Dentistry in the preceding century was primarily replacement dentistry, with carious lesions being surgically excised. Secondary caries and fractures are the primary causes of restoration failures. The notion of minimal intervention dentistry arose as a result of improved understanding of the carious process and the advent of adhesive restorative materials. It is now understood that demineralized but non-cavitated enamel and dentin can be repaired, and therefore, G.V. Black's surgical method for treating a carious lesion, combined with "extension for prevention," is no longer acceptable [1].

The minimal intervention strategy begins with disease diagnosis and risk assessment in order to make an informed treatment decision. The initial carious lesion can be managed in a variety of ways, including non-invasive management and surgical care. Advances in caries management have sparked a trend toward tooth structure conservation and also toward bonding approaches that give a substitute to mechanical retention [2].ss

Despite a decline in recent decades, dental caries remains one of the most common diseases internationally. Caries treatment is a major issue in oral healthcare because it affects international clinical and economic burden [3]

Dental caries management is an essential concern in oral healthcare. Nevertheless, the absence or failure of preventive care will result in the necessity for surgical intervention. This involves both delayed interventions and smaller-sized preparations limited to the removal of carious tissue only [4].

The fundamentals of cavity preparation have evolved as a result of adhesive techniques. Retentive measures can be decreased to a minimum by preserving dental tissue that was previously excised for retentive objectives. The saucer-shaped cavity design is a modern method of non-carious tooth preservation that makes great use of the adhesive technique [5].

The preparation of the tunnel cavity constituted a novel approach to the management of carious lesions in the molars and premolars. In primary approximal caries lesions, the tunnel preparation filled with glass- ionomer cement is not a typically satisfactory alternative [6].

To truly understand minimally invasive dentistry some important principles of (MID) should be considered before planning to do cavity preparation including.

1. Early caries diagnosis
2. Classification of caries depth and progression
3. Individual risk assessment
4. Optimal caries preventive measures
5. Remineralization of early lesions
6. Minimally invasive cavity preparation techniques
7. Repair rather than replacement of defective restoration
8. Assessing disease management outcomes at intervals

Diagnosing caries involves more than just detecting the carious lesion. Detecting caries activity, which may be much more critical, can be a challenge. When dental plaque adheres to the teeth, it begins the process of demineralization of the underlying tooth structure. Keeping in mind that caries activity cannot be detected at a single point in time, it must be monitored over a long period of time. In most cases, radiographs and clinical findings are employed to establish this determination, but new diagnostic technologies are on the rise. When it comes to occlusal decay, there are a number of different procedures that may be used to detect it. Some of the more recent technologies used in dentistry include laser fluorescence, tuned-aperture computed tomography, and optical coherence tomography [7].

Mount and Hume developed a new classification of the carious lesion in 1997. This new technique identifies the location, extent, and complexity of a cavity while also encouraging a conservative approach to natural tooth structure preservation. This novel system is intended to enhance the lesion's capacity for healing [8]. Table (1)

Table 1: New Classification of Caries Depth and Progression.

Risk is the likelihood that some harmful event will occur. Caries risk is described as “the probability of future caries disease development” [9].

Patient’s Assessment and Classification Based on Their Risk of Developing Caries

Low Risk

There have been no cases of caries in recent years, Coalesced or plugged fissure and pit, Maintaining proper oral hygiene, appropriate fluoride application, Dental examinations on a regular visit [10].

Moderate Risk

In recent years, there has been one carious lesion. Deep fissures and pits, proper oral hygiene White spots radiolu-cencies in the inter-proximal area, insufficient exposure to fluoride, Inconsistent dental visits [10].

High Risk

Two or more carious lesions within the last three years, Caries on smooth surfaces in the past. Deep fissures and pits. No/minimal exposure to fluoride. Low oral hygiene. Frequent sugar consumption. An insufficient flow of saliva. Inconsistent dental visits [10].

“Prevention is better than cure”. The dentistry profession focus has shifted progressively toward caries prevention through a variety of techniques. The following techniques demonstrate the optimal caries preventive measures [11].

