risk as Low, Moderate, High, or Extreme 71 Levels of Chemical Therapy Needed According to the Caries Risk Assessment 71 Low Caries Risk Chemical Therapy 72 Moderate Caries Risk Chemical Therapy 72 High Caries Risk Chemical Therapy 72 Extreme Caries Risk Chemical Therapy 73 Anticaries Agents and Delivery Systems 73 Bioactive Materials and the Future 74 When to Consider Conventional Treatment in High Risk Patients? 74 Summary 74 Further Reading 75 References 75 6 Intraoral Vaccine and Their Potential Clinical Use 77 Lesley Ann Bergmeier Key Topics 77 Learning Objectives 77 Introduction 77 A Brief History of Vaccination 78 Principals of Vaccination 78 Types of Vaccine Preparations 80 Immunisation 83 The Structure and Function of the Oral Cavity 84 Immune Responses in the Oral Cavity 85 Inflammation and the Immune Response: Defending the Barricades 85 Inductive and Effector Sites in the Oral Cavity 88 Mucosal Immunisation and Oral Tolerance 89 Oral Diseases and Vaccination 89 Dental Caries 90 Periodontal Disease 91 Behçet''s Disease (BD) 92 Sublingual and Buccal Vaccine Delivery 92 ''Biologics''-passive Immunotherapy with Monoclonal Antibodies 93 Cancer 95 Summary 95 References 96 7 Can Minimally Invasive Strategies Be Applicable in Restorative Dentistry? 101 Sevil Gurgan, Zeynep Bilge Kutuk, and Aylin Baysan Key Topics 101 Learning Objectives 101 Introduction 101 Evolution of Minimally Invasive (MI) Strategies in Restorative Dentistry 102 mi Operative Management Strategies in Anterior and Posterior Dentition 103 mi Management of Early Carious Lesions 103 Fissure Sealants 103 Preventive Resin Restoration (PRR) 104 Resin Infiltration Technique 104 mi Restorations in Non-Carious Cervical Lesions 105 mi Management for Deep Carious Lesions 105 Remineralisation of Demineralised Dentine 105 Cavity Design and Principles for MID 106 Appropriate Excavation Methods 106 mi Restorations in Posterior Teeth 107 mi Restorations in The "Aesthetic Zone" 107 "No-Prep" Adhesive Restorations: Another Way to Deal with Problems Related to Aesthetics 108 Management of Tooth Discoloration with MI Approach 108 Tooth Whitening/Bleaching 108 Management of Tooth Wear with MI Approaches 111 Tooth Loss and MI Restorative Approaches 113 An Alternative Replacement Approach to Tooth Loss: Resin Bonded Bridges 113 Repair of Defective Restorations 115 Summary 116 Further Reading 117 References 117 8 Dental Materials and Their Clinical Implications in Minimally Invasive Dentistry 123 Saroash Shahid and Robert Hill Key Topics 123 Learning Objectives 123 Introduction 123 Glass Ionomer Cements and the Atraumatic Restorative Treatment (ART) 124 Bioactive Dental Composites 126 Cention N 126 Activa Bioactive 127 Bioactive Glass as Remineralizing Agent 127 Original Studies by Hench and Spilman on Incorporating Fluoride 129 New Fluoride- Containing Bioactive Glasses 129 Sol=Gel Fluoride- Containing Bioactive Glasses 130 Chloride- Containing Bioactive Glasses 131 Incorporating Bioactive Glasses into Resin Matrices 131 Summary 135 Further Reading 135 References 136 9 Where Are We with a Minimally Invasive Approach in Periodontology? 141 David Gillam, Nik Pandya, and Wendy Turner Key Topics 141 Learning Objectives 141 Introduction 141 Changing Concepts: Dynamic Paradigm Shifts in Dentistry and in Periodontology 142 Non-surgical and Surgical Procedures in Periodontology 143 Non-surgical Procedures 144 Surgical Procedures in Minimally Invasive Periodontal Surgery (mips/mist) 146 Advantages of Minimally Invasive Periodontal Surgery 146 Disadvantages of Minimally Invasive Periodontal Surgery 147 Example of Applying the Principles of Minimal Invasive Periodontal Surgery in a Periodontal Practice 148 Relevant Medical and Dental History 148 Clinical Examination 148 Main Complaint 149 Surgical Procedure 149 Post-operative Instructions 150 Patient Outcomes 151 Post Script 152 Concluding Remarks 152 Glossary 153 Further Reading 155 References 155 10 Pulp and Endodonic Regeneration 158 Alastair J. Sloan Key Topics 158 Learning Objectives 158 Introduction 158 The Dentin-Pulp Complex 159 Dental Pulp Stem Cells and Regeneration of the Dentine-Pulp Complex 161 Vital Pulp Therapy 163 Regenerative Endodontics 165 Summary 167 References 168 11 Minimally Invasive Dentistry in Paediatric Dentistry 173 Paul Ashley and Ferranti Wong Key Topics 173 Learning Objectives 173 Introduction 173 Differences between Primary and Permanent Teeth and How This Will Influence the MI Approach 174 Eruption and Exfoliation 174 Thinner Enamel and Dentine 175 Pulp Chamber and Canals 175 Dental Materials for Primary Teeth 176 Differences between Treating Children and Adults and How This Will Influence the MI Approach 177 Managing Behaviour 177 Health Promotion for Children 177 mi Therapies for Children 178 Silver Diamine Fluoride 178 Sealing in Caries 178 Atraumatic Restorative Technique 180 Summary 180 References 180 12 Minimally Invasive Dentistry in Orthodonti.