Conservative Composite Resin Restoration for Proximal Caries - Two Case Reports

Equivalence study of the resin-dentine interface of internal tunnel restorations when using an enamel infiltrant resin with ethanol-wet dentine bonding

This preregistered ex vivo investigation examined the dentinal hybrid layer formation of a resinous infiltrant (Icon), with reference to both thickness (HLT) and homogeneity when combined with modified tunnel preparation (occlusal cavity only) and internal/external caries infiltration. The adhesives Syntac and Scotchbond MP were used as controls (Groups 1 and 3) or in combination with Icon (Groups 2 and 4). A split-tooth design using healthy third molars from 20 donors resulted in 20 prepared dentine cavities per experimental group. The cavity surfaces (n = 80) were etched (37% H3PO4), rinsed, and air-dried. Rewetting with ethanol was followed by application of the respective primers. After labeling with fluorescent dyes, either Syntac Adhesive/Heliobond or Scotchbond MP Adhesive was used alone or supplemented with Icon. HLT, as evaluated by scanning electron microscopy, did not significantly differ (P > 0.05), and confocal laser scanning microscopy revealed homogeneously mixed/polymerized resin-dentine interdiffusion zones in all groups. Icon can be successfully integrated into an ethanol-wet dentine bonding strategy, and will result in compact and homogeneous hybrid layers of comparable thickness considered equivalent to the non-Icon controls, thus allowing for preservation of the tooth's marginal ridge and interdental space in the case of internal/external infiltration of proximal caries.

Tunnel Restoration: A Minimally Invasive Dentistry Practice

With advances in technology, dentists nowadays manage dental caries with the philosophy of minimally invasive dentistry. Dental restoration is now performed most conservatively with minimal destruction of tooth structure when operative dentistry is indicated. Some operative dentists suggested using tunnel restoration for treating proximal caries as a conservative alternative to the conventional box preparation. The main advantage of tunnel restoration over the conventional box or slot preparation includes being more conservative and increasing tooth integrity and strength by preserving the marginal ridge. However, tunnel restoration is technique sensitive and requires advanced operative skills. Tunnel restoration can be an option to restore proximal caries if the dentist selects the proper case and pays attention to the details of the restorative procedures. With the dentist's advanced training, advanced light-emitting diode handpieces, magnifying loupes, precise digital imaging and new generation restorative materials, good results can be obtained in selected cases. This study reviews the literature on tunnel restoration and provides updated techniques and clinical data that can be used in tunnel restoration to oversee its limitations and the perspective on restorative treatment.