Wrestling with Microorganisms Induces Caries

Antibacterial solutions have been recommended, such as mouthwash, with the purpose of lowering cariogenic bacteria. Chlorhexidine digluconate (CHX) is a widely utilized antimicrobial agent due to its capacity to drastically lower the number of cariogenic microorganisms in the oral cavity [12-13].

Diet Modification

The majority of initiatives to reduce sugar intake in the community are ineffective. The same association has been discovered in other countries among caries preponderance, sugar intake, and extensive use of fluorides.

The diet modification can be achieved through some of the following strategies.

• Natural demineralization inhibitors, such as fluorides, are added to drinking water.
• Consume more preventive dietary components such as polyphenols found in cheese, and milk. Casein phosphopeptides complexed with calcium phosphate in milk
• Sugar substitution [11,14].

Raising the Resistance of Teeth to Decay

This can be achieved by using fluorides and other methods to strengthen the teeth, while lowering sugar exposure, which has an effect on the cariogenic bacteria and acid formation in dental plaque.

• Fluoride, pit & fissure sealant
• Remineralization with amorphous calcium phosphate (ACP) [11,15].

Enamel demineralization and remineralization occur when oral bacteria build a biofilm on the enamel surface and are exposed to fermentable dietary carbohydrates, particularly sucrose. Enamel can recover some of the minerals lost when the pH is elevated and the supersaturating conditions are restored. This is called remineralization. Calcium and phosphate in the biofilm fluid or salivary Calcium and phosphate can redeposit minerals that have been lost by enamel after the biofilm is cleared by tooth brushing. This means that there is still a small loss of minerals. However, calcium and phosphate can be recovered less than they were lost [16].

Numerous Remineralizing Agents

Various agents can be used to achieve remineralization of early lesions. These agents are

• Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP).
• Combination of CPP-ACP and fluoride.
• Novamin.
• TiF4 technology.
• Tricalcium phosphate.
• Nano hydroxyapatite [17].

The contemporary notion of "minimal-invasive dentistry" advocates a more conservative approach to the removal of bacterially infected and irrevocably demineralized carious dentin in order to preserve as much remineralizable dentin as possible and avoid pulp exposure. The quest for a less invasive, painless, and conservative approach to caries excavation has resulted in the development of procedures that focus exclusively on diseased dentin removal. Further advancement of the carious lesion should be halted by removing only the bacterially contaminated dentin. Unfortunately, there are still issues about how to determine this caries eradication target, as it is unlikely to be clinically attainable [18].

The following techniques are used in minimally invasive cavity preparation.

1. Mechanical rotary high/ low-speed system.

• Fissurotomy burs.
• Polymer burs as (Smart burs).

2. Chemomechanical cavity preparation system.

• Application Carisolv agent.
• Application Papain gel agent.

3. Air abrasion.

4. Ultrasonics and Sono Abrasion.

5. Atraumatic restorative treatment (ART).

6. Laser

7. Ozone system.

8. Antibacterial photodynamic therapy (aPDT)

Mechanical Rotary High/ Low-Speed System

For the purpose of cavity preparation, two types of burs will be discussed in this section.

Fissurotomy Burs

They are intended specifically for pit and fissure lesions in order to facilitate ultraconservative dental treatment. The fissurotomy bur gently expands the fissures, creating a large surface area for the sealant material to adhere to it [19].

The burs tips are tiny and more conservative than those of a 1/4 round bur. The head length of the Fissurotomy original and Fissurotomy Micro NTF is

2.5 mm, whereas the head length of the Fissurotomy STF is 1.5 mm [20].

• Conservative molar pit/fissure excavation. The Fissurotomy Original bur can be used.
• Ultraconservative molar pit/fissure excavation. The Fissurotomy Micro NTF, with a Narrow Taper Fissure can be used.
• Primary teeth, adult premolars, and enameloplasty Micro STF Fissurotomy, with a Shallow Taper Fissure can be used
• [20].

Advantages

Fissurotomy burs have many advantages including.

• Often time without using local anesthesia. These types of burs can be used in conservative cavity preparation with fissure caries.
• Low heat generation and vibration.
• Enhancement of patient comfort [20].

Disadvantages

Fissurotomy burs have a few disadvantages including.

• Must be used in conjunction with the proper restorative materials.
• Exorbitant price [20].

