Proof first, profit second.
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Biomedical subjects
Publications and source records attributed to G Milicich.
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Microdentistry principles are based on the early control of and intervention in the effects of the caries process. Once a decision to treat a lesion has been made, a further understanding of the biomechanical functioning of the tooth in relation to anatomical structures is required. Preservation of these structures requires the development of skills to allow the preparation of minimally invasive cavity designs. This may involve learning to use magnification, air abrasion, caries detection dye, or a diagnostic laser. Autocure glass ionomer cements complement minimally invasive cavity designs. The preservation of healthy tooth structure using noninvasive treatment techniques or minimally invasive cavity designs is now one of the primary goals of modern operative dentistry.
Because of the difficulties associated with the diagnosis of occlusal caries, many clinicians have adopted the philosophy of "watch and wait". The decision to treat, be it by sealing or cavity preparation, is often made after the caries process is well established, and either bonding techniques fail, or unnecessary sound tooth structure is lost. The current diagnostic model of visual, probe, and radiographic examination is qualitative, subject to operator interpretation, and consequently can produce varied diagnoses from dentists examining the same patient. Recent advances in caries diagnosis and an understanding of the caries process, fissure morphology, and bonding principles allow early intervention. Mirror and probe examination is only 25 percent accurate in detecting early occlusal caries. The use of caries detection dye and laser caries diagnosis raises diagnostic accuracy beyond 90 percent. Hidden caries is now an historic phrase. Early and accurate diagnosis of occlusal caries enables successful prevention and minimal intervention restorative techniques, ending the common evolution from occlusal restorations through to cusp restorations, crowns, and endodontics.
Stress distribution in human tooth structure can be visualized through the use of Moiré fringes, which has improved the clinical understanding of recently identified anatomical structures in molar occlusal surfaces. This article discusses the concept of a "peripheral rim of enamel" and describes the manifestation of compressive and tensile fractures within the peripheral rim of enamel and dentin. It also emphasizes the benefits of microdentistry techniques and minimally invasive preparation designs in the long-term preservation of the natural tooth structure.