Оглавление
Группа авторов. Caries Excavation: Evolution of Treating Cavitated Carious Lesions
Monographs in Oral Science
Caries Excavation: Evolution of Treating Cavitated Carious Lesions
Contents
List of Contributors
Foreword
Preface
Pathophysiology of Dental Caries
Abstract
Microbiology of Tooth Decay
Histology of a Carious Tissue – The Microbiological Perspective
Pulp Response to Dental Caries
Dentine Histology at the Dentine Enamel Junction Is Different from that of Deep Dentine
Dentine Matrix Contains Sequestered Signalling Molecules
The Dental Pulp Defence Strategies
Dental Pulp Local Regulation
References
Caries Epidemiology and Its Challenges
Abstract
Detection and Assessment Devices
Visual/Tactile Devices Currently in Use
Reporting Data from Caries Epidemiological Surveys
Global Epidemiology of Dental Caries
Global Burden of Untreated Cavitated Dentine Carious Lesions
Prevalence and Extent of Carious Lesions in Infants and Young Children
Prevalence and Extent of Carious Lesions in Children
Which Are the Most Carious Lesion-Susceptible Permanent Teeth and Surfaces in Child Populations?
Prevalence and Extent of Carious Lesions in Adults and the Elderly
Challenges
References
Carious Lesion Diagnosis: Methods, Problems, Thresholds
Abstract
Detection versus Diagnosis of Caries
Caries Detection Methods. Visual-Tactile Inspection
Radiography
Fluorescence-Based Technologies
Transillumination
Lesion Activity Assessment
References
Removing or Controlling? How Caries Management Impacts on the Lifetime of Teeth
Abstract
Traditional Management (Removal) of Caries
Carious Lesions and Factors Impacting on Lesion Management
Intervention Thresholds: Lesion Changes over Time
Differences between Lesions: Impact of Surface Cavitation
The Problem with Invasive Therapies
The Repeat Restoration Cycle
Principles to Avoid or Slow Down the Repeat Restoration Cycle
Conclusions
References
Restoring the Carious Lesion
Abstract
Restorative Risks for the Pulp. Pulpal Trauma due to Preparation
Tooth Hypersensitivity
Use of Liners
Challenges for Bonding Resin-Based Materials to Different Dentine Surfaces
Adhesion of Glass-Ionomer-Based Materials to Tooth Tissue
Factors Limiting Durability of Resin Bonding to Dentine
Alterations of Dentine
Different Bonding Systems and Their Suitability for Different Lesions. Bonding Systems
Restorative Materials
Resin Composite Restorative Materials
Glass-Ionomer Cement
The Problem of Carious Dentine – The Mechanics of Teeth with Deep Lesions
Conclusion
References
Removing Carious Tissue: Why and How?
Abstract
The Aims of Carious Tissue Removal
The Principles of Carious Tissue Removal
The Problems of Assessing Carious Tissue Removal
Overview of Removal Strategies
Non-Selective Removal to Hard Dentine
Selective Removal to Firm Dentine
Selective Removal to Soft Dentine
Stepwise Removal
No Removal at All. Sealing in Strategies
Non-Restorative Cavity Control
Conclusion
References
Stepwise Excavation
Abstract
The Clinical Manipulation of Lesion Activity: The Key to Deep Lesion Management
The Dilemma: Issues for the Deep Carious Lesion
No Global Consensus
The Deeper Stages of Lesion Progression: Definition and Subjacent Pathology
Deep Carious Lesion and Radiographical Definition
Potential Reasons for Failures following Pulp Capping in Deep Lesions
Extremely Deep Carious Lesions and Subjacent Pulp Responses
Microbial Data
Why Does the Colour of Demineralised Dentine Change?
An Improved Evidence Platform Should Be the Solution to the Historical Dilemma
The Evidence behind Avoiding Pulp Exposure
Clinical Trials and Stepwise Excavation
Stepwise Excavation and Some Critical Points
Future Expectation of Clinical Evidence between Less Invasive Carious Removal Procedures
Is Shrinkage of Retained Carious Dentine a Problem in Selective Carious Tissue Removal?