Polymer Burs as (Smart Burs)

The development of a specific form of bur employing a medical-grade polyetherketone-ketone has resulted in the development of the smart polymer bur, which is a rotary instrument designed for minimally invasive cavity preparation. The polymer bur design is based on the tooth structure's differential hardness [21].

Dentin is between 51 and 65 Knoop Hardness (KHN), depending on depth. Superficial dentin is harder than deep dentin. The average Knoop Hardness for active caries is 6.7 KHN, while arrested caries is 39.2 KHN. So, an instrument for dentin caries removal with a hardness of around 50 KHN was developed. Based on the aforementioned findings, polymer bud burs were created. (Smart Prep), the first polymer bud bur, was introduced in 2003. This particular polymer has a hardness of 50 KHN, which is between healthy dentin and carious dentin. So, the polymer bur's cutting edges wear out in contact with healthy dentin, leaving just the cariously infected dentin being removed [18].

Advantages

The use of polymer burs in cavity preparation offers the clinician a number of advantages including the following.

1. The polymer bur excavates only the carious portion of the tooth, lowering the risk of exposing the pulp tissue and thereby reducing pain and/or irritation during cavity preparation or after the procedures.
2. Due to the nature of their action, they are single-use, minimizing the possibility of cross-infection in dentistry [20].

Disadvantages

The use of polymer burs has a few disadvantages, including the following.

1. Expensive
2. Technique sensitive
3. If the bur comes into contact with the enamel or intact dentin during an operative procedure, the risks of bur destruction are higher [20].

In this section we will discuss two types of chemical system and their methods for cavity preparation.

Application Carisolv Agent

Carisolv is a material with a gelatinous consistency that is used to remove caries using chemomechanical approaches. The (new carisolv twin multimix syringe dispenser) is the name given to the delivery method. It equilibrates the two components, resulting in the emergence of an active gel from the tip of the syringe. Here is the clinical procedure for the carisolv. carisolv gel should be prepared and dispensed into an appropriate container using the Multimix Syringe Dispenser. This gel is then placed on the tooth carious lesion. The carious lesion should be soaked for a minimum of 30 seconds and a maximum of 60 seconds [22].

In the following step, an appropriate carisolv instrument should be chosen to match the cavity size, location, and accessibility. A spoon excavator should be used to gently scrape and excavate the superficial softened carious dentine; water flushing or drying the cavity should be avoided. The technique should be continued until the gel becomes clear and the dentist feels the cavity surface is hard through the use of an excavator. The dentist should check the cavity if it feels free from caries. It should be cleaned using a wet cotton pellet or washed with water [22].

Advantages

The use of Chemomechanical cavity preparation system offers the clinician a number of advantages including the following.

•  It just eliminates the infected
•  Maintains the tooth
•  Reducing the possibility of pulp exposure.
•  Painless
•  It is biocompatible and does not cause pulp
•  Promotes the bonding of adhesive fillings [22,23].

Disadvantages

When considering the chemomechanical cavity preparation system the following disadvantages will be presented.

• It takes more time to complete the
• Unappealing odor
• Unpalatable flavor
• Expensive
• If the patient is kept for an extended period of time, he or she may become uncooperative [24].

Application Papain Gel Agent

To counter the drawbacks of the carisolv system, a new formula was created in 2003 in Brazil to universalize the use of chemo-mechanical caries removal techniques and general health promotion [25]. Papacarie was really the marketing name for the new formula. It is presented in the form of a syringe containing a blue-colored gel. It is constituted mostly of papain, chloramines, toluidine blue, and salts, which function as thickening agents and contribute to papacarie bactericidal, bacteriostatic, and anti- inflammatory features. Papain is derived from the latex of the green mature papaya's leaves and fruits [26].

Prophylaxis is performed with a rubber cup and pumice. Rinse thoroughly with an air/water spray or a cotton pellet soaked in water. Tooth isolation Allowing the chemicals to act for 20 to 30 seconds after applying the papacarie, Using the other side of the excavator, clear out soft carious dentin; softened tissue should be scraped out. Application of gel, if necessary when a cavity is caries-free, rinse with a water spray [27].

Advantages

Papain gel has many advantages including the following.

