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

Schwendicke, Falk; Splieth, Christian H.; Breschi, Lorenzo; Banerjee, Avijit; Fontana, Margherita; Paris, Sebastian; Burrow, Michael F.; Crombie, Felicity; Page, Lyndie A. Foster; Hernández, Patrícia Gatón; Giacaman, Rodrigo A.; Gugnani, Neeraj; Hickel, Reinhard; Jordan, Rainer A.; Leal, Soraya Coelho; Lo, Edward C M; Tassery, Hervé; Thomson, William; Manton, David J.

doi:10.1007/s00784-019-03058-w

Cited by 137 publications

(210 citation statements)

References 80 publications

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“…The prevalence of proximal lesions in adolescents and young adults remains to be high, even in low risk populations [10]. However, these lesions progress at low proportions and velocity, at least in countries with established caries preventive systems which have experienced a considerable caries decline.…”

Section: Discussionmentioning

confidence: 99%

“…In succession of the international consensus paper on "When to intervene in the caries process" [10], the question arises on how to intervene. Due to the different clinical approaches for non-and cavitated proximal lesions, this systematic review tries to answer the two following PICO questions (participants, interventions, comparisons and outcomes):…”

Section: Methodsmentioning

confidence: 99%

“…A range of treatment options for managing proximal lesions are available, including non-operative/non-invasive and minimally/micro-invasive approaches as well as restorative treatments [8,9]. Different terms for caries management options have been used in the literature in the past and suggested for future terminology [10,11]. Therefore, in this review, a compromise using the terms non-operative/non-invasive as well as minimally/micro-invasive parallel is used to give credit to the original literature and recent terminology.…”

Section: Introductionmentioning

confidence: 99%

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How to intervene in the caries process: proximal caries in adolescents and adults—a systematic review and meta-analysis

et al. 2020

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Objectives For an ORCA/EFCD consensus, this systematic review assessed the question "How to intervene in the caries process in proximal caries in adolescents and adults". Material and methods Separating between the management of initial and cavitated proximal caries lesions, Medline via PubMed was searched regarding non-operative/non-invasive, minimally/micro-invasive and restorative treatment. First priority was systematic reviews or randomized controlled trials (RCTs), otherwise cohort studies. After extraction of data, the potential risk of bias was estimated depending on the study type, and the emerging evidence for conclusions was graded.Results Regarding non-invasive/non-operative care (NOC), no systematic reviews or RCTs were found. In cohort studies (n = 12) with a low level of evidence, NOC like biofilm management and fluoride was associated with a low proportion and slow speed of progression of initial proximal lesions. Minimally/micro-invasive (MI) treatments such as proximal sealants or resin infiltration (four systematic reviews/meta-analyses) were effective compared with a non-invasive/placebo control at a moderate level of evidence. Data on restorative treatment came with low evidence (5 systematic reviews, 13 RCTs); with the limitation of no direct comparative studies, sample size-weighted mean annual failure rates of class II restorations varied between 1.2 (bulk-fill composite) and 3.8% (ceramic). Based on one RCT, class II composite restorations may show a higher risk of failure compared with amalgam. Conclusions Proximal caries lesions can be managed successfully with non-operative, micro-invasive and restorative treatment according to lesion stage and caries activity. Clinical relevance Proximal caries treatment options like non-operative, micro-invasive and restorative care should be considered individually.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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How to intervene in the caries process: proximal caries in adolescents and adults—a systematic review and meta-analysis

et al. 2020

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“…All initial caries lesions should be treated by the use of topical fluoride and monitored for progression. Further options are the use of fissure sealant in occlusal lesions and may include resin infiltration in proximal lesions into the outer third of the dentine. In patients who cannot cooperate with treatment, silver diamine fluoride can be an intermediate alternative .…”

Section: Policymentioning

confidence: 99%

Carious lesions and first restorative treatment

Bondioni¹

2020

International Dental Journal

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“…Fatores comportamentais, sociais e econômicos são componentes importantes no desenvolvimento da doença, a qual pode ser interrompida a qualquer momento por meio da remoção dos fatores etiológicos, reestabelecendo assim a saúde. Desta forma, o cirurgião-dentista deve conhecer e ser capaz de identificar os componentes de atividade da doença para poder tomar a melhor decisão de tratamento, que em diversas circunstâncias não é restauradora 5,6 .…”

Section: Introductionunclassified

O ensino da Odontologia minimamente invasiva: relato de experiência

Gonçalves

Cenci

Corrêa³

et al. 2019

Rev ABENO

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RESUMOPor muitos anos o ensino de Odontologia foi baseado apenas na reprodução de técnicas restauradoras e o estudante era motivado a apenas realizar procedimentos, sem desenvolver habilidades reflexivas, as quais são tão importantes quanto as técnicas. O presente relato de experiência discute um caso clínico como problematizador no ensino da Odontologia minimamente invasiva. Discussões e formulação de tabelas e quadros foram realizadas pelos estudantes, assim como a elaboração de um guia prático para auxiliar a escolha do tratamento restaurador. As atividades foram tidas como produtivas e complementares na resolução das dúvidas que ainda estavam pendentes. Conclui-se que a utilização da metodologia ativa relatada na construção de conhecimento foi uma importante estratégia para criar situações de aprendizado na abordagem da Odontologia minimamente invasiva. O aprendizado significativo advindo de um caso clínico em andamento se mostrou uma importante estratégia de ensino. Descritores: Cárie Dental. Tomada de Decisões. Caso Clínico. Ensino em Odontologia. INTRODUÇÃOA cárie dental é o agravo de maior prevalência da cavidade oral 1-3 , apresentando etiologia multifatorial 4 . Fatores comportamentais, sociais e econômicos são componentes importantes no desenvolvimento da doença, a qual pode ser interrompida a qualquer momento por meio da remoção dos fatores etiológicos, reestabelecendo assim a saúde. Desta forma, o cirurgião-dentista deve conhecer e ser capaz de identificar os componentes de atividade da doença para poder tomar a melhor decisão de tratamento, que em

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

Cited by 137 publications

References 80 publications

How to intervene in the caries process: proximal caries in adolescents and adults—a systematic review and meta-analysis

How to intervene in the caries process: proximal caries in adolescents and adults—a systematic review and meta-analysis

Carious lesions and first restorative treatment

O ensino da Odontologia minimamente invasiva: relato de experiência

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