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The residual caries dilemma.
1Department of Cariology Endodontology Pedodontology, ACTA, Amsterdam, The Netherlands. k.weerheijm@acta.nl
Community Dentistry and Oral Epidemiology
|December 22, 1999
Summary
Minimal intervention in restorative dentistry aims to arrest caries with less operative treatment. A combination of sealing the caries, excavating dentine, and using cariostatic materials is necessary for caries arrest.
Area of Science:
- Restorative Dentistry
- Cariology
- Dental Materials
Background:
- Restorative dentistry traditionally assumes bacterial infection necessitates operative intervention.
- Minimal intervention strategies aim to create favorable environments for caries arrest.
- The management of residual primary caries is crucial, especially in atraumatic restorative treatment (ART) where complete excavation is challenging.
Purpose of the Study:
- To review measures for managing residual carious dentine.
- To evaluate the justification for complete versus incomplete excavation of occlusal dentinal caries.
- To assess strategies for caries arrest in restorative dentistry.
Main Methods:
- Review of literature on measures to manage residual caries.
- Consideration of three key intervention types: isolation, excavation, and cariostatic filling materials.
- Analysis of the combined effectiveness of these measures.
Main Results:
- Each measure (isolation, excavation, cariostatic material) contributes to caries arrest individually.
- No single measure is sufficient on its own to arrest the caries process.
- A combination of all three measures appears necessary for effective caries arrest.
Conclusions:
- Residual caries may not be the sole criterion for re-restoration.
- Complete caries removal should be pursued whenever possible.
- If complete removal is not feasible, the sealing capacity of the filling material becomes more critical than its cariostatic properties.