4 research outputs found

    Best clinical practice guidance for treating deep carious lesions in primary teeth: an EAPD policy document.

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    PURPOSE The European Academy of Paediatric Dentistry (EAPD) has developed this best clinical practice guidance to help clinicians manage deep carious lesions in primary teeth. METHODS Three expert groups conducted systematic reviews of the relevant literature. The topics were: (1) conventional techniques (2) Minimal Intervention Dentistry (MID) and (3) materials. Workshops were held during the corresponding EAPD interim seminar in Oslo in April 2021. Several clinical based recommendations and statements were agreed upon, and gaps in our knowledge were identified. RESULTS There is strong evidence that indirect pulp capping and pulpotomy techniques, and 38% Silver Diamine Fluoride are shown to be effective for the management of caries in the primary dentition. Due to the strict criteria, it is not possible to give clear recommendations on which materials are most appropriate for restoring primary teeth with deep carious lesions. Atraumatic Restorative Technique (ART) is not suitable for multi-surface caries, and Pre-formed Metal Crowns (PMCs) using the Hall technique reduce patient discomfort. GIC and RMGIC seem to be more favourable given the lower annual failure rate compared to HVGIC and MRGIC. Glass carbomer cannot be recommended due to inferior marginal adaptation and fractures. Compomers, hybrid composite resins and bulk-fill composite resins demonstrated similar values for annual failure rates. CONCLUSION The management of deep carious lesions in primary teeth can be challenging and must consider the patient's compliance, operator skills, materials and costs. There is a clear need to increase the use of MID techniques in managing carious primary teeth as a mainstream rather than a compromise option

    Best clinical practice guidance for treating deep carious lesions in primary teeth: an EAPD policy document

    Get PDF
    Purpose: The European Academy of Paediatric Dentistry (EAPD) has developed this best clinical practice guidance to help clinicians manage deep carious lesions in primary teeth. Methods: Three expert groups conducted systematic reviews of the relevant literature. The topics were: (1) conventional techniques (2) Minimal Intervention Dentistry (MID) and (3) materials. Workshops were held during the corresponding EAPD interim seminar in Oslo in April 2021. Several clinical based recommendations and statements were agreed upon, and gaps in our knowledge were identified. Results: There is strong evidence that indirect pulp capping and pulpotomy techniques, and 38% Silver Diamine Fluoride are shown to be effective for the management of caries in the primary dentition. Due to the strict criteria, it is not possible to give clear recommendations on which materials are most appropriate for restoring primary teeth with deep carious lesions. Atraumatic Restorative Technique (ART) is not suitable for multi-surface caries, and Pre-formed Metal Crowns (PMCs) using the Hall technique reduce patient discomfort. GIC and RMGIC seem to be more favourable given the lower annual failure rate compared to HVGIC and MRGIC. Glass carbomer cannot be recommended due to inferior marginal adaptation and fractures. Compomers, hybrid composite resins and bulk-fill composite resins demonstrated similar values for annual failure rates. Conclusion: The management of deep carious lesions in primary teeth can be challenging and must consider the patient's compliance, operator skills, materials and costs. There is a clear need to increase the use of MID techniques in managing carious primary teeth as a mainstream rather than a compromise option. 2022, The Author(s).The European Academy of Paediatric Dentistry wants to thank the Norwegian Society of Paediatric Dentistry for organizing the online 12th EAPD Interim Seminar and Workshop in Oslo in April 2021 on "treating deep carious lesions in primary teeth". Special thanks to the chair of the local organizing committee, and the president of the Norwegian Society of Paediatric Dentistry, as well as all those involved in arrangements, for organizing a successful and memorable seminar. Furthermore, the EAPD wants to express gratitude to all participants of the workshops from the member countries for their valuable contributions. Workshop I: Conventional: Griet Vansteenkiste (Belgium), Kristina Goršeta (Croatia), Maria Spyridonos (Cyprus), Romana Koberova-Ivancakova (Czech Republic), Marja-Liisa Laitala (Finland), Jan Kühnisch (Germany), Aris Arhakis (Greece), Elaine Shore (Ireland), Malka Ashkenazi (Israel), Domenico Tripodi (Italy), Marlies Elfrink (Netherlands), Atanasia Bletsa (Norway), Ewa Gazda (Poland), Ana Carla Coelho Canta (Portugal), Veronica Motoc (Romania), Shevchenko Maxim (Russia), Jelena Juloski (Serbia), Tadeja Ris Koler (Slovenia), Olga Cortes (Spain), Helen Isaksson (Sweden), Juliane Leonhardt-Amar (Switzerland), Dilek Ozge Yilmaz (Turkey), Ferranti Wong (UK) and Mariya Dolhova (Ukraine). Workshop II: MID Geertje Van Gorp (Belgium), Željko Verzak (Croatia), Charalamos Sakkas (cyprus), Jana Vasakova (Czech Republic), Eija Salmela (Finland), Christian Splieth (Germany), Konstantina Chatzidimitriou (Greece), Rose-Marie Daly (Irland), Aviv Shmueli (Israel), Marina Vitale (Italy), Wilma Wiertz-Vogels (Netherlands), Tove I Wigen (Norway), Agnieszka Wal-Adamczak (Poland), Carmen Savin (Romania), Zueva Tatyana (Russia), Zoran Mandinic (Serbia), Alenka Pavli (Slovenia), Eva Martinez (Spain), Maria Andersson(Sweden), Valeria Diene (Switzerland), Elif Kuru(Turkey),Sanjeev Sood (UK), Maryana Kalitina Ukraine)Workshop III: Materials: Katrin Bekes (Austria), Costas Onisiphorou (Cyprus), Pernille Hess (Denmark), Paivi Havela (Finland), Stefanie Amend (Germany), Nikos Kotsanos (Greece), Silvia Pizzi (Italy), Ingvild Johnsen Brusevold (Norway), Natalia Gódkowska (Poland), Alexandrina Muntean (Romania), Mirjana Ivanovic (Serbia), Luka Hocevar (Slovenia), Paola Beltri (Spain), Senem Selvi Kuvvetli (Turkey), Paul Ashley (UK), Oleg Kovnatskyi (Ukraine), Isabel Olegario (Ireland).Scopu
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