• Biocompatible
• Antibacterial features.
• There is no need for local anesthesia.
• Preserves the integrity of the healthy tissue.
• There is no production of a smear layer [27].

Air Abrasion

Air abrasion is a method of removing carious tooth structure that utilizes kinetic energy. A strong tight flow of dynamic aluminum oxide particles is oriented at the target surface. The air abrasion system employs abrasive particles that are oriented to the cavity damaged area. Damaged tooth structure can be quickly removed with a powerful flow of abrasive particles [28-29].

Advantages

The use of air abrasion offers many advantages.

• Often time No local anesthesia is required.
• Less discomfort.
• No heat generation and vibration production [30].

Disadvantages

When considering the air abrasion, the following disadvan-tages will be presented.

• Because the depth of cavity penetration cannot be regulated, it must be supported with visual observation at periodic intervals.
• Protective eyewear must be utilized by patients, operators, and to stop abrasive particles from accidentally hitting the eyes.
• Another area of concern is the diffusion of powder particles into the oral cavity and/or their unwanted ingestion, for which rubber dam isolation is required.

Additionally, air abrasive systems should not be used in conjunction with magnifying devices such as loupes or dental operating microscopes since the rebounded particles would cause lens damage [31].

Ultrasonics and Sono Abrasion Systems

Since the 1950s, high-frequency ultrasonic oscillating device have been advocated for the excision of proximal carious lesions in both anterior and posterior teeth in order to provide a more conservative cavity preparation. To remove the dentin, a diamond- covered tip oscillating at a minimum frequency of 6.5 kHz and a maximum frequency of 20–40 kHz is employed [32].

Sono abrasion is a technique for selective enamel and dentin preparation that is high-quality, safe, and effective. This procedure employs high-frequency, sonic air scalers equipped with modified abrasive tips that move longitudinally between 0.055 and 0.135 mm and transversely between 0.08 and 0.15 mm. [32].

Advantages

The use of Ultrasonics and Sono Abrasion systems offers many advantages including the following.

1. No or minimal noise, vibration.
2. No heat and pressure production [32].

Disadvantages

Ultrasonics and Sono Abrasion systems have the following disadvantages which are.

1. There is low abrasion.
2. High hub excursion (0.4 mm) of tips.
3. Weakening of enamel rods with concomitant cracks close to prepared areas [32].

The first evaluation of this method occurred in the 1980s. Its concepts are based on minimal intervention dentistry. All procedures are performed entirely by hand instrument and with adhesive restoration [33]. While the MID principles entail utilizing all available technologies and instruments in order to maximize the preservation of natural tissues, ART enables the eradication or control of caries in low-income countries using the least sophisticated technology [34].

ART utilizes manual, non-rotary instruments for caries lesion removal, minimizing, if not completely abolishing, the need for local anesthesia and costly rotary or other cavity preparation equipment. After minimally preparing the ART cavity, it is restored using glass ionomer cement (GIC) [35]. Which chemically bonds to the tooth structure, exchanging ions that have been found to contribute to the remineralization of caries-affected dentin [36].

Advantages

Atraumatic restorative treatment (ART) provides the follow-ing advantages.

• Low cost.
• No aerosol generation due to the absence of rotary system accompanied by water cooling.
• Less traumatic procedure.
• Conserve tooth structure [37].

The interaction of tissue with the laser beam is the basis for laser dentistry. Tissue interaction can take one or more of the following forms: "absorption, reflection, transmission, or scattering". Laser light can be used for diagnosis (detection methods), dies activation for disinfection, photodynamic, photochemical laser effects, and laser application on dental hard and soft tissues, among other things. Since the early 1960s, when lasers were first developed, cavity preparation with lasers has been a significant topic of research. For cavity preparation and caries removal, various laser types with similar wavelengths in the middle infrared area of the electromagnetic spectrum are now employed [38].

The following lasers are currently being tested for their potential to ablate hard tissue more selectively:

• Erbium: Yttrium – aluminum-garnet (YAG)
• Neodymium: YAG – Mid infrared (IR) to IR emission
• Excimer lasers (ArF [Argon: Freon] XeCl [Xenon: Chlor-ine] UV emission)
• Holmium

Carious lesion material includes a greater proportion of water than healthy tooth hard tissues. As a result, caries seems to have a higher ablation efficiency than healthy tissues [39].

