Caries Management: A Journey between Black’s principals and Minimally Invasive Concepts

Abstract

Dental caries is a multifactorial microbial disease that affects tooth hard tissue leading to destruction of its mineral and organic components. The current work reviewed the development of caries assessment methods and excavation concepts in the past two centuries. In the late ninetieth century, G.V. Black introduced a classification of dental caries, as well as established the principals of tooth preparation, based on his understanding of the nature of the disease. However, due to the great development of dental materials and caries detection methods, most of Black’s principals are no longer valid nowadays. In light of the minimal invasive philosophy, several new caries excavation concepts were introduced. These concepts converts ‘old’ Black’s caries excavation concept of “extension for prevention” to “prevention of extension”. Since 2000 the concepts of caries excavation have greatly changed due to the popularity of the ‘partial caries removal’ concept. As an example of this new ‘conservative’ vision, the “Fédération Dentaire Internationale” (FDI) (World Dental Federation) approved the atraumatic restorative technique (ART) as one of the caries excavation methods in 2002.