How to intervene in the caries process in adults: proximal and secondary caries? An EFCD-ORCA-DGZ expert Delphi consensus statement
Objectives To provide consensus recommendations on how to intervene in the caries process in adults, specifically proximal and secondary carious lesions. Methods Based on two systematic reviews, a consensus conference and followed by an e-Delphi consensus process were held with EFCD/ORCA/DGZ delegat...
Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , |
---|---|
Other Authors: | |
Format: | Article in Journal/Newspaper |
Language: | English |
Published: |
Springer
2020
|
Subjects: | |
Online Access: | https://hdl.handle.net/1805/27442 |
id |
ftiupui:oai:scholarworks.iupui.edu:1805/27442 |
---|---|
record_format |
openpolar |
spelling |
ftiupui:oai:scholarworks.iupui.edu:1805/27442 2023-10-09T21:55:02+02:00 How to intervene in the caries process in adults: proximal and secondary caries? An EFCD-ORCA-DGZ expert Delphi consensus statement Schwendicke, Falk Splieth, Christian H. Bottenberg, Peter Breschi, Lorenzo Campus, Guglielmo Doméjean, Sophie Ekstrand, Kim Giacaman, Rodrigo A. Haak, Rainer Hannig, Matthias Hickel, Reinhard Juric, Hrvoje Lussi, Adrian Machiulskiene, Vita Manton, David Jablonski-Momeni, Anahita Opdam, Niek Paris, Sebastian Santamaria, Ruth Tassery, Hervé Zandona, Andrea Zero, Domenick Zimmer, Stefan Banerjee, Avijit Cariology, Operative Dentistry and Dental Public Health, School of Dentistry 2020 application/pdf https://hdl.handle.net/1805/27442 en eng Springer 10.1007/s00784-020-03431-0 Clinical Oral Investigations Schwendicke, F., Splieth, C. H., Bottenberg, P., Breschi, L., Campus, G., Doméjean, S., Ekstrand, K., Giacaman, R. A., Haak, R., Hannig, M., Hickel, R., Juric, H., Lussi, A., Machiulskiene, V., Manton, D., Jablonski-Momeni, A., Opdam, N., Paris, S., Santamaria, R., … Banerjee, A. (2020). How to intervene in the caries process in adults: Proximal and secondary caries? An EFCD-ORCA-DGZ expert Delphi consensus statement. Clinical Oral Investigations, 24(9), 3315–3321. https://doi.org/10.1007/s00784-020-03431-0 https://hdl.handle.net/1805/27442 Attribution 4.0 International http://creativecommons.org/licenses/by/4.0/ Publisher caries consensus decision-making Article 2020 ftiupui 2023-09-22T14:21:56Z Objectives To provide consensus recommendations on how to intervene in the caries process in adults, specifically proximal and secondary carious lesions. Methods Based on two systematic reviews, a consensus conference and followed by an e-Delphi consensus process were held with EFCD/ORCA/DGZ delegates. Results Managing an individual’s caries risk using non-invasive means (oral hygiene measures including flossing/interdental brushes, fluoride application) is recommended, as both proximal and secondary carious lesions may be prevented or their activity reduced. For proximal lesions, only cavitated lesions (confirmed by visual-tactile, or radiographically extending into the middle/inner dentine third) should be treated invasively/restoratively. Non-cavitated lesions may be successfully arrested using non-invasive measures in low-risk individuals or if radiographically confined to the enamel. In high-risk individuals or if radiographically extended into dentine, for these lesions, additional micro-invasive (lesion sealing and infiltration) treatment should be considered. For restoring proximal lesions, adhesive direct restorations allow minimally invasive, tooth-preserving preparations. Amalgams come with a lower risk of secondary lesions and may be preferable in more clinically complex scenarios, dependent on specific national guidelines. In structurally compromised (especially endodontically treated) teeth, indirect cuspal coverage restorations may be indicated. Detection methods for secondary lesions should be tailored according to the individual’s caries risk. Avoiding false positive detection and over-treatment is a priority. Bitewing radiographs should be combined with visual-tactile assessment to confirm secondary caries detections. Review/refurbishing/resealing/repairing instead of replacing partially defective restorations should be considered for managing secondary caries, if possible. Conclusions An individualized and lesion-specific approach is recommended for intervening in the caries process in adults. Article in Journal/Newspaper Orca Indiana University - Purdue University Indianapolis: IUPUI Scholar Works |
institution |
Open Polar |
collection |
Indiana University - Purdue University Indianapolis: IUPUI Scholar Works |
op_collection_id |
ftiupui |
language |
English |
topic |
caries consensus decision-making |
spellingShingle |
caries consensus decision-making Schwendicke, Falk Splieth, Christian H. Bottenberg, Peter Breschi, Lorenzo Campus, Guglielmo Doméjean, Sophie Ekstrand, Kim Giacaman, Rodrigo A. Haak, Rainer Hannig, Matthias Hickel, Reinhard Juric, Hrvoje Lussi, Adrian Machiulskiene, Vita Manton, David Jablonski-Momeni, Anahita Opdam, Niek Paris, Sebastian Santamaria, Ruth Tassery, Hervé Zandona, Andrea Zero, Domenick Zimmer, Stefan Banerjee, Avijit How to intervene in the caries process in adults: proximal and secondary caries? An EFCD-ORCA-DGZ expert Delphi consensus statement |
topic_facet |
caries consensus decision-making |
description |
Objectives To provide consensus recommendations on how to intervene in the caries process in adults, specifically proximal and secondary carious lesions. Methods Based on two systematic reviews, a consensus conference and followed by an e-Delphi consensus process were held with EFCD/ORCA/DGZ delegates. Results Managing an individual’s caries risk using non-invasive means (oral hygiene measures including flossing/interdental brushes, fluoride application) is recommended, as both proximal and secondary carious lesions may be prevented or their activity reduced. For proximal lesions, only cavitated lesions (confirmed by visual-tactile, or radiographically extending into the middle/inner dentine third) should be treated invasively/restoratively. Non-cavitated lesions may be successfully arrested using non-invasive measures in low-risk individuals or if radiographically confined to the enamel. In high-risk individuals or if radiographically extended into dentine, for these lesions, additional micro-invasive (lesion sealing and infiltration) treatment should be considered. For restoring proximal lesions, adhesive direct restorations allow minimally invasive, tooth-preserving preparations. Amalgams come with a lower risk of secondary lesions and may be preferable in more clinically complex scenarios, dependent on specific national guidelines. In structurally compromised (especially endodontically treated) teeth, indirect cuspal coverage restorations may be indicated. Detection methods for secondary lesions should be tailored according to the individual’s caries risk. Avoiding false positive detection and over-treatment is a priority. Bitewing radiographs should be combined with visual-tactile assessment to confirm secondary caries detections. Review/refurbishing/resealing/repairing instead of replacing partially defective restorations should be considered for managing secondary caries, if possible. Conclusions An individualized and lesion-specific approach is recommended for intervening in the caries process in adults. |
author2 |
Cariology, Operative Dentistry and Dental Public Health, School of Dentistry |
format |
Article in Journal/Newspaper |
author |
Schwendicke, Falk Splieth, Christian H. Bottenberg, Peter Breschi, Lorenzo Campus, Guglielmo Doméjean, Sophie Ekstrand, Kim Giacaman, Rodrigo A. Haak, Rainer Hannig, Matthias Hickel, Reinhard Juric, Hrvoje Lussi, Adrian Machiulskiene, Vita Manton, David Jablonski-Momeni, Anahita Opdam, Niek Paris, Sebastian Santamaria, Ruth Tassery, Hervé Zandona, Andrea Zero, Domenick Zimmer, Stefan Banerjee, Avijit |
author_facet |
Schwendicke, Falk Splieth, Christian H. Bottenberg, Peter Breschi, Lorenzo Campus, Guglielmo Doméjean, Sophie Ekstrand, Kim Giacaman, Rodrigo A. Haak, Rainer Hannig, Matthias Hickel, Reinhard Juric, Hrvoje Lussi, Adrian Machiulskiene, Vita Manton, David Jablonski-Momeni, Anahita Opdam, Niek Paris, Sebastian Santamaria, Ruth Tassery, Hervé Zandona, Andrea Zero, Domenick Zimmer, Stefan Banerjee, Avijit |
author_sort |
Schwendicke, Falk |
title |
How to intervene in the caries process in adults: proximal and secondary caries? An EFCD-ORCA-DGZ expert Delphi consensus statement |
title_short |
How to intervene in the caries process in adults: proximal and secondary caries? An EFCD-ORCA-DGZ expert Delphi consensus statement |
title_full |
How to intervene in the caries process in adults: proximal and secondary caries? An EFCD-ORCA-DGZ expert Delphi consensus statement |
title_fullStr |
How to intervene in the caries process in adults: proximal and secondary caries? An EFCD-ORCA-DGZ expert Delphi consensus statement |
title_full_unstemmed |
How to intervene in the caries process in adults: proximal and secondary caries? An EFCD-ORCA-DGZ expert Delphi consensus statement |
title_sort |
how to intervene in the caries process in adults: proximal and secondary caries? an efcd-orca-dgz expert delphi consensus statement |
publisher |
Springer |
publishDate |
2020 |
url |
https://hdl.handle.net/1805/27442 |
genre |
Orca |
genre_facet |
Orca |
op_source |
Publisher |
op_relation |
10.1007/s00784-020-03431-0 Clinical Oral Investigations Schwendicke, F., Splieth, C. H., Bottenberg, P., Breschi, L., Campus, G., Doméjean, S., Ekstrand, K., Giacaman, R. A., Haak, R., Hannig, M., Hickel, R., Juric, H., Lussi, A., Machiulskiene, V., Manton, D., Jablonski-Momeni, A., Opdam, N., Paris, S., Santamaria, R., … Banerjee, A. (2020). How to intervene in the caries process in adults: Proximal and secondary caries? An EFCD-ORCA-DGZ expert Delphi consensus statement. Clinical Oral Investigations, 24(9), 3315–3321. https://doi.org/10.1007/s00784-020-03431-0 https://hdl.handle.net/1805/27442 |
op_rights |
Attribution 4.0 International http://creativecommons.org/licenses/by/4.0/ |
_version_ |
1779318821949014016 |