2023 年 1 巻 1 号 p. 33-40
Appropriate diagnosis and treatment are necessary if teeth are to be maintained in a long-term healthy and functional condition after caries treatment. It is therefore important to reduce the risk of repeat restoration by diagnosing and treating the caries with high accuracy in a minimally invasive manner. We herein report two cases with difficult-to-diagnose interproximal caries in which good outcomes were obtained by minimally invasive and highly accurate diagnosis and treatment. Specifically, minimally invasive treatment was performed by the combined use of multisurface near-infrared imaging (NIRI) acquired noninvasively with an oral scanner to investigate the caries area and a microscope to remove the minimum tooth substance under a magnified field of view. In both cases, the extent of the interproximal caries could not be accurately diagnosed by visual examination and panoramic X-rays. It is assumed that such cases usually require restoration with Black’s class II cavity, and treatment for caries removal is often initiated from the surface of the adjacent tooth without grasping the exact infected area. However, NIRI enabled the extent of the caries to be accurately diagnosed, which meant it was possible to identify the tooth substance of the proximal surface that could be preserved before carrying out the procedure. The proximal surface was also accessed from the carious region on the occlusal surface under the magnified field of view provided by a microscope, which enabled the removal of only the minimum amount of caries, sparing as much of the proximal surface tooth substance as possible. Although such microscope use requires a high level of treatment skill, it enabled minimally invasive restoration with composite resin. These two cases suggest that the combination of the noninvasive diagnosis provided by NIRI and treatment under the magnified field of view provided by a microscope may be useful for maintaining a good long-term prognosis after interproximal caries treatment.
