Interventions for treating cavitated or dentine carious lesions

Schwendicke, Falk; Walsh, Tanya; Fontana, Margherita; Bjørndal, Lars; Clarkson, Jan E; Lamont, Thomas; Levey, Colin; Göstemeyer, Gerd; Santamaría, Ruth M.; Ricketts, David; Innes, Nicola

doi:10.1002/14651858.cd013039

Cited by 8 publications

(4 citation statements)

References 35 publications

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“…Among those insured with Medicaid and commercial dental plans, the frequency of each procedure category by age are consistent with clinical expectations, the course of caries and the policy coverages. Among all age groups, restorations are the most common treatments for caries, followed by extractions and endodontic procedures, with prosthodontics being relatively uncommon [23].…”

Section: Discussionmentioning

confidence: 99%

Estimation of oral disease burden from claims and self‐reported data

Okunseri

Frantsve‐Hawley²,

Thakkar‐Samtani³

et al. 2022

J Public Health Dent

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Section: Discussionmentioning

confidence: 99%

Estimation of oral disease burden from claims and self‐reported data

Okunseri

Frantsve‐Hawley²,

Thakkar‐Samtani³

et al. 2022

J Public Health Dent

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“…Recently, a systematic review reported that selective carious‐tissue removal in one stage was preferred over a stepwise excavation in deep carious lesions in permanent teeth (Schwendicke et al, 2021). However, it is not known whether teeth with deep carious lesions would benefit from a partial or full pulpotomy procedure rather than selective caries removal in one‐stage or stepwise excavation (Bjørndal et al, 2010; Bogen et al, 2008; Demant et al, 2021; Wells et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of vital pulp treatment in managing nontraumatic pulpitis associated with no or nonspontaneous pain: A systematic review

et al. 2022

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BackgroundThe exposed pulp has been the topic of numerous studies, but well‐designed and well‐executed comparative trials on the outcome and treatment of these teeth have been limited.ObjectivesThis study was conducted to answer the following questions: in patients with nontraumatic pulpitis associated with no or nonspontaneous pain in permanent teeth, (i) is direct pulp capping or pulpotomy (partial/full) as effective as selective or stepwise caries removal [Population/participants, Intervention(s), Comparator(s)/control, Outcome(s) (PICO) 1], (ii) is pulpotomy (partial/full) as effective as direct pulp capping (PICO 2) and (iii) is pulpotomy (partial/full) as effective as a pulpectomy (PICO 3), in terms of a combination of patient and clinical reported outcomes, with ‘tooth survival’ as the most critical outcome?MethodsA literature search was conducted using Clarivate Analytics' Web of Science, Scopus, PubMed and Cochrane Central Register of Controlled Trials from inception to November 3rd 2021. Grey literature and contents of the major subject journals were examined. Eligibility criteria followed the PICO questions. Two independent reviewers performed study selection, data extraction and appraisal; disagreements were resolved by a third reviewer. The risk of bias was assessed by the revised Cochrane risk‐of‐bias tool for randomized trials.ResultsThree randomized clinical trials (RCTs) were included in the review. No study fulfilled the criteria to answer PICO 1. There were no significant differences in the reported outcomes between investigated treatments in all included RCTs. None of the included studies reported the most critical outcome ‘tooth survival’. A high loss of patients during the follow‐up period was observed.DiscussionAlthough a few studies fulfilled strict eligible criteria, the results of this systematic review clearly highlight a paucity of available evidence. At the present time, clinical decisions cannot be substantiated by direct comparative trials.ConclusionsBased on limited evidence, this systematic review discovered no significant differences in effectiveness between compared vital pulp treatments in managing nontraumatic pulpitis associated with no or nonspontaneous pain. Further high‐quality RCTs are necessary to investigate the effectiveness of direct pulp capping or pulpotomy (partial/full) compared to selective or stepwise caries removal.RegistrationPROSPERO database (CRD42021259742).

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“…Pit and fissure sealing is a widely accepted, evidence-based preventive dental measure used on caries-prone pits and fissures, especially in young permanent molars, with the aim of preventing the onset of new caries or arresting existing non-cavitated caries lesions [1]. The efficacy of sealants has been researched and validated in several clinical investigations, systematic reviews and meta-analyses [2][3][4][5]. Today, the most-used sealants are methacrylate-based, white opaque, flowable and light-curing, enabling their safe, fast and effective application in the main target group, children and adolescents.…”

Section: Introductionmentioning

confidence: 99%

3-Year Clinical Performance of a New Pit and Fissure Sealant

Schill

Gräser²,

Bücher

et al. 2022

JCM

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The aim of this 3-year, randomized clinical trial (RCT) in split-mouth design was to explore the clinical survival of a Bis-GMA-free pit and fissure sealant (Helioseal F Plus) in comparison to a control material (Helioseal F). The initial population consisted of 92 adolescents. Follow-ups took place after one year (N = 85), two years (N = 82) and three years (N = 76) after application. At each examination, sealant retention and the presence of caries were recorded. The statistical analysis included the calculation of Kaplan–Meier survival curves, log-rank tests and a Cox proportional hazard regression model. No adverse events were documented. The proportion of completely intact sealants and those with minimal loss was almost identical in both groups, at 84.3% (Helioseal F; 113/134) and 81.7% (Helioseal F Plus; 107/131) after three years of observation. The regression analysis revealed an operator dependency, but no significant differences were found between the materials, the study centers, the chosen isolation technique, patient age or sex. After 3 years, 91.7% and 100.0% of all molars were free of non-cavitated carious lesions or carious cavities, respectively. It can be concluded that the new fissure sealing material can be considered as at least equivalent in terms of survival and retention behavior compared to the predecessor material.

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Interventions for treating cavitated or dentine carious lesions

Cited by 8 publications

References 35 publications

Estimation of oral disease burden from claims and self‐reported data

Estimation of oral disease burden from claims and self‐reported data

Effectiveness of vital pulp treatment in managing nontraumatic pulpitis associated with no or nonspontaneous pain: A systematic review

3-Year Clinical Performance of a New Pit and Fissure Sealant

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