In an in-vitro investigation conducted by Bader C and Krejci I, it was discovered that the Er: YAG laser successfully ablated carious dentin with minimum thermal damage to the surrounding healthy dentin [40]. The Er: YAG laser has been shown to be a successful system for cavity preparation since it can cut at high speeds, induce secondary dentin formation, and function as an antibacterial agent. Radiation with an Er: YAG laser may alter the dentin structure by removing the smear layer and exposing the dentinal tubules, presumably enhancing the surface adherence to adhesive systems, and hence the sealing of the restorations will be greatly improved [39].

Advantages

The use of laser in minimal invasive dentistry offers the following advantages.

• Thin layers removal of tooth structure.
• Painless procedure.
• No vibrations.

No irreversible alterations to the dentine-pulpal complex [41].

Disadvantages

When considering the use of laser in clinical practice the following disadvantages will be expected.

• Requiring clinical training
• Costly device [41].

Since the nineteenth century, ozone therapy has been utilized therapeutically. The antimicrobial impact of ozone is owing to the fact that it damages cells' cytoplasmic membranes by ozonolysis of dual bonds and also modifies intracellular contents due to secondary oxidants' actions. This activity is non- specific and precise for microbial cells; it has no effect on human body cells. Because bacteria are the source of many dental issues, a potent therapy is required to effectively eliminate these causative organisms. Ozone therapy was introduced as a new approach of treating caries in the last few years. It has been suggested that applying ozone to carious lesions will halt or reverse the progression of these lesions and that using ozone will provide an alternative to the existing drilling and filling. Additionally, it has been demonstrated that Ozone can be used to kill the bacteria present in carious lesions painlessly and even without a local anesthetic [42].

One critical point to note is that during the initial stages of decay therapy, the treated regions will be rather soft and incapable of supporting any restoration. If a restoration is intended following ozone treatment, it should be scheduled during the review appointment 2-3 months after the initial ozone treatment, when the remineralization process should be well developed, the lesion static and actually reversed, and the dental tissue will be hard enough to support a restoration [39].

Advantages

The use of Ozone technology in minimal invasive dentistry offers the following advantages.

1) No local anesthesia is required.

2) No need for drilling and filling [10].

Antibacterial photodynamic therapy (aPDT) is an excellent option for treating caries lesions in the deep dentin. It has the potential to significantly lower the bacterial load of live microorganisms found in dentin, thereby promoting dental tissue mend. Additionally, just the surface and soft damaged dentin tissue can be excavated, preserving tooth structure. In general, aPDT can help treat caries lesions in a way that isn't very invasive [43].

The Mechanism of Action

Antimicrobial photodynamic therapy action is achieved by a combination of non-toxic photosensitizers (PS) with an accurate wavelength of visible light, which is activated and can cause a phototoxic response in the presence of ambient oxygen. The reactive oxygen species (ROS) created can damage biomolecules and oxidize cellular structures, ultimately killing microorganisms. Each of these variables (PS, light, and oxygen) is safe in isolation, but when combined, they can generate fatal cytotoxic (ROS) capable of selectively destroying cells. PDT can be performed multiple times due to its non-invasive nature and lack of cumulative toxicity effect. Additionally, due to its minimal danger, it is safe to use on old or compromised individuals [44].

The initial light sources employed in photodynamic therapy were ordinary lamps that produced incoherent, polychromatic light with a significant heat component. With the advancement of lasers with unique properties such as monochromaticity, coherence, and collimation, the light source has proved to be more effective for photodynamic therapy. Diode lasers operate in the resonant wavelength absorption band of the majority of currently employed dyes, are more portable, and are less expensive. Moreover, LED sources are already incorporated into the dental practice and can be employed in PDT without the need for additional equipment. However, no difference in efficacy was seen between using (LED and HeNe) light sources for photodynamic therapy [45].

Toluidine blue and methylene blue photosensitizing chemicals are the most frequently utilized in oral antimicrobial photodynamic therapy, due to their great selectivity for gram-positive and gram-negative bacteria. The interaction between the positive charges on the dye and the negative charges on the microbial cell's outer surface dictates the selectivity of this sort of dye microbial cells [45].

