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Article: When to intervene in the caries process? An expert Delphi consensus statement

TitleWhen to intervene in the caries process? An expert Delphi consensus statement
Authors
KeywordsDental caries
Consensus
Decision-making
Operative dentistry
Restorations
Issue Date2019
PublisherSpringer for German Society of Oral and Maxillofacial Surgery. The Journal's web site is located at http://link.springer.de/link/service/journals/00784/index.htm
Citation
Clinical Oral Investigations, 2019, v. 23 n. 10, p. 3691-3703 How to Cite?
AbstractObjectives: To define an expert Delphi consensus on when to intervene in the caries process and on existing carious lesions using non- or micro-invasive, invasive/restorative or mixed interventions. Methods: Non-systematic literature synthesis, expert Delphi consensus process and expert panel conference. Results: Carious lesion activity, cavitation and cleansability determine intervention thresholds. Inactive lesions do not require treatment (in some cases, restorations will be placed for reasons of form, function and aesthetics); active lesions do. Non-cavitated carious lesions should be managed non- or micro-invasively, as should most cavitated carious lesions which are cleansable. Cavitated lesions which are not cleansable usually require invasive/restorative management, to restore form, function and aesthetics. In specific circumstances, mixed interventions may be applicable. On occlusal surfaces, cavitated lesions confined to enamel and non-cavitated lesions radiographically extending deep into dentine (middle or inner dentine third, D2/3) may be exceptions to that rule. On proximal surfaces, cavitation is hard to assess visually or by using tactile methods. Hence, radiographic lesion depth is used to determine the likelihood of cavitation. Most lesions radiographically extending into the middle or inner third of the dentine (D2/3) can be assumed to be cavitated, while those restricted to the enamel (E1/2) are not cavitated. For lesions radiographically extending into the outer third of the dentine (D1), cavitation is unlikely, and these lesions should be managed as if they were non-cavitated unless otherwise indicated. Individual decisions should consider factors modifying these thresholds. Conclusions: Comprehensive diagnostics are the basis for systematic decision-making on when to intervene in the caries process and on existing carious lesions.
Persistent Identifierhttp://hdl.handle.net/10722/278111
ISSN
2019 Impact Factor: 2.812
2015 SCImago Journal Rankings: 0.752

 

DC FieldValueLanguage
dc.contributor.authorSchwendicke, F-
dc.contributor.authorSplieth, C-
dc.contributor.authorBresch, L-
dc.contributor.authorBanerjee, A-
dc.contributor.authorFontana, M-
dc.contributor.authorParis, S-
dc.contributor.authorBurrow, MF-
dc.contributor.authorCrombie, F-
dc.contributor.authorPage, LF-
dc.contributor.authorGatón-Hernández, P-
dc.contributor.authorGiacaman, R-
dc.contributor.authorGugnani, N-
dc.contributor.authorHickel, R-
dc.contributor.authorJordan, RA-
dc.contributor.authorLeal, S-
dc.contributor.authorLo, E-
dc.contributor.authorTassery, H-
dc.contributor.authorThomson, WM-
dc.contributor.authorManton, DJ-
dc.date.accessioned2019-10-04T08:07:42Z-
dc.date.available2019-10-04T08:07:42Z-
dc.date.issued2019-
dc.identifier.citationClinical Oral Investigations, 2019, v. 23 n. 10, p. 3691-3703-
dc.identifier.issn1432-6981-
dc.identifier.urihttp://hdl.handle.net/10722/278111-
dc.description.abstractObjectives: To define an expert Delphi consensus on when to intervene in the caries process and on existing carious lesions using non- or micro-invasive, invasive/restorative or mixed interventions. Methods: Non-systematic literature synthesis, expert Delphi consensus process and expert panel conference. Results: Carious lesion activity, cavitation and cleansability determine intervention thresholds. Inactive lesions do not require treatment (in some cases, restorations will be placed for reasons of form, function and aesthetics); active lesions do. Non-cavitated carious lesions should be managed non- or micro-invasively, as should most cavitated carious lesions which are cleansable. Cavitated lesions which are not cleansable usually require invasive/restorative management, to restore form, function and aesthetics. In specific circumstances, mixed interventions may be applicable. On occlusal surfaces, cavitated lesions confined to enamel and non-cavitated lesions radiographically extending deep into dentine (middle or inner dentine third, D2/3) may be exceptions to that rule. On proximal surfaces, cavitation is hard to assess visually or by using tactile methods. Hence, radiographic lesion depth is used to determine the likelihood of cavitation. Most lesions radiographically extending into the middle or inner third of the dentine (D2/3) can be assumed to be cavitated, while those restricted to the enamel (E1/2) are not cavitated. For lesions radiographically extending into the outer third of the dentine (D1), cavitation is unlikely, and these lesions should be managed as if they were non-cavitated unless otherwise indicated. Individual decisions should consider factors modifying these thresholds. Conclusions: Comprehensive diagnostics are the basis for systematic decision-making on when to intervene in the caries process and on existing carious lesions.-
dc.languageeng-
dc.publisherSpringer for German Society of Oral and Maxillofacial Surgery. The Journal's web site is located at http://link.springer.de/link/service/journals/00784/index.htm-
dc.relation.ispartofClinical Oral Investigations-
dc.subjectDental caries-
dc.subjectConsensus-
dc.subjectDecision-making-
dc.subjectOperative dentistry-
dc.subjectRestorations-
dc.titleWhen to intervene in the caries process? An expert Delphi consensus statement-
dc.typeArticle-
dc.identifier.emailBurrow, MF: mfburr58@hku.hk-
dc.identifier.emailLo, E: edward-lo@hku.hk-
dc.identifier.authorityBurrow, MF=rp01306-
dc.identifier.authorityLo, E=rp00015-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1007/s00784-019-03058-w-
dc.identifier.pmid31444695-
dc.identifier.scopuseid_2-s2.0-85071559129-
dc.identifier.hkuros306973-
dc.identifier.volume23-
dc.identifier.issue10-
dc.identifier.spage3691-
dc.identifier.epage3703-
dc.publisher.placeGermany-

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