Managing carious lesions

consensus recommendations on carious tissue removal

F. Schwendicke (Lead / Corresponding author), J.E. Frencken, L. Bjørndal, M. Maltz, D.J. Manton, David Ricketts, K. Van Landuyt, A. Banderjee, G. Campus, S. Doméjean, M. Fontana, S. Leal, E. Lo, V. Machiulskiene, A. Schulte, C. Splieth, A.F. Zandona, N.P.T. Innes

Research output: Contribution to journalArticle

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Abstract

The International Caries Consensus Collaboration undertook a consensus process and here presents clinical recommendations for carious tissue removal and managing cavitated carious lesions, including restoration, based on texture of demineralized dentine. Dentists should manage the disease dental caries and control activity of existing cavitated lesions to preserve hard tissues and retain teeth long-term. Entering the restorative cycle should be avoided as far as possible. Controlling the disease in cavitated carious lesions should be attempted by cleansable methods first. Only when cavitated carious lesions either are noncleansable or can no longer be sealed are restorative interventions indicated. When a restoration is indicated, the priorities are as follows: preserving healthy and remineralizable tissue, achieving a restorative seal, maintaining pulpal health, and maximizing restoration success. Carious tissue is removed purely to create conditions for long-lasting restorations. Bacterially contaminated or demineralized tissues close to the pulp do not need to be removed. In deeper lesions in teeth with sensible (vital) pulps, preserving pulpal health should be prioritized, while in shallow or moderately deep lesions, restoration longevity becomes more important. For teeth with shallow or moderately deep cavitated lesions, carious tissue removal is performed according to selective removal to firm dentine. In deep cavitated lesions in primary or permanent teeth, selective removal to soft dentine should be performed, although in permanent teeth, stepwise removal is an option. The evidence and, therefore, these recommendations support less invasive carious lesion management, delaying entry to, and slowing down, the restorative cycle by preserving tooth tissue and retaining teeth long-term.
Original languageEnglish
Pages (from-to)58-67
Number of pages10
JournalAdvances in Dental Research: an E-Supplement to Journal of Dental Research
Volume28
Issue number2
Early online date20 Apr 2016
DOIs
Publication statusPublished - May 2016

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Tooth
Dentin
Health
Dental Caries
Dentists

Keywords

  • dental caries
  • stepwise excavation
  • selective excavation
  • incomplete excavation
  • caries sealing
  • minimally invasive dentistry

Cite this

Schwendicke, F. ; Frencken, J.E. ; Bjørndal, L. ; Maltz, M. ; Manton, D.J. ; Ricketts, David ; Van Landuyt, K. ; Banderjee, A. ; Campus, G. ; Doméjean, S. ; Fontana, M. ; Leal, S. ; Lo, E. ; Machiulskiene, V. ; Schulte, A. ; Splieth, C. ; Zandona, A.F. ; Innes, N.P.T. / Managing carious lesions : consensus recommendations on carious tissue removal. In: Advances in Dental Research: an E-Supplement to Journal of Dental Research. 2016 ; Vol. 28, No. 2. pp. 58-67.
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abstract = "The International Caries Consensus Collaboration undertook a consensus process and here presents clinical recommendations for carious tissue removal and managing cavitated carious lesions, including restoration, based on texture of demineralized dentine. Dentists should manage the disease dental caries and control activity of existing cavitated lesions to preserve hard tissues and retain teeth long-term. Entering the restorative cycle should be avoided as far as possible. Controlling the disease in cavitated carious lesions should be attempted by cleansable methods first. Only when cavitated carious lesions either are noncleansable or can no longer be sealed are restorative interventions indicated. When a restoration is indicated, the priorities are as follows: preserving healthy and remineralizable tissue, achieving a restorative seal, maintaining pulpal health, and maximizing restoration success. Carious tissue is removed purely to create conditions for long-lasting restorations. Bacterially contaminated or demineralized tissues close to the pulp do not need to be removed. In deeper lesions in teeth with sensible (vital) pulps, preserving pulpal health should be prioritized, while in shallow or moderately deep lesions, restoration longevity becomes more important. For teeth with shallow or moderately deep cavitated lesions, carious tissue removal is performed according to selective removal to firm dentine. In deep cavitated lesions in primary or permanent teeth, selective removal to soft dentine should be performed, although in permanent teeth, stepwise removal is an option. The evidence and, therefore, these recommendations support less invasive carious lesion management, delaying entry to, and slowing down, the restorative cycle by preserving tooth tissue and retaining teeth long-term.",
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Schwendicke, F, Frencken, JE, Bjørndal, L, Maltz, M, Manton, DJ, Ricketts, D, Van Landuyt, K, Banderjee, A, Campus, G, Doméjean, S, Fontana, M, Leal, S, Lo, E, Machiulskiene, V, Schulte, A, Splieth, C, Zandona, AF & Innes, NPT 2016, 'Managing carious lesions: consensus recommendations on carious tissue removal', Advances in Dental Research: an E-Supplement to Journal of Dental Research, vol. 28, no. 2, pp. 58-67. https://doi.org/10.1177/0022034516639271