Minimally Invasive Cavity Preparation Designs: Cavity Design Principles:

• Getting access to the lesion's body without being too destructive
• Excavation of tooth structure that has been damaged and not capable of regeneration
• Preventing the exposure of intact dentine during the caries removal
• Keeping and reinforcing healthy enamel that has been undermined
• Minimizing the restoration's boundary
• Maintaining the restoration's margins away from the gingival tissue
• Occlusal stress reduction on the ultimate restoration [2].

Types of Proximal Cavity Design in Minimally Invasive Cavity Preparation Include the Following

Specific designs for approximal lesions:

• Tunnel
• Microchip cavity
• Minibox cavity
• Full box cavity preparation [2].

Repair Rather Than Replacement of Defective Restoration

Repairing a restoration rather than replacing it must always be based on the patient's risk of caries development, the professional's assessment of benefits vs. risks, and conservative cavity preparation guidelines. Replacement of present restorations accounts for between 50% and 71% of each general dentist's activity worldwide [46].

As amalgam and resin restorations are phased out, larger restorations with gradually lower life spans are created. Several reasons for replacing rather than repairing restorations include concerns about the bond strength of initially placed materials, residual caries, and frequent caries around the boundary of a restoration, suggesting a higher risk of developing caries on other sites, also under current restorations. Taking all of these factors into account, as well as the fact that caries does not advance under well-sealed restorations and that caries develops gradually in populations, repairing poor restorations rather than replacing them is a feasible and more conservative treatment choice. Independence retention and resistant design should be ensured through the cavity preparation procedures [46].

Assessing Disease Management Outcomes at Intervals

Throughout this phase of caries treatment, it may be necessary for the patient to revisit the dentist for diagnostic examinations, observation, and patient motivation. Treatment should be continued until the bacterial infection is eradicated and the reversible carious lesions heal completely. After achieving "absence of disease," the irreversible structural and functional loss could be addressed with minimally invasive, patient-friendly treatment methods [11].

Dental practitioners should consider this point in history as the new era of dentistry transformation from the Dr. G.V. Black role that says "extension for prevention" to a more conservative approach that is minimally invasive cavity preparation. In this case, there is no need to remove sound tooth structure in order to provide retention for the restoration.

The Implementation of the minimally invasive dentistry principles outlined above will lead to drastic changes in the way dental practitioners deal with the caries process.

Water fluoridation, the advancement of the adhesive system, the development of bioactive materials, and the increased understanding of dental professionals in the field of preventive and conservative dentistry should be great transformation points to lead dentistry to a new horizon.

Some of the minimally invasive cavity preparation techniques have a few disadvantages, which are either the cost, the effectiveness of these techniques, or the availability of these devices. We hope for a great solution to overcome these issues in order to make these techniques available to dental practitioners so more research can be done and more data can be gathered in order to conduct more investigations, upgrade the available techniques, and develop a new approach to manage the caries process.

Funding

Self-funding.

Conflict of Interests

Nil.

