Decision Tree Analysis on Management of Deep Carious Lesion
Author(s): Shree Ranjan Pandey, Nivedhitha MS*
An ongoing active carious lesion is the main cause of dental pain, this is often associated with presence of dental cavities, presence of adherent plaque-based biofilm, lack of aesthetics and associated structural and functional problems. To further prevent the spread of the active carious lesion restorative intervention is of great significance. The tooth structure preservation is important to have a positive response when pulpal sensibility tests are performed, in addition to this carious tissue removal should be adapted accordingly to cause minimal damage to the remaining dentin structure, this can be done by employing a minimally invasive approach. The removal of the carious tissue depends on the proximity of the lesion to the pulp, pulpal sensibility responses, the extent of the remaining supragingival tooth structure and the operator control-based factors like moisture control and access. The removal of the soft dentine is recommended in deep carious lesion, avoiding the pulpal exposure followed by sealing of the dentinal tubules beneath the adhesive restoration. The modern technologies of air abrasion, the use of chemo mechanical agents, and rotary plastic burs are the recent advancement in soft tissue caries removal. Avoiding the pulpal exposure must be the key factor in managing such lesions, with healthy enamel/dentine margins at the cavity periphery and by using adhesive restorative biomaterials is very critical to manage such lesions.