The Stepwise Carious Tissue Removal Principles and Protocol
References
Selective Removal of Carious Tissue
Abstract
Evolution of Caries Tissue Removal
Risk of Pulpal Exposure and Outcome of Non-Selective Carious Tissue Removal
Selective Removal to Firm Dentine
Selective Removal to Soft Dentine
How to Perform Selective Carious Tissue Removal
Diagnostic Issues with Selective Carious Tissue Removal to Soft Dentine
Health of Pulp
Monitoring Carious Lesion Progression
Conclusion
References
Atraumatic Restorative Treatment: Restorative Component
Abstract
Indications and Contra-Indications of ART Restorations
Setting
Patient Age and Profile
Cavities
Caries Tissue Removal in the ART Method
Restorative Material in the ART Approach: GICs
Cavity Depth
The Use of Hand Instruments
Survival of ART Restorations. Criteria to Evaluate ART Restorations
Survival of Single- and Multiple-Surface ART/HVGIC Restorations in Primary and Permanent Posterior Teeth by Year of Survival
ART/HVGIC and Conventionally Produced Restorations
Final Remarks
References
Sealing Carious Tissue Using Resin and Glass-Ionomer Cements
Abstract
No Excavation of Any Carious Tooth Tissue/Lesion: Effects of Sealing on Bacteria in Lesions
Current State of the Evidence
Non-Cavitated Occlusal Lesions Managed Using Sealants
Non-Cavitated Proximal Lesions Sealed Using Sealants and Resin Infiltration
Cavitated Lesions Managed Using Adhesive Restorations
Effects of Sealing
Advantages and Disadvantages, Pulpal and Restorative Issues, Limitations of the Material to Seal
Diagnostic Challenges
When and When Not to Seal Carious Tissue
Summary of Clinical Recommendations
References
Sealing Carious Tissue in Primary Teeth Using Crowns: The Hall Technique
Abstract
Overview
History of the Hall Technique
Summary
Technique Acceptance
Summary
Cost-Effectiveness
Summary
The Hall Technique Step by Step
Step 1: Case Selection
Step 2: Child and Parent Preparation and the Materials Needed
Step 3: Assessment of Crown Morphology, Contact Areas and Occlusion
Step 4: Size of the Hall Crown
Step 5: Fill the Crown
Step 6: Fit and Seat the Crown
Step 7: Further Seating
Step 8: Final Cement Clearance and Occlusion Check
Conclusion
References
No Removal and Inactivation of Carious Tissue: Non-Restorative Cavity Control
Abstract
Is Restorative Treatment Necessary?
Non-Restorative Cavity Control: Primary Dentition
Indication of NRCC
Treatment Protocol of NRCC
Scientific Evidence for Success of NRCC in Primary Dentition
Non-Restorative Cavity Control: Permanent Dentition
Scientific Evidence for Success of NRCC in Permanent Dentition
The Role of Fluoride in Arresting Dentine Caries
Adverse Effects of SDF
Conclusion
References
Evidence-Based Deep Carious Lesion Management: From Concept to Application in Everyday Clinical Practice
Abstract
What Do Dental Practitioners Do in Practice?
Facilitators and Barriers to Implementing Science into Practice
Conclusion and Perspectives
References
The Problem: Relevance, Quality, and Homogeneity of Trial Designs, Outcomes, and Reporting
Abstract
Pathway of Evidence to Practice
Barriers to Evidence Synthesis
Ask the Correct Questions
Outcomes as a Barrier to Synthesis
Limitations to the External Validity of RCTs
Improving the Pathway to Practice
Marginal Gains Add Up
Ask the Correct Questions
Align Research Questions to Clinical Questions
Improve Reporting
References
An Agreed Terminology for Carious Tissue Removal
Abstract
Background to Standardisation in Terminology
Updating the Existing Terminology
Dental Caries Management and Carious Lesion Management
Terminology for Descriptions of States of Carious Dentine
Carious Tissue Removal Terminology
Atraumatic Restorative Treatment
No Removal (No Dentinal Carious Tissue Removal)
Selective Removal
Stepwise Removal (Stepwise Carious Lesion Removal)
Non-Selective Removal
Conclusion
References
Clinical Recommendations on Carious Tissue Removal in Cavitated Lesions
Abstract
Appendix
References
Caries Excavation: Evidence Gaps
Abstract
Evidence-Based Practice
How Much Caries Should We Excavate and How Should We Do It?
What Do Dentists Do Now?
When Do Clinicians Decide to Intervene?
Other Contentious Areas
What Can We Do When Evidence Is Lacking to Inform Clinical Decision Making and Practice?
Conclusion
References
Author Index
Subject Index