1. Nayak D, Ignatius G, Shenoy A, Nayak SD. Minimal Intervention Dentistry: Air Abrasion. Heal Talk. 2013; 5: 12-13.
2. Neena IE, Edagunji G, Poornima P, Nagaveni NB, Roopa KB, Bharath KP. Minimal invasive dentistry. Int J Contemp Dent Med Rev. 2015; 2015: 1-4.
3. Laske M, Opdam NJM, Bronkhorst EM, Braspenning JCC, van der Sanden WJM, Huysmans MCDNJM, et al. Minimally invasive intervention for primary caries lesions: Are dentists implementing this concept? Caries Res. 2019; 53: 204-16.
4. Lueckel MH, Paris S. When and how to intervene in the caries process. Oper Dent. 2016; 41: 35-47.
5. Bindslev HP, Petersen HB, Simonsen P, Baelum V. Tunnel or saucer-shaped restorations: a survival analysis. Clin Oral Investig. 2005; 9: 233-8.
6. Nicolaisen S, von der Fehr FR, Lunder N, Thomsen I. Performance of tunnel restorations at 3-6 years. J Dent. 2000; 28: 383-7.
7. Kinch MCA, McLean ME. Minimally invasive dentistry. J Am Dent Assoc. 2003; 134: 87-95.
8. Mount GJ, Hume WR. A new cavity classification. Aust Dent J. 1998; 43: 153-9.
9. Bhatiya P, Thosar N. Minimal invasive dentistry an emerging trend in pediatric dentistry: A review. Int J. Contemp Dent Med Rev. 2015; 2015:1-6.
10. Jayesh R, Ramakrishnan D. MINIMAL- INVASIVE METHODS OF CAVITY PREPARATION. Eur J Mol Clin Med. 2020; 7: 2068-78.
11. Gujjar KR, Sumra N. Minimally Invasive Dentistry- A Review. Int J Clin Prev Dent. 2013; 9: 109-20.
12. Rijkom VHM, Truin GJ, van’t Hof MA. A Meta-analysis of Clinical Studies on the Caries- inhibiting Effect of Chiorhexidine Treatment. J Dent Res. 1996; 75: 790-5.
13. Emilson CG. Potential Efficacy of Chiorhexidine against Mutans Streptococci and Human Dental Caries. J Dent Res. 1994; 73: 682-91.
14. Loveren VC, Duggal MS. The role of diet in caries prevention. Int Dent J. 2001; 51: 399-406.
15. Horst JA, Tanzer JM, Milgrom PM. Fluorides and Other Preventive Strategies for Tooth Decay. Dent Clin North Am. 2018; 62: 207-34.
16. Cury JA, Tenuta LMA. Enamel remineralization: controlling the caries disease or treating early caries lesions? Braz Oral Res. 2009; 23: 23-30.
17. Burman A, Nair VVR, Sistla GS, Choudhary T, Gupta S, Bothra S. Minimal Invasive Dentistry: An Update. J Adv Med Dent Scie Res. 2021; 9: 67-71.
18. Lohmann J, Schäfer E, Dammaschke T. Histological determination of cariously altered collagen after dentin caries excavation with the polymer bur PolyBur P1 in comparison to a conventional bud bur. Head Face Med. 2019; 15: 1-7.
19. Bagherian A, Akbari M, Rezaeian M, Ansari G. Microleakage assessment of fissure sealant following fissurotomy bur or pumice prophylaxis use before etching. Dent Res J. 2013; 10: 643-6.
20. Rajnekar R, Mankar N, Chandak PN, Ikhar A, Gupta R, Dugar M. Dental Burs in Restorative Dentistry and Endodontics–Past and Present: A Review. J Res Med Dent Sci. 2021; 9: 163-70.
21. Krishna AK, Prathibha RS, Athimuthu A, Prasanna P, Patil P, Deepali KJ. Comparison of efficacy of caries removal using polymer bur and chemomechanical caries removal agent: A clinical and microbiological assessment ? An in vivo study. J Indian Soc Pedod Prev Dent. 2017; 35: 6-13.
22. Huda EA. Evaluation of Carisolv in the Chemico- Mechanical Removal of Carious Dentine in Primary Molars (In vivo study). Tikrit J Dent Sci. 2014; 3: 61-70.
23. Cecchin D, Farina AP, Orlando F, Brusco EHC, Carlini-Júnior B. Effect of carisolv and papacárie on the resin-dentin bond strength in sound and caries-affected primary molars. Braz J Oral Sci. 2010; 9: 25-29.
24. Kathuria V, Ankola AV, Hebbal M, Mocherla M. Carisolv- An Innovative Method of Caries Removal. J Clin Diagn Res. 2013; 7: 3111-3115.
25. Ganesh M, Parikh D. Chemomechanical caries removal (CMCR) agents: Review and clinical application in primary teeth. J Dent Oral Hyg. 2011; 3: 34-45.
