Recommended procedures for managing carious lesions in primary teeth with pulp involvement-a scoping review

Area of Science:

• Pediatric Dentistry
• Cariology
• Dental Public Health

Background:

• Managing dental caries in primary teeth with pulp involvement presents significant clinical challenges.
• Existing clinical guidelines provide recommendations for effective management strategies.

Purpose of the Study:

• To identify and analyze policies, guidelines, and recommendations for treating primary teeth with pulp-involved carious lesions.
• To highlight existing research gaps and establish a foundation for future investigations.

Main Methods:

• A comprehensive literature search was performed across major databases and grey literature sources.
• Included guidelines, consensus statements, and policy documents on primary teeth pulp therapy and extraction thresholds.
• Two independent reviewers screened and analyzed 14 selected documents published between 2008 and 2024.

Main Results:

• The review analyzed various treatments for deep caries in primary teeth, including pulp capping, pulpotomy, pulpectomy, lesion sterilization, and extraction.
• Analysis of 14 selected guidelines revealed evolving clinical practices in primary teeth pulp therapy.
• Indirect/direct pulp capping, pulpotomy, and pulpectomy were examined as treatment options.

Conclusions:

• Treatment for primary teeth with pulp involvement should be guided by clinical indications, favoring minimally invasive techniques.
• Indirect pulp capping, pulpotomy, and pulpectomy are recommended, while direct pulp capping and extraction are generally discouraged.
• Further research is essential to address identified gaps, improve guideline development, and enhance recommendation consistency.