Managing carious lesions : consensus recommendations on carious tissue removal. / Schwendicke, F. (Lead / Corresponding author); Frencken, J.E.; Bjørndal, L.; Maltz, M.; Manton, D.J.; Ricketts, David; Van Landuyt, K.; Banderjee, A.; Campus, G.; Doméjean, S.; Fontana, M.; Leal, S.; Lo, E.; Machiulskiene, V.; Schulte, A.; Splieth, C.; Zandona, A.F.; Innes, N.P.T.

In: Advances in Dental Research: an E-Supplement to Journal of Dental Research, Vol. 28, No. 2, 05.2016, p. 58-67.

Research output: Contribution to journalArticle

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T1 - Managing carious lesions

T2 - consensus recommendations on carious tissue removal

AU - Schwendicke, F.

AU - Frencken, J.E.

AU - Bjørndal, L.

AU - Maltz, M.

AU - Manton, D.J.

AU - Ricketts, David

AU - Van Landuyt, K.

AU - Banderjee, A.

AU - Campus, G.

AU - Doméjean, S.

AU - Fontana, M.

AU - Leal, S.

AU - Lo, E.

AU - Machiulskiene, V.

AU - Schulte, A.

AU - Splieth, C.

AU - Zandona, A.F.

AU - Innes, N.P.T.

PY - 2016/5

Y1 - 2016/5

N2 - The International Caries Consensus Collaboration undertook a consensus process and here presents clinical recommendations for carious tissue removal and managing cavitated carious lesions, including restoration, based on texture of demineralized dentine. Dentists should manage the disease dental caries and control activity of existing cavitated lesions to preserve hard tissues and retain teeth long-term. Entering the restorative cycle should be avoided as far as possible. Controlling the disease in cavitated carious lesions should be attempted by cleansable methods first. Only when cavitated carious lesions either are noncleansable or can no longer be sealed are restorative interventions indicated. When a restoration is indicated, the priorities are as follows: preserving healthy and remineralizable tissue, achieving a restorative seal, maintaining pulpal health, and maximizing restoration success. Carious tissue is removed purely to create conditions for long-lasting restorations. Bacterially contaminated or demineralized tissues close to the pulp do not need to be removed. In deeper lesions in teeth with sensible (vital) pulps, preserving pulpal health should be prioritized, while in shallow or moderately deep lesions, restoration longevity becomes more important. For teeth with shallow or moderately deep cavitated lesions, carious tissue removal is performed according to selective removal to firm dentine. In deep cavitated lesions in primary or permanent teeth, selective removal to soft dentine should be performed, although in permanent teeth, stepwise removal is an option. The evidence and, therefore, these recommendations support less invasive carious lesion management, delaying entry to, and slowing down, the restorative cycle by preserving tooth tissue and retaining teeth long-term.

AB - The International Caries Consensus Collaboration undertook a consensus process and here presents clinical recommendations for carious tissue removal and managing cavitated carious lesions, including restoration, based on texture of demineralized dentine. Dentists should manage the disease dental caries and control activity of existing cavitated lesions to preserve hard tissues and retain teeth long-term. Entering the restorative cycle should be avoided as far as possible. Controlling the disease in cavitated carious lesions should be attempted by cleansable methods first. Only when cavitated carious lesions either are noncleansable or can no longer be sealed are restorative interventions indicated. When a restoration is indicated, the priorities are as follows: preserving healthy and remineralizable tissue, achieving a restorative seal, maintaining pulpal health, and maximizing restoration success. Carious tissue is removed purely to create conditions for long-lasting restorations. Bacterially contaminated or demineralized tissues close to the pulp do not need to be removed. In deeper lesions in teeth with sensible (vital) pulps, preserving pulpal health should be prioritized, while in shallow or moderately deep lesions, restoration longevity becomes more important. For teeth with shallow or moderately deep cavitated lesions, carious tissue removal is performed according to selective removal to firm dentine. In deep cavitated lesions in primary or permanent teeth, selective removal to soft dentine should be performed, although in permanent teeth, stepwise removal is an option. The evidence and, therefore, these recommendations support less invasive carious lesion management, delaying entry to, and slowing down, the restorative cycle by preserving tooth tissue and retaining teeth long-term.

KW - dental caries

KW - stepwise excavation

KW - selective excavation

KW - incomplete excavation

KW - caries sealing

KW - minimally invasive dentistry

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DO - 10.1177/0022034516639271

M3 - Article

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JO - Advances in Dental Research: an E-Supplement to Journal of Dental Research

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