Abstract
Caries management at the lesion level is dependent on the lesion activity, the presence of a cavitation (either cleanable or non-cleanable), and lesion depth as evaluated via radiographic examination. A variety of non-invasive, micro-invasive, and minimally invasive treatment (with or without restoration) options are available for primary and permanent teeth. Non-invasive strategies include oral hygiene instructions, dietary counseling, and personal as well as professional use of fluoridated products that reduce demineralization and increase re-mineralization. Micro-invasive procedures include the use of occlusal resin sealants and resin infiltrants, while minimally invasive strategies comprise those related to selective removal of caries tissues and placement of restorations. Deep caries management includes indirect pulp capping, while exposed pulp may be treated using direct pulp capping and partial or complete pulpotomy. The aim of the present study was to review available evidence on recommended preventive and restorative strategies for caries lesions in Latin American/Caribbean countries, and subsequently develop evidence-based recommendations for treatment options that take into consideration material availability, emphasize ways to adapt available treatments to the local context, and suggest ways in which dentists and health systems can adopt these treatments.
Highlights
Submitted: March 3, 2021 Accepted for publication: March 9, 2021 Last revision: March 15, 2021The lack of consensus on dental caries management was recently recognized during a discussion between various expert authors from the Latin American and Caribbean countries (LACC), and the aim of this review was to address this gap by developing relevant evidence-based recommendations and strategies that took geographical factors as well as the patient’s individual needs into consideration
The questionable integrity and stability of sealants placed on occlusal lesions that appear non-cavitated clinically but extend into the middle or inner dentine radiographically should be taken into consideration, and a minimally invasive restorative strategy should be adopted in such cases.[13]
Lower longevity of resin sealant due to partial or total loss over the studied period was reported. Both strategies had similar efficacy in terms of lesion arrestment (94% for sealant and 100% for composite resin) over 3-4years follow-up Success rate in terms of restoration longevity was lower for sealants (76%) than for composite resin (94%) Deposition of tertiary dentine deposition was found in both groups
Summary
Amaury POZOS-GUILLÉN(a) Gustavo MOLINA(b) Vera SOVIERO(c,d) Rodrigo Alex ARTHUR(e) Daniel CHAVARRIA-BOLAÑOS(f) Ana María ACEVEDO(g). (a)Universidad Autónoma de San Luis Potosí, Faculty of Dentistry, Basic Sciences Laboratory, San Luis Potosí, México. (b)Universidad Nacional de Córdoba, The Dental Faculty, Department of Dental Materials, Córdoba, Argentina. (c)Universidade Estadual do Rio de Janeiro UERJ, School of Dentistry, Department of Preventive and Community Dentistry, Rio de Janeiro, RJ, Brazil. (d)Centro Universitário Arthur Sá Earp Neto – Unifase, School of Dentistry, Petrópolis, RJ, Brazil. (e)Universidade Federal do Rio Grande do Sul - UFRGS, Dental School, Department of Preventive and Community Dentistry, Porto Alegre, RS, Brazil. (f)Universidad de Costa Rica, Faculty of Dentistry, Department of Diagnostic and Surgical Sciences, San José, Costa Rica. (g)Universidad Central de Venezuela, Faculty of Dentistry, Institute of Dental Research “Raul Vincentelli”, Caracas, Venezuela
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