Dental caries: Therapeutic possibilities

Contemporary tendencies in dentistry are based on the concept of maximal protection of healthy tooth tissues. Caries removal has been done traditionally with mechanical rotary instruments that are fast and precise. However, conventional cavity preparation has potential adverse effects to the pulp due to heat, pressure and vibrations. Moreover, drilling often causes pain and requires local anaesthesia, and these procedures are frequently perceived as unpleasant. Etiology, development and prevention of dental caries are better understood today and new restorative materials that bond micromechanically and/or chemically to dental tissues have been introduced. Thus, development of a new, less destructive caries removal technique is allowed. In the last decades, many alternative methods have been introduced in an attempt to replace rotary instruments. These are claimed to be efficient and selective for diseased tissues and to offer comfortable treatment to the patients. New methods include air abrasion, air polishing, ultrasonic, polymer burs, enzymes, systems for chemo-mechanical caries removal, and lasers. The aim of this paper was to discuss various caries removal techniques and possibilities of their use in clinical practice. Based on the literature review it can be concluded that none of the new caries removal methods can completely replace conventional rotary instruments.