26. Garg Y, Bhaskar DJ, Punia H, Garg K, Sagorika, Saxena A. Chemomechanical Caries Removal: Pain free technique: Review article. Arch Dent Med Res. 2015; 1:33-42.
27. Puri A, Gaurav K, Kaur J, Sethi D, Jindal L, Jain S. Chemomechanical Caries Removal: An Overview. IDA Lud J –le Dent. 2020; 4: 27-38.
28. Banerjee A, Watson TF, Kidd EAM. Dentine caries excavation: a review of current clinical techniques. Br Dent J. 2000; 188: 476-482.
29. Somaraj V, Ravishankar P, Ramya S, Jeevetha M, Gandhimathi M, Gowthambala S. Minimal Invasive Dentistry: Dawn of a New Era in Tooth Preservation. Int J Res Stud Med Health Sci. 2018; 3: 10-13.
30. Leon, A., Ungureanu, L., Pu?ca?u, C. Air Abrasion: Interdisciplinary Modern Technologies— Approach to Minimally Invasive Treatment of Dental Caries. In: Pomazan, V. M., editor. Proceedings of the International Conference on Interdisciplinary Studies (ICIS 2016) - Interdisciplinarity and Creativity in the Knowledge Society. London: IntechOpen; 2016
31. Hegde VS, Khatavkar RA. A new dimension to conservative dentistry: Air abrasion. J Conserv Dent. 2010; 13: 4-8.
32. Showkat N, Singh G, Singla K, Sareen K, Chowdhury C, Jindal L. Minimal Invasive Dentistry: Literature Review. J Curr Med Res Opin. 2020; 3: 631-636.
33. Fairaq MM, Naghi KM, Alshouibi EN. MINIMALLY INVASIVE DENTISTRY. Indo Am JP Sci. 2019; 6: 1422-1428.
34. Jain S, Katiyar A. An Era from Extention for Prevention to Constriction with Conservation. Int J Dent Sci Innov Res (IJDSIR). 2018; 1: 6-13.
35. Lopez N, Simpser-Rafalin S, Berthold P. Atraumatic Restorative Treatment for Prevention and Treatment of Caries in an Underserved Community. Am J Public Health. 2005; 95: 1338-1339.
36. Ngo HC, Mount G, McIntyre J, Do L. An in vitro model for the study of chemical exchange between glass ionomer restorations and partially demineralized dentin using a minimally invasive restorative technique. J Dent. 2011; 39: S20–S26.
37. Frencken JE, Pilot T, Songpaisan Y, Phantumvanit P. Atraumatic Restorative Treatment (ART): Rationale, Technique, and Development. J Public Health Dent. 1996; 56:135-140.
38. Baroud H, Hadaya C, Hardan L, Zogheib CM. Preventive and Minimal Invasive Dentistry in Adult Patients. Smile Dent. J. 2013; 8: 8-15.
39. Jingarwar MM, Bajwa NK, Pathak A. Minimal intervention dentistry - a new frontier in clinical dentistry. J Clin Diagn Res. 2014; 8: ZE04-ZE08.
40. Bader C, Krejci I. Indications and limitations of Er: YAG laser applications in dentistry:?Review Am J Dent. 2006; 19: 178-186.
41. Beloica M, Vuli?evi? Z, Mandini? Z, Radovi? I, Jovi?i? O, Carevic M, et al. Hard dental tissue minimal-invasive preparation using contemporary polymer rotating instruments and laser. Srp Arh Celok Lek. 2014; 142: 365-70.
42. Naik SV, Rajeshwari K, Kohli S, Zohabhasan S, Bhatia S. Ozone- A Biological Therapy in Dentistry- Reality or Myth????? Open Dent J. 2016; 10: 196-206.
43. Diniz IMA, Horta ID, Azevedo CS, Elmadjian TR, Matos AB, Simionato MRL, et al. Antimicrobial photodynamic therapy: a promise candidate for caries lesions treatment. Photodiagnosis Photodyn Ther. 2015; 12: 511-8.
44. Carrera ET, Dias HB, Corbi SCT, Marcantonio RAC, Bernardi ACA, Bagnato VS, et al. The application of antimicrobial photodynamic therapy (aPDT) in dentistry: a critical review. Laser Phys. 2016; 26: 1-13.
45. Santin GC, Oliveira DSB, Galo R, Borsatto MC, Corona SAM. Antimicrobial Photodynamic Therapy and Dental Plaque: A Systematic Review of the Literature. Sci World J. 2014; 2014: 1-9.
46. Tyas MJ, Anusavice KJ, Frencken JE, Mount GJ. Minimal intervention dentistry-a review. FDI Commission Project 1-97. Int Dent J. 2000; 50(1): 1-12.