Managing Carious Lesions: Consensus Recommendations on Carious Tissue Removal

F Schwendicke; J E Frencken; L Bjørndal; M Maltz; D J Manton; D Ricketts; K Van Landuyt; A Banerjee; G Campus; S Doméjean; M Fontana; S Leal; E Lo; V Machiulskiene; A Schulte; C Splieth; A F Zandona; N P T Innes

doi:10.1177/0022034516639271

Managing Carious Lesions: Consensus Recommendations on Carious Tissue Removal

F Schwendicke, J E Frencken, L Bjørndal, M Maltz, D J Manton, D Ricketts, K Van Landuyt, A Banerjee, G Campus, S Doméjean, M Fontana, S Leal, E Lo, V Machiulskiene, A Schulte, C Splieth, A F Zandona, N P T Innes

Section 02 - Paediatric Dentistry

3 Citations (Scopus)

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 using methods which are aimed at biofilm removal or control 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 toselective removal to firm dentine.In deep cavitated lesions in primary or permanent teeth,selective removal to soft dentineshould be performed, although in permanent teeth,stepwise removalis 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 language	English
Journal	Advances in Dental Research
Volume	28
Issue number	2
Pages (from-to)	58-67
Number of pages	10
ISSN	0895-9374
DOIs	https://doi.org/10.1177/0022034516639271
Publication status	Published - May 2016

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Schwendicke, F., Frencken, J. E., Bjørndal, L., Maltz, M., Manton, D. J., Ricketts, D., Van Landuyt, K., Banerjee, A., Campus, G., Doméjean, S., Fontana, M., Leal, S., Lo, E., Machiulskiene, V., Schulte, A., Splieth, C., Zandona, A. F., & Innes, N. P. T. (2016). Managing Carious Lesions: Consensus Recommendations on Carious Tissue Removal. Advances in Dental Research, 28(2), 58-67. https://doi.org/10.1177/0022034516639271

Schwendicke, F, Frencken, JE, Bjørndal, L, Maltz, M, Manton, DJ, Ricketts, D, Van Landuyt, K, Banerjee, 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, vol. 28, no. 2, pp. 58-67. https://doi.org/10.1177/0022034516639271

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title = "Managing Carious Lesions: Consensus Recommendations on Carious Tissue Removal",

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 using methods which are aimed at biofilm removal or control 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 toselective removal to firm dentine.In deep cavitated lesions in primary or permanent teeth,selective removal to soft dentineshould be performed, although in permanent teeth,stepwise removalis 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.",

author = "F Schwendicke and Frencken, {J E} and L Bj{\o}rndal and M Maltz and Manton, {D J} and D Ricketts and {Van Landuyt}, K and A Banerjee and G Campus and S Dom{\'e}jean and M Fontana and S Leal and E Lo and V Machiulskiene and A Schulte and C Splieth and Zandona, {A F} and Innes, {N P T}",

note = "{\textcopyright} International & American Associations for Dental Research 2016.",

year = "2016",

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doi = "10.1177/0022034516639271",

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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, D

AU - Van Landuyt, K

AU - Banerjee, 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 using methods which are aimed at biofilm removal or control 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 toselective removal to firm dentine.In deep cavitated lesions in primary or permanent teeth,selective removal to soft dentineshould be performed, although in permanent teeth,stepwise removalis 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 using methods which are aimed at biofilm removal or control 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 toselective removal to firm dentine.In deep cavitated lesions in primary or permanent teeth,selective removal to soft dentineshould be performed, although in permanent teeth,stepwise removalis 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.

U2 - 10.1177/0022034516639271

DO - 10.1177/0022034516639271

M3 - Journal article

C2 - 27099358

SN - 0895-9374

VL - 28

SP - 58

EP - 67

JO - Advances in dental research

JF - Advances in dental research

IS - 2

ER -

Managing Carious Lesions: Consensus Recommendations on Carious Tissue Removal

Abstract

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