Black GV. A work on operative dentistry.Chicago: Medical Dental Publishing; 1908
Elderton RJ. The prevalence of failure of restorations: a literature review. J Dent. 1976; 4:207-210
Maltz M, Henz SL, de Oliveira EF, Jardim JJ. Conventional caries removal and sealed caries in permanent teeth: a microbiological evaluation. J Dent. 2012; 40:776-782 https://doi.org/10.1016/j.jdent.2012.05.011
Fejerskov O, Kidd EAM. Dental caries: the disease and its clinical management.Oxford: Blackwell; 2003
Schwendicke F, Frencken JE, Bjorndal L Managing carious lesions: consensus recommendations on carious tissue removal. Adv Dent Res. 2016; 28:58-67 https://doi.org/10.1177/0022034516639271
Pires PM, Neves AA, Makeeva IM Contemporary restorative ion-releasing materials: current status, interfacial properties and operative approaches. Br Dent J. 2020; 229:450-458 https://doi.org/10.1038/s41415-020-2169-3
FDI policy statement on minimal intervention dentistry (MID) for managing dental caries. Adopted by the General Assembly. September 2016, Poznan, Poland. Int Dent J. 2016; 67:6-7 https://doi.org/10.1111/idj.12308
Innes NP, Frencken JE, Bjorndal L Managing carious lesions: consensus recommendations on terminology. Adv Dent Res. 2016; 28:49-57 https://doi.org/10.1177/0022034516639276
Bjorndal L, Fransson H, Bruun G Randomized clinical trials on deep carious lesions: 5-year follow-up. J Dent Res. 2017; 96:747-753 https://doi.org/10.1177/0022034517702620
Mertz-Fairhurst EJ, Curtis JW, Ergle JW Ultraconservative and cariostatic sealed restorations: results at year 10. J Am Dent Assoc. 1998; 129:55-66
Schwendicke F, Dorfer CE, Paris S. Incomplete caries removal: a systematic review and meta-analysis. J Dent Res. 2013; 92:306-314 https://doi.org/10.1177/0022034513477425
Bjorndal L. Reentry may not be needed after partial caries removal in mainly young permanent molars with caries involving half or more of the dentin thickness. J Evid Based Dent Pract. 2013; 13:62-63 https://doi.org/10.1016/j.jebdp.2013.04.008
Banerjee A, Frencken JE, Schwendicke F, Innes NPT. Contemporary operative caries management: consensus recommendations on minimally invasive caries removal. Br Dent J. 2017; 223:215-222
Innes NP, Evans DJ, Stirrups DR. The Hall technique; a randomized controlled clinical trial of a novel method of managing carious primary molars in general dental practice: acceptability of the technique and outcomes at 23 months. BMC Oral Health. 2007; 7 https://doi.org/10.1186/1472-6831-7-18
(Deep) dentine caries and restorative care: Adopted by the FDI General Assembly: 7 September 2018, Buenos Aires, Argentina. Int Dent J. 2019; 69:7-8 https://doi.org/10.1111/idj.12464
Slimani A, Terrer E, Manton DJ, Tassery H. Carious lesion detection technologies: factual clinical approaches. Br Dent J. 2020; 229:432-442 https://doi.org/10.1038/s41415-020-2116-3
Schwendicke F, Gostemeyer G. Understanding dentists' management of deep carious lesions in permanent teeth: a systematic review and meta-analysis. Implement Sci. 2016; 11 https://doi.org/10.1186/s13012-016-0505-4
Schwendicke F, Stangvaltaite L, Holmgren C Dentists' attitudes and behaviour regarding deep carious lesion management: a multi-national survey. Clin Oral Investig. 2017; 21:191-198 https://doi.org/10.1007/s00784-016-1776-5
Chai B, Tay B, Chow C Treatment preferences for deep caries lesions among Australian dentists. Aust Dent J. 2020; 65:83-89 https://doi.org/10.1111/adj.12740
Burke F. Technique tips: patient information leaflet information for patients for whom deep caries has been sealed into a vital asymptomatic tooth. Dental Update. 2018; 45
Bjorndal L, Darvann T, Thylstrup A. A quantitative light microscopic study of the odontoblast and subodontoblastic reactions to active and arrested enamel caries without cavitation. Caries Res. 1998; 32:59-69 https://doi.org/10.1159/000016431
Bjorndal L, Reit C, Bruun G Treatment of deep caries lesions in adults: randomized clinical trials comparing stepwise vs. direct complete excavation, and direct pulp capping vs. partial pulpotomy. Eur J Oral Sci. 2010; 118:290-297 https://doi.org/10.1111/j.1600-0722.2010.00731.x
Hevinga MA, Opdam NJ, Frencken JE Does incomplete caries removal reduce strength of restored teeth?. J Dent Res. 2010; 89:1270-1275 https://doi.org/10.1177/0022034510377790
Tjaderhane L, Tezvergil-Mutluay A. Performance of adhesives and restorative materials after selective removal of carious lesions: restorative materials with anticaries properties. Dent Clin North Am. 2019; 63:715-729 https://doi.org/10.1016/j.cden.2019.05.001
Minimally Invasive Selective Caries Removal put into Practice Bhupinder Dawett Sarah Young Chris Deery Avijit Banerjee Dental Update 2024 47:10, 707-709.
Authors
BhupinderDawett
BDS MDPH
Doctoral Research Fellow, School of Clinical Dentistry, University of Sheffield
Professor of Cariology & Operative Dentistry, Hon Consultant in Restorative Dentistry, King's College London Dental Institute at Guy's Hospital, KCL, King's Health Partners, London, UK
Dental caries remains a significant health problem globally, causing morbidity in those affected and consuming health resources. The management of caries consumes considerable finances both for individuals and the public purse. The scientific understanding of the dental caries process has evolved considerably over the last four decades with a move towards a minimum intervention oral care (MIOC) approach to managing patients. The minimally invasive operative intervention that retains demineralised, caries-affected dentine under a well-sealed restoration in order to avoid instrumentation close to the pulp, has shown clinical efficacy in treating individual teeth, as part of the MIOC framework. However, implementation of the selective caries removal approach in deep lesions is still not thought to be practised routinely by clinicians both globally, and in the UK. This article discusses some of the issues that may account for this and describes a case study using this operative strategy.
CPD/Clinical Relevance: Restoring deep carious lesions can be a challenge, but using selective caries removal approaches will help minimise the adverse effects of pulp trauma.
Article
Although epidemiological surveys over the last four decades have shown an improvement of the rates of dental caries in the UK, caries is still a common problem with the 2009 Adult Dental Health Survey indicating that 84% of UK adults have at least one restoration.1 The Child Dental Health Survey 20132 reported that nearly half (46%) of 15 year olds in the UK have obvious caries experience and a similar number (45%) of 15 year olds reported that their daily life had been affected by problems with their teeth and mouth in the preceding 3 months.2 Over a third (35%) of parents of 15-year-old children reported that their child's oral health had impacted negatively on family life and, over the same period, nearly a quarter of parents had needed to take time off work because of their child's oral health.3 Children indicating engagement with positive oral health behaviours were less likely to have severe or extensive caries. Furthermore, the burden of severe or extensive caries was borne unequally across society, with those most deprived being more affected.
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