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Treatment options for permanent teeth with deep caries.

Monika Marending1, Thomas Attin, Matthias Zehnder

  • 1Clinic for Preventive Dentistry, Periodontology and Cariology, University of Zürich, Zürich, Switzerland.

Swiss Dental Journal
|November 23, 2016
PubMed
Summary

This review compares treatments for deep carious lesions in permanent teeth, exploring minimally invasive options like complete or partial caries removal versus sealing. It considers microbiological and immunological factors to guide clinical decisions for better patient outcomes.

Keywords:
cariesexcavationpulp

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Area of Science:

  • Restorative Dentistry
  • Cariology
  • Dental Pulp Biology

Background:

  • Deep carious lesions approaching the pulp chamber present complex treatment challenges.
  • Adhesive restorative materials enable minimally invasive treatment strategies.
  • The optimal extent of caries excavation remains a critical clinical question.

Purpose of the Study:

  • To review and compare current treatment options for permanent teeth with deep carious lesions.
  • To evaluate the microbiological and immunological aspects influencing treatment decisions.
  • To discuss the potential benefits of calcium silicate cements over calcium hydroxide.

Main Methods:

  • Narrative review of existing literature.
  • Analysis of clinical studies comparing different caries removal and sealing techniques.
  • Consideration of microbiological and immunological factors in carious lesions.

Main Results:

  • Minimally invasive approaches are feasible for deep carious lesions.
  • The decision between complete excavation, partial excavation, or sealing depends on lesion characteristics.
  • Calcium silicate cements show promise as alternatives to calcium hydroxide for pulp capping.

Conclusions:

  • Treatment decisions for deep caries require balancing excavation extent with microbiological and immunological considerations.
  • Sealing or partial excavation may be viable alternatives to complete caries removal in select cases.
  • Further research comparing calcium silicate cements and calcium hydroxide in clinical settings is warranted.