M Duggal1, S Gizani2, S Albadri3, N Krämer4, E Stratigaki5, H J Tong6, K Seremidi2, D Kloukos7,8, A BaniHani9, R M Santamaría10, S Hu11, M Maden12, S Amend13, C Boutsiouki13, K Bekes14, N Lygidakis15, R Frankenberger16, J Monteiro17, V Anttonnen18, R Leith19, M Sobczak20, S Rajasekharan21, S Parekh22. 1. College of Dental Medicine, QU Health, Qatar University, Doha, Qatar. 2. Department of Paediatric Dentistry, School of Dentistry, National and Kapodistrian, University of Athens, Athens, Greece. 3. School of Dentistry, Unit of Oral Health, University of Liverpool, Liverpool, UK. 4. Department of Paediatric Dentistry, Justus-Liebig University Gießen, Giessen, Germany. 5. Department of Pediatric Oral Health and Orthodontics, University Center of Dental Medicine, Basel, Switzerland. 6. Discipline of Orthodontics and Paediatric Dentistry, Faculty of Dentistry, National University of Singapore, Singapore, Singapore. 7. Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, Bern, Switzerland. 8. Department of Orthodontics and Dentofacial Orthopedics, 251 Hellenic Air Force and VA General Hospital, Athens, Greece. 9. Department of Paediatric Dentistry, School of Dentistry, University of Leeds, Leeds, UK. 10. Department of Preventive and Paediatric Dentistry, University of Greifswald, Greifswald, Germany. 11. Faculty of Dentistry, National University of Singapore, Singapore, Singapore. 12. Liverpool Reviews and Implementation Group, University of Liverpool, Liverpool, UK. 13. Department of Paediatric Dentistry, Justus-Liebig-University Giessen, University Medical Centre Giessen and Marburg (Campus Giessen) Medical Centre for Dentistry, Schlangenzahl 14, 35392, Giessen, Germany. 14. Department of Paediatric Dentistry, Medical University Vienna, University Clinic of Dentistry, Sensengasse 2a, 1090, Vienna, Austria. 15. Lygidakis Dental Clinic (Private Dental Practice), 2 Papadiamantopoulou str. & Vasilissis Sofias Ave, 11528, Athens, Greece. 16. Medical Centre for Dentistry, Department of Operative Dentistry and Endodontics, Phillips-University Marburg, University Medical Centre Giessen and Marburg (Campus Marburg), Georg-Voigt-Str. 3, 35039, Marburg, Germany. 17. Department of Paediatric Dentistry, Sheffield Teaching Hospitals, Sheffield, UK. 18. Research Unit of Oral Health Sciences, University of Oulu, Oulu, Finland. 19. Dublin Dental University Hospital, Trinity College, Dublin, Ireland. 20. Specialized Dental Practice, Warsaw, Poland. 21. Department of Paediatric Dentistry, School of Oral Health Sciences, Ghent University, B-9000, Ghent, Belgium. 22. Department of Paediatric Dentistry, UCL Eastman Dental Institute, London, UK. s.parekh@ucl.ac.uk.
Abstract
PURPOSE: The European Academy of Paediatric Dentistry (EAPD) has developed this best clinical practice guidance to help clinicians manage deep carious lesions in primary teeth. METHODS: Three expert groups conducted systematic reviews of the relevant literature. The topics were: (1) conventional techniques (2) Minimal Intervention Dentistry (MID) and (3) materials. Workshops were held during the corresponding EAPD interim seminar in Oslo in April 2021. Several clinical based recommendations and statements were agreed upon, and gaps in our knowledge were identified. RESULTS: There is strong evidence that indirect pulp capping and pulpotomy techniques, and 38% Silver Diamine Fluoride are shown to be effective for the management of caries in the primary dentition. Due to the strict criteria, it is not possible to give clear recommendations on which materials are most appropriate for restoring primary teeth with deep carious lesions. Atraumatic Restorative Technique (ART) is not suitable for multi-surface caries, and Pre-formed Metal Crowns (PMCs) using the Hall technique reduce patient discomfort. GIC and RMGIC seem to be more favourable given the lower annual failure rate compared to HVGIC and MRGIC. Glass carbomer cannot be recommended due to inferior marginal adaptation and fractures. Compomers, hybrid composite resins and bulk-fill composite resins demonstrated similar values for annual failure rates. CONCLUSION: The management of deep carious lesions in primary teeth can be challenging and must consider the patient's compliance, operator skills, materials and costs. There is a clear need to increase the use of MID techniques in managing carious primary teeth as a mainstream rather than a compromise option.
PURPOSE: The European Academy of Paediatric Dentistry (EAPD) has developed this best clinical practice guidance to help clinicians manage deep carious lesions in primary teeth. METHODS: Three expert groups conducted systematic reviews of the relevant literature. The topics were: (1) conventional techniques (2) Minimal Intervention Dentistry (MID) and (3) materials. Workshops were held during the corresponding EAPD interim seminar in Oslo in April 2021. Several clinical based recommendations and statements were agreed upon, and gaps in our knowledge were identified. RESULTS: There is strong evidence that indirect pulp capping and pulpotomy techniques, and 38% Silver Diamine Fluoride are shown to be effective for the management of caries in the primary dentition. Due to the strict criteria, it is not possible to give clear recommendations on which materials are most appropriate for restoring primary teeth with deep carious lesions. Atraumatic Restorative Technique (ART) is not suitable for multi-surface caries, and Pre-formed Metal Crowns (PMCs) using the Hall technique reduce patient discomfort. GIC and RMGIC seem to be more favourable given the lower annual failure rate compared to HVGIC and MRGIC. Glass carbomer cannot be recommended due to inferior marginal adaptation and fractures. Compomers, hybrid composite resins and bulk-fill composite resins demonstrated similar values for annual failure rates. CONCLUSION: The management of deep carious lesions in primary teeth can be challenging and must consider the patient's compliance, operator skills, materials and costs. There is a clear need to increase the use of MID techniques in managing carious primary teeth as a mainstream rather than a compromise option.
Authors: Ruth M Santamaría; N P T Innes; Vita Machiulskiene; Julian Schmoeckel; Mohammad Alkilzy; Christian H Splieth Journal: Caries Res Date: 2017-12-20 Impact factor: 4.056
Authors: Christian H Splieth; Avijit Banerjee; Peter Bottenberg; Lorenzo Breschi; Guglielmo Campus; Kim Rud Ekstrand; Rodrigo A Giacaman; Rainer Haak; Matthias Hannig; Reinhard Hickel; Hrvoje Juric; Adrian Lussi; Vita Machiulskiene; David J Manton; Anahita Jablonski-Momeni; Niek J M Opdam; Sebastian Paris; Ruth M Santamaría; Falk Schwendicke; Herve Tassery; Andrea Ferreira Zandona; Domenick T Zero; Stefan Zimmer; Sophie Doméjean Journal: Caries Res Date: 2020-07-01 Impact factor: 4.056
Authors: J Kühnisch; K R Ekstrand; I Pretty; S Twetman; C van Loveren; S Gizani; M Spyridonos Loizidou Journal: Eur Arch Paediatr Dent Date: 2016-01-05
Authors: Jo E Frencken; Mathilde C Peters; David J Manton; Soraya C Leal; Valeria V Gordan; Ece Eden Journal: Int Dent J Date: 2012-10 Impact factor: 2.607