Sammendrag

Sammendrag

Pulpa har viktige funksjoner for en tanns liv og overlevelse. Tenner med dype karieslesjoner bør behandles konservativt hvis mulig. Vi har flere aktuelle behandlingsalternativ, men felles for dem er at vi må stille en pålitelig diagnose for pulpas «helsetilstand» før vi tar beslutning om hva som er best i det enkelte tilfelle. En moderne tilnærming til kariesbehandling har beveget seg fra et rent mekanistisk syn på behandlingen til et mer biologisk syn. For å unngå unødvendig eksponering av en vital og levedyktig pulpa, er man i dag forsiktig med å fjerne selv mykt dentin i de mest pulpanære områdene. Man spiller heller på tennenes og pulpas evne til å stanse bakterienes vekst og virke.
Denne artikkelen omtaler derfor ett- og to-trinns selektiv fjerning av kariøst dentin i vitale tenner før permanent restaurering utføres.

Emneord

  1. Kariologi
  2. endodontologi
  3. mikrobiologi

Abstract

The pulp has many important roles as to the function and survival of teeth. Teeth with deep carious lesions should be treated conservatively if possible. There are several treatment options for this purpose, but they all have in common the necessity of finding a reliable and correct diagnose for the «health status» of the pulp before making a treatment decision. Modern approaches to caries treatment have moved from a pure mechanistic view to a more biological view. Today, dentists are more careful when removing even soft dentine close to the pulp in order to avoid unnecessary exposure of a vital pulp. Dentists are playing together with the pulp’s ability to arrest the bacteria’s growth and activity.
This deals with one- and two-step selective removal of carious dentine in vital teeth before making a permanent restoration.

Keywords

  1. Cariology
  2. endodontology
  3. microbiology

Get full access to this article

View all available purchase options and get full access to this article.

Referanser

1.
Duncan HF, Galler KM, Tomson PL, Simon S, El-Karim I, Kundzina R, et al. European Society of Endodontology position statement: Management of deep caries and the exposed pulp. Int Endod J 2019. https://doi.org/10.1111/iej.13080
2.
Kidd E, Fejerskov O. Changing concepts in cariology: forty years on. Dent Update 2013; 40: 277–8, 80–2, 85–6. https://doi.org/10.12968/denu.2013.40.4.277
3.
Kidd E, Fejerskov O, Nyvad B. Infected Dentine Revisited. Dent Update 2015; 42: 802–6, 8–9. https://doi.org/10.12968/denu.2015.42.9.802
4.
Bjorndal L, Fransson H, Bruun G, Markvart M, Kjaeldgaard M, Nasman P, et al. Randomized Clinical Trials on Deep Carious Lesions: 5-Year Follow-up. J Dent Res 2017; 96: 747–53. https://doi.org/10.1177/0022034517702620
5.
Bitello-Firmino L, Soares VK, Damé-Teixeira N, Parolo CCF, Maltz M. Microbial Load After Selective and Complete Caries Removal in Permanent Molars: a Randomized Clinical Trial. Braz Dent J 2018; 29: 290–5. https://doi.org/10.1590/0103-6440201801816
6.
Marggraf T, Ganas P, Paris S, Schwendicke F. Bacterial reduction in sealed caries lesions is strain- and material-specific. Sci Rep 2018; 8: 3767. https://doi.org/10.1038/s41598-018-21842-8
7.
Kadali NS, Alla RK, Av R, Mc SS, Raju Mantena S, Raju RV. An overview of composition, properties, and applications of Biodentine. Int J Dent Materials 2021. https://doi.org/10.37983/IJDM.2021.3404
8.
Bjorndal L. Stepwise Excavation. Monogr Oral Sci 2018; 27: 68–81. https://doi.org/10.1159/000487834
9.
Bjorndal L, Reit C, Bruun G, Markvart M, Kjaeldgaard M, Nasman P, et al. Treatment of deep caries lesions in adults: randomized clinical trials comparing stepwise vs. direct complete excavation, and direct pulp capping vs. partial pulpotomy. Eur J Oral Sci 2010; 118: 290–7. https://doi.org/10.1111/j.1600-0722.2010.00731.x
10.
Bjorndal L, Simon S, Tomson PL, Duncan HF. Management of deep caries and the exposed pulp. Int Endod J 2019. https://doi.org/10.1111/iej.13128
11.
Maltz M, Alves LS. Incomplete caries removal significantly reduces the risk of pulp exposure and post-operative pulpal symptoms. J Evid Based Dent Pract 2013; 13: 120–2. https://doi.org/10.1016/j.jebdp.2013.07.014
12.
Maltz M, Koppe B, Jardim JJ, Alves LS, de Paula LM, Yamaguti PM, et al. Partial caries removal in deep caries lesions: a 5-year multicenter randomized controlled trial. Clin Oral Investig 2017. https://doi.org/10.1007/s00784-017-2221-0
13.
Schwendicke F, Frencken JE, Bjorndal L, Maltz M, Manton DJ, Ricketts D, et al. Managing Carious Lesions: Consensus Recommendations on Carious Tissue Removal. Adv Dent Res 2016; 28: 58–67. https://doi.org/10.1177/0022034516639271

Information & Authors

Information

Published In

Go to Aktuel Nordisk Odontologi
Volume 49Number 12 January 2024
Pages: 4260

History

Published online: 2 January 2024
Issue date: 2 January 2024

Authors

Affiliations

Frode Staxrud [email protected]
Nordisk Institutt for Odontologiske materialer, Oslo, Norge

Metrics & Citations

Metrics

Citations

Export citation

Select the format you want to export the citations of this publication.

View Options

Get Access

Buy Digital Article
Perpetual access
NOK127.20
Add to cart
Local taxes may change at checkout
Buy digital issue
Perpetual access
NOK367.20
Add to cart
Local taxes may change at checkout

Login Options

Restore guest purchases

Enter your email address to restore your content access:

Note: This functionality works only for purchases done as a guest. If you already have an account, log in to access the content to which you are entitled.

View options

PDF

Download PDF

Full Text

View Full Text

Figures and Media

Figures

Media

Tables

Share

Share

Share the article link

Share on social media

Share on Messenger