Minimally invasive dentistry.

BACKGROUND: During the past few decades, scientific developments in cariology, dental materials and diagnostic systems have changed dentistry's approach to diagnosis and management of dental caries. The authors summarize these developments. OVERVIEW: Dental adhesives and restorative materials, new understanding of the caries process and remineralization, and changes in caries prevlance have catalyzed the evolution in caries management from G.V. Black's "extension for prevention" to "minimally invasive." The authors describe the scientific basis for early diagnosis; a modified classification of caries based on site and size of lesion remineralization; reduction of cariogenic bacteria; and minimally invasive cavity preparation design, techniques and material selection. CONCLUSIONS AND PRACTICE IMPLICATIONS: Minimally invasive dentistry is based on advances in science. Emerging technologies will facilitate evolution to primary prevention of caries, though technical, cultural and economic obstacles to full implementation in clinical